Aa
Aa
A
A
A
Close
Avatar universal

blood test results

I was diagnosed Hashimoto's in February this year and my endocrinologist has told me I have iron deficiency and Vitamin D deficiency. My symptoms I currently have are:

Hand tremor, one hand only
Headaches
Eye pain
Fatigue
Dry skin that sloughs off after a shower and comes off in big flakes
White "cobblestone" areas on my skin
Red, flat, pinprick spots appearing on my skin, as if underneath my skin
Weight loss
Constipation, comes and goes
Fatigue
Irritability
Spotting between periods
Heavy periods but have been lighter of late

I take 125mcg Levo a day.

Blood test results from May and June are below:

May

TSH - 5.01 normal range 0.2-4.2
FT4 - 18.7 normal range 12-22
FT3 - 5.2 normal range 3.1-6.8
Anti TPO antibodies - 52 normal range 0-34

June

TSH - 2.5 normal range 0.2-4.2
FT4 - 15.7 normal range 12-22
FT3 - 4.6 normal range 3.9-6.7

Any thoughts on the above would be most helpful. Thankyou :)
13 Responses
Sort by: Helpful Oldest Newest
Avatar universal
You want B-12 to be in excess of 700. So you definately could use B-12
Helpful - 0
1756321 tn?1547095325
Serum B12 must be 550 pg/mL (400 pmol/L) in order to have a good amount of B12 in the cerebrospinal fluid. In Japan at least they have changed the start of the B12 reference range from about 200 pg/mL (145 pmol/L) to 550 pg/mL (400 pmol/L). Your lab is in ng/L but that is the equivalent to pg/mL.

Mayo Clinic goes into some detail on lower levels of B12 although 400 ng/L (pg/mL) is still too low. MMA stands for methymalonic acid btw...

"Patients with serum B12 levels between 150 and 400 ng/L are considered borderline and should be evaluated further by functional tests for vitamin B12 deficiency. The plasma homocysteine level is a good screening test. A normal level effectively excludes vitamin B12 and folate deficiency in an asymptomatic patient. However, the test is not specific and many situations can cause an increased level. In contrast, an increased serum MMA level is more specific for cellular-level B12 deficiency and is not increased by folate deficiency."
Helpful - 0
Avatar universal
Ah, I see. It's my bad, I looked at the wrong results! Sorry!

Yes, Vitamin B12 is 395 ng/L (180-900). Folate was done too but my endocrinologist seemed happy with it at 6.2ug/L (4.6-18.7)
Helpful - 0
1756321 tn?1547095325
There is no pmol/L for vitamin D. It's either the SI (international units) of nmol/L or the conventional units (mainly used in the US) of ng/mL. Sorry for the confusion there. You lab is 59.6 nmol/L. I couldn't raise my vitamin D until I corrected my severe magnesium deficiency (that mineral is the boss!).

My white spots show up in weeks after not having B12 and that wouldn't show up on my B12 serum! But anyway, the B12 reference range is far too low. Normal may not be normal in other words. Do you have your B12 results?
Helpful - 0
Avatar universal
Thanks for replying, I didn't realise I need to continue taking the Vitamin D on a maintenance dose but it didn't seem to raise my levels much as I have been supplementing with a 3000 International Unit supplement!

Most of the symptoms listed did worsen after the increase, yes - the dry skin flaking off in big bits, fatigue, irritation at the front of my neck, constipation, heavy periods etc.
Helpful - 0
Avatar universal
Thanks for your reply.

Yes, the red spots do not blanch when I press on them so it looks like petechiae then. Thanks for letting me know :)

So instead of my Vitamin D being 59.6 pmol/L it would actually read as 0.0596 nmol/L? That doesn't seem right...

I wish I'd included a picture of the white patches now as there is a prominent one on my ankle! I can always add it to my photo album but it would have been more relevant had I have posted it with my question initially!

Vitamin B12 was normal so I've been told by my endocrinologist.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Ferritin is an iron storage hormone; of course, your levels at 15 and 22 are way too low.  There are iron supplements that do not contain B-12; adequate iron is necessary for the proper synthesis of thyroid hormone.

Just having vitamin D "in range" isn't adequate, as many doctors think.  Levels should be somewhere between 50-80 and once you get them there, you should continue to supplement on a "maintenance" dose to insure that they stay there, since adequate vitamin D is also necessary for proper synthesis of thyroid hormone.

The levo reaches full potential within 4-6 weeks after a dosage change and I'm wondering why your levels dropped after the dosage change, when they should actually have increased.  Did any of your symptoms worsen after the increase?
Helpful - 0
1756321 tn?1547095325
Sorry, I actually meant nmol/L! :)

Petechaie do not turn white (blanch) when you press on them. They are usually found in clusters but you can have a few random spots here and there.

Not sure about the white spots. I have white spots on my skin from vitiligo and more white spots show up when I don't have enough B12. Another cause of white spots is yeast infection called tinea versicolour and then there is Idiopathic Guttate Hypomelanosis.
Helpful - 0
Avatar universal
Thanks for replying

The Vitamin D levels are in nmol/L sorry. So does that mean that the level needs to be calculated into pmol/L format?

The cobblestone appearance on my skin...it's hard to explain. They consist of each of them being a small patch of lighter white skin. They look like scars but they are not if that makes sense as I know I have not damaged the area there by myself. They don't make my skin look lacy like livedo reticularis.

With the red spots there is only one of them on my fingertip and the other little one is on the palm of my hand, they aren't in clusters as such like the petechiae I've googled.
Helpful - 0
1756321 tn?1547095325
Vitamin D Council recommend vitamin D levels to be at least 125 pmol/L (50 ng/mL). Your lab measurements are in pmol/L. This recommendation is based on thousands of studies. Here is just two reasons (I added the pmol/L in [ ] brackets)...

"Recent studies have demonstrated that a minimum 25(OH)D level of 32 ng/mL [79.8 pmol/L] is necessary for optimal protection from fracture and intestinal absorption of calcium." - Calcium and Vitamin D: Skeletal and Extraskeletal Health. Curr Rheumatol Rep. Apr 2008; 10(2): 110–117.

"The results of the meta-analysis revealed that by raising the serum level of vitamin D to 34 ng/ml [84.8 pmol/L], the incidence rates of colorectal cancer could be reduced by half.  Even higher levels of serum Vitamin D further reduced colorectal cancer risk, as head researcher Edward Gorham, Ph.D. reported,  “We project a two-thirds reduction in incidence with serum levels of 46 ng/ml [114.8 pmol/L], which corresponds to a daily intake of 2,000 IU of vitamin D3." John Hopkins - Vitamin D & Colorectal Cancer.



Helpful - 0
1756321 tn?1547095325
The red spots sound like petechiae and the white cobblestone areas sounds like livedo reticularis. You can google images to see if they match what you have. There are numerous reasons for both conditions.

Helpful - 0
Avatar universal
Thanks for replying :)

Oops, I forgot to say about the supplementation...apologies.

I was supplementing Vitamin D until my retest for Vitamin D was normal. I was supplementing iron as well until I realised the supplement I was taking contains B12 - which will skew the results of a gastroscopy I am being booked in for. So at the moment I take no iron supplement or Vitamin D supplement but for very different reasons.

Vitamin D and ferritin levels I forgot to add too.

Dec 2013 - Vitamin D: 44 (<75)
Ferritin: 22 (30-400)

May 2014 - Vitamin D: 59.6 (<75) but sub-optimal is 25-50, doctor said normal so I stopped taking the Vitamin D supplement
Ferritin: 15 (30-400)

I was on the Levo at 100mcg during May and my medication was then increased to the 125mcg but my doctor then for some reason wanted to test my thyroid again but it had not been the full 6-8 weeks so I had only just started out on the Levo at 125mcg.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Are you supplementing iron and vitamin D?

Were you taking the 125 mcg levo when both of these labs were done?  

While some of your symptoms could have indicated over medication, your labs don't really bear that out.  

Rule of thumb for FT4 is mid range (50%).  In May, yours was 67%, which was on the high side, and could have caused some hyper symptoms, but in June, it's only 37%, which is clearly hypo.

Rule of thumb for FT3 is upper half to upper third of its range.  In May, yours was at 56%, which is right where it should be, though many of us find that we need it a bit higher than that to alleviate symptoms.  In June, your FT3 is only 25% of its range, which, again, is clearly hypo.

FT4 is a storage hormone and isn't used directly by the individual cells; it must be converted to FT3, which is the hormone used by individual cells and which correlates best with symptoms.

Fatigue and irritability can apply to either hypo or hyper.  Weight loss, eye pain, hand tremor (usually both hands) and headache (if all thyroid related) are most often related to hyper/over medication.  Dry skin, constipation, heavy periods, typically, usually relate to hypothyroidism.

The white patches on your skin could be a condition called vitiligo, which is another autoimmune disease.

I doubt the red pin prick spots are thyroid related.  I've had those most of my life and I've only had thyroid issues (diagnosed) for the past 7 yrs.
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.