New labs, would appreciate comments.

[FaithforHealing]

Dx'd with hypo and started levothyroxine in Feb. I suppose these labs look pretty good and the fact that I'm still having fatigue, brain fog and pain issues might just not be my thyroid but something else?  My Vit b12 and ferritin were also flagged as high, but I didn't get a Vit D level, although I have been taking 5000 a day since February. I had a few weeks of really feeling good after about 6 weeks of levo and then two weeks later back to a lot of the original symptoms. Some days are better than others, but the fatigue is persistent.  And now my CO2 was flagged as low, and that seems to open up a whole new can of worms.

I'd appreciate opinions on these. Thanks!

Vitamin B12 Level
1438 pg/mL (211 pg/mL - 946 pg/mL)

Thyroid Stimulating Hormone
1.00 mIU/L (0.27 mIU/L - 4.20 mIU/L)

T4 (Thyroxine) - Free
1.51 ng/dL (0.93 ng/dL - 1.70 ng/dL)

T3 (Triiodothyronine) - Total
138.4 ng/dL (80.0 ng/dL - 200.0 ng/dL)

T3 (Triiodothyronine) - Free
3.30 pg/mL (2.00 pg/mL - 4.40 pg/mL)

[gimel]

Since you are already taking thyroid med, TSH becomes irrelevant.  Your Free T4 is more than minimum recommended.  Your Free T3 is a bit lower than optimal for many people.  In addition your Reverse T3 is on the high end, so the ratio of Free T3 to Reverse T3, at 1.3 (3.3 times 10 divided by 25.5) is lower than than recommended, which is 1.8 according to one source, and 2.0 according to another source.  

There are many potential contributors to your Reverse T3 being on the higher end of its range.  So, the best approach might be to just reduce your T4 med some and add in some T3 med and gradually increase the dose until you feel well.  

Red star has already covered the B12.  You do need to test for Vitamin D to see where you are on that.    

[FaithforHealing]

Received my Reverse T3 results finally. Still hoping to get some opinions on my labs. I'm not clear on how to figure the FT3 to RT3 ratio, they are in different units. Thanks.

Reverse T3
25.5 ng/dL (rr 9.0 - 27.0)

Thyroid Stimulating Hormone
1.00 mIU/L (0.27 mIU/L - 4.20 mIU/L)

T4 (Thyroxine) - Free
1.51 ng/dL (0.93 ng/dL - 1.70 ng/dL)

T3 (Triiodothyronine) - Total
138.4 ng/dL (80.0 ng/dL - 200.0 ng/dL)

T3 (Triiodothyronine) - Free
3.30 pg/mL (2.00 pg/mL - 4.40 pg/mL)

[FaithforHealing]

Thanks, Barb. I always appreciate your input. I had read it was non-toxic, but didn't know if I had the whole story. My Ferritin was also high at 222.7 (rr 6.0-155.0), is that of any concern or relevance? My Iron Level, Iron Binding Capacity and Percent Transferrin Saturation were all well within normal range.

Any thoughts on my new labs? I did call the lab and they do send the reverse t3 out so I don't have that yet. I'm starting to think I have something other than thyroid issues. I was so hoping it was all due to hypothyroidism and I'd feel better with the levothyroxine.

The other thing that concerns me is that my TSH was 1.43 (rr 0.30 - 5.50) with the same horrible symptoms six months before my dx in Feb with 6.35 (rr 0.27 - 4.20). Would the thyroid fail that fast in six months? Supposedly it's not Hashi's. Does TSH tend to go up and down at different times? Of course they didn't do anything but TSH so I don't know what anything else was at the time.

I don't know what to think at this point, but still feeling pretty bad. :(
Thanks

[Barb135]

Vitamin B-12 is non-toxic, so it doesn't really matter if your level is high... you might have taken your daily dosage before you had the blood draw which caused the result to be high.  If I have my weekly shot just prior to my blood work, I have to make sure I tell my doctor, because my level will be high, but if I'm due for a shot, my level will be very low.

Excess B-12 goes out in your urine...

[FaithforHealing]

Is Vit b12 of 1438 pg/mL (211 pg/mL - 946 pg/mL) considered significantly high?

[Red_Star]

Excerpts from the article - MTHFR genetic defect – what it is and how it can affect you...

"You can find yourself with high folate or high B12 i.e. your body will have problems converting inactive forms of folate and B12 to the active forms. So the inactive folate or B12 will simply build up in your serum, also inhibiting the active forms. Most serum folate tests are actually measuring folic acid, which needed to be converted to methylfolate to be used metabolically."

"You can’t change a defective gene. But you can help it do its job better and minimize problems.

Some find their ‘folic acid’ lab test levels are high (it’s one of several folate vitamins) since a defect in the gene prevents your body from using it, so it goes high…unused. The recommended solution is avoid supplements and many processed foods with folic acid, especially if you are Homozygous (having a copy of the same defective gene from each parent). Healthy foods that contain folate should be okay, as would be the active form of folate called methylfolate as a supplement, also called 5-MTHF (5-methyltetrahydrofolate).

B12 might also be high, so patients tend to avoid the synthetic supplemental version of B12 called cyanocobalamin and instead favor the more useable methylcobalamin (methylB12), which will help break down those high levels. But the methylB12 will be used by your body in detoxing you from toxins, so you may need to start low to avoid detox side effects like fatigue, achiness, etc.

Another good B-vitamin is the methyl version of B6, called P-5-P."

[FaithforHealing]

The reverse t3 was ordered, but I didn't see that online. Just had these done about 4 pm, does that one take longer?