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Old 10-28-2012, 08:44 PM   #16
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Re: Assistance Reading Lab Work

frisson - If the labs you quote are typical of how your labs have been running for some time, then your lab readings are very similar to Mamaraven who also posted here 10-28-2012. I repeat my response here, almost word for word.

what we have here is a paradox - your blood levels are hyperthyroid but your cells are hypothyroid - and that is why you feel hypo. Here is the explanation...

Your low TSH says you are getting to much thyroid hormone, which is confirmed by your FT4 and FT3 which are both about 40-50% higher than normal (that is, higher than median values). Your RT3 is in the neighborhood of two times normal.

You do not say if you take Synthroid (or other T4). If you do, then you are taking too much and your body is trying to cope by converting the excess T4 to RT3. The problem with this is that RT3 inhibits the action of your T3 (prevents T3 from doing the jobs it is supposed to do in the cells of your body) and that is why you are having HYPO symptoms.

Similarly if you do not take T4, then your natural thyroid gland is hyper, producing too much T4, and your body is trying to cope by converting the excess T4 to RT3, and the RT3 is interfering so much so with your T3 that you are having HYPO symptoms. If this is the case, hopefully your new doc understands this, or if not, be sure to ask for a referral to an endocrinologist at the earliest.
good luck.

 
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Old 10-28-2012, 09:47 PM   #17
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Re: Assistance Reading Lab Work

Hi Frisson,

Regarding your picture showing your nail changes- My nails started with that same appearance. Nearly 12 or more years later they are extremely worse. The separation from my nail bed continued over the complete nail and slowly effected all my finger and toe nails I'm believing that I have been on too high of a dose. Once I have lowered my synthroid dosage my nails (fingers crossed) are starting to heal.

Hope this helps- Please let me know how you make out with this? I have never met or talked to anyone with this. My Dr's have told me for years that my nail issue is not related to my nail psoriasis. I have been sooo desperate to get this under control..

 
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Old 11-02-2012, 11:54 AM   #18
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Re: Assistance Reading Lab Work

Quote:
Originally Posted by telus View Post
frisson - If the labs you quote are typical of how your labs have been running for some time, then your lab readings are very similar to Mamaraven who also posted here 10-28-2012. I repeat my response here, almost word for word.

what we have here is a paradox - your blood levels are hyperthyroid but your cells are hypothyroid - and that is why you feel hypo. Here is the explanation...

Your low TSH says you are getting to much thyroid hormone, which is confirmed by your FT4 and FT3 which are both about 40-50% higher than normal (that is, higher than median values). Your RT3 is in the neighborhood of two times normal.

You do not say if you take Synthroid (or other T4). If you do, then you are taking too much and your body is trying to cope by converting the excess T4 to RT3. The problem with this is that RT3 inhibits the action of your T3 (prevents T3 from doing the jobs it is supposed to do in the cells of your body) and that is why you are having HYPO symptoms.

Similarly if you do not take T4, then your natural thyroid gland is hyper, producing too much T4, and your body is trying to cope by converting the excess T4 to RT3, and the RT3 is interfering so much so with your T3 that you are having HYPO symptoms. If this is the case, hopefully your new doc understands this, or if not, be sure to ask for a referral to an endocrinologist at the earliest.
good luck.


I can't verify if my labs generally run like this since it was my first time ever having my thyroid tested. I have never medicated for a thyroid issue, this past year was the first time I considered my thyroid being a possible cause for my issues. My entire family (the females) have thyroid issues, my aunts and grandma all suffer from hypothyroidism and my mother suffered from hyperthyroidism (with a goiter) and she had her thyroid removed back in 96 or 97 and has been on thyroid medication ever since.

Your explanation seems to make a lot of sense, and it is something I will bring up to my doctor at my next visit with her at least to hear her opinion on it. I just received my new lab results today which I will be posting shortly, and they are a bit different than the values I had in September. My RT3 did not show up as being high the second time around.

 
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Old 11-02-2012, 12:00 PM   #19
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Re: Assistance Reading Lab Work

Quote:
Originally Posted by cloudrunner74 View Post
Hi Frisson,

Regarding your picture showing your nail changes- My nails started with that same appearance. Nearly 12 or more years later they are extremely worse. The separation from my nail bed continued over the complete nail and slowly effected all my finger and toe nails I'm believing that I have been on too high of a dose. Once I have lowered my synthroid dosage my nails (fingers crossed) are starting to heal.

Hope this helps- Please let me know how you make out with this? I have never met or talked to anyone with this. My Dr's have told me for years that my nail issue is not related to my nail psoriasis. I have been sooo desperate to get this under control..
Since posting the pictures of my nails the separation has increased a bit which bothers me. I do not have nail psoriasis so I know that there has to be another reason for this issue to occur... I am sorry that you had to deal with it for so long! It is good to hear though that your lowered synthroid dosage is helping your nails heal, I myself do not take thyroid medication. I am still in the process of figuring out what is wrong with me so I still have no idea what would cause this. The red bands at the bottom of my nails has gotten darker, but my liver labs were great both times I had them tested in the last month so I think I will just have to deal with it for the time being. I hope your nails have a full recovery very soon!

 
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Old 11-02-2012, 12:05 PM   #20
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Re: Assistance Reading Lab Work

Hey everyone!

Today I received my new lab results and this time my RT3 has lowered quite a bit. My Free T's have reduced as well. My doctor is not concerned by my levels so she does not plan to continue investigating my thyroid for the time being. My symptoms still persist (although my anxiety has disappeared in the last 2 weeks and I am cold more often than hot now which is a nice change) my fatigue has increased in the last few weeks though.

9/20/12
Free T4 ------ 1.61 --------- [0.82-1.77] ----- (83% of range)
Free T3 ------ 3.8 ---------- [2.0-4.4] ------- (75% of range)
Reverse T3 --- 40.2 H ------- [13.5-34.2] ---- (129% of range)
TSH ---------- 0.671 ------- [0.450-4.500] --- (5% of range)
TPO ---------- 15 ---------- [0-34] ---------- (44% of range)
TgAb --------- <20 -------- [0-40]

10/24/12
Free T4 ------ 1.1 ------- [0.8-1.8] ----- (30% of range)
Free T3 ------ 3.3 ------- [2.3-4.2] ----- (53% of range)
Reverse T3 --- 19 ------- [7-24] -------- (71% of range)
Total T3 ----- 91 -------- [76-181] ----- (14% of range)

She did not run my TSH this time so I have no clue what it is. Do these results (10/24/12) look all right? I did not have Total T3 done the first time but my doctor wanted to check it the second time around so this is my first lab result for the Total T3. Also, is it normal for thyroid values to fluctuate like this within a month? I realize the values are not significantly different, but I had expected my new results to mimic the readings I had in September (with a hopefully lowered RT3).

The rest of my labs were good, and the only flags I had were low Vitamin D, low progesterone, and low iron binding capacity.

In September my iron serum levels were through the roof, and this time they have lowered but I am curious if the TIBC result I have means anything? I realize this is the thyroid board so if nobody knows that it fine just thought I would throw it in here.

10/24/12
Iron, Total ------------- 122 -- [40-175] --- (38% of range)
Iron Binding Capacity --- 245 -- [250-450] -- ( -2.5% of range)
% Saturation ----------- 50 --- [15-50%] -- (100% of range)
Folate, Serum ---------- 6.5 --- [>5.4]

9/20/12
Ferritin ---------------- 65 ---- [13-150] --- (38% of range)
Transferrin ------------ 237 --- [200-370] -- (22% of range)

10/24/12
Vitamin B12 ------------- 440 -- [200-1100] - (27% of range)
Vitamin D, 25-Hydroxy --- 26 --- [30-100] --- ( -6% of range)

*** My doctor said my B levels were good, but I would like to raise that number up. Is this something I should speak with my doctor about first, or can I just start supplementing at home?

Last edited by frisson; 11-03-2012 at 09:54 AM. Reason: Changed formatting for easier readability, also added in % of range.

 
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Old 11-03-2012, 06:00 AM   #21
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Re: Assistance Reading Lab Work

Bump.

Anyone know if thyroid levels generally fluctuate that heavily within a month when a person is not currently on thyroid meds of any kind?


* Quick question about my glucose... both tests in September and October required a 12 hour fast. My glucose was at the top of the range both times (a bit higher though in September). Do thyroid issues contribute to high glucose?

9/20/12
Glucose --------- 97 ----- [65-99] ----- (94% of range)

10/24/12
Glucose --------- 94 ----- [65-99] ----- (85% of range)

________________________________________ _________

This is my post from yesterday, I am just pasting it here for quicker access:

Hey everyone!

Today I received my new lab results and this time my RT3 has lowered quite a bit. My Free T's have reduced as well. My doctor is not concerned by my levels so she does not plan to continue investigating my thyroid for the time being. My symptoms still persist (although my anxiety has disappeared in the last 2 weeks and I am cold more often than hot now which is a nice change) my fatigue has increased in the last few weeks though.

9/20/12
Free T4 ------ 1.61 --------- [0.82-1.77] ----- (83% of range)
Free T3 ------ 3.8 ---------- [2.0-4.4] ------- (75% of range)
Reverse T3 --- 40.2 H ------- [13.5-34.2] ---- (129% of range)
TSH ---------- 0.671 ------- [0.450-4.500] --- (5% of range)
TPO ---------- 15 ---------- [0-34] ---------- (44% of range)
TgAb --------- <20 -------- [0-40]

10/24/12
Free T4 ------ 1.1 ------- [0.8-1.8] ----- (30% of range)
Free T3 ------ 3.3 ------- [2.3-4.2] ----- (53% of range)
Reverse T3 --- 19 ------- [7-24] -------- (71% of range)
Total T3 ----- 91 -------- [76-181] ----- (14% of range)

She did not run my TSH this time so I have no clue what it is. Do these results (10/24/12) look all right? I did not have Total T3 done the first time but my doctor wanted to check it the second time around so this is my first lab result for the Total T3. Also, is it normal for thyroid values to fluctuate like this within a month? I realize the values are not significantly different, but I had expected my new results to mimic the readings I had in September (with a hopefully lowered RT3).

The rest of my labs were good, and the only flags I had were low Vitamin D, low progesterone, and low iron binding capacity.

In September my iron serum levels were through the roof, and this time they have lowered but I am curious if the TIBC result I have means anything? I realize this is the thyroid board so if nobody knows that it fine just thought I would throw it in here.

10/24/12
Iron, Total ------------- 122 -- [40-175] --- (38% of range)
Iron Binding Capacity --- 245 -- [250-450] -- ( -2.5% of range)
% Saturation ----------- 50 --- [15-50%] -- (100% of range)
Folate, Serum ---------- 6.5 --- [>5.4]

9/20/12
Ferritin ---------------- 65 ---- [13-150] --- (38% of range)
Transferrin ------------ 237 --- [200-370] -- (22% of range)

10/24/12
Vitamin B12 ------------- 440 -- [200-1100] - (27% of range)
Vitamin D, 25-Hydroxy --- 26 --- [30-100] --- ( -6% of range)

*** My doctor said my B levels were good, but I would like to raise that number up. Is this something I should speak with my doctor about first, or can I just start supplementing at home?

Last edited by frisson; 11-03-2012 at 09:54 AM. Reason: Copied original post I am referring to for quicker access, also included additional question about glucose levels.

 
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Old 11-03-2012, 11:03 AM   #22
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Re: Assistance Reading Lab Work

So I don't know if it matters but as far as symptoms since my last test go I have lost more hair in the last month, my muscles have felt like I work out 6 hours a day with heavy weights everyday (almost a bruised feeling), my knee has been in severe pain and I never have knee problems, last night I had weird surges of adrenaline from 11:45p - 3:00a (with fast heart rate, and a numb feeling in my hands and toes), my skin is severely dry and the rash on my right hand is worse, I also started getting dandruff (which I never had before), and one more thing my nails have become even more brittle as they separate from the nail bed but they are also very very thick (weird I know).

 
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Old 11-04-2012, 01:30 AM   #23
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Re: Assistance Reading Lab Work

Quote:
Originally Posted by frisson View Post
Anyone know if thyroid levels generally fluctuate that heavily within a month when a person is not currently on thyroid meds of any kind? Do thyroid issues contribute to high glucose?
No I don't think it's normal for thyroid levels to fluctuate like this within a month but sometimes it does happen. Your FT4 is a bit on the low side at the moment and considering your new symptoms it is quite possible you're now shifting towards hypoT, I think you situation calls for further monitoring. Thyroid levels can affect your glucose levels, not sure what the typical scenario would be (and I believe with diabetes one cannot always tell which of them affects the other).

 
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Old 11-04-2012, 11:12 AM   #24
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Re: Assistance Reading Lab Work

Ever seen "Hashi's" mentioned here? You can find much info on it. Some salient points are these: Hashimoto's thyroiditis is the most common cause of hypothyroidism in the United States; is a condition caused by inflammation of the thyroid gland; tends to occur in families; is 5-10 times more common in women than in men; blood drawn from patients with Hashimoto's throiditis reveals an increased number of thyroid peroxidase antibodies, the antibodies cause inflammation in the thyroid gland, the thyroid gland is destroyed, and the patient ultimately is rendered hypothyroid. There are a few patients with Hashimoto's thyroiditis who may undergo a hyperthyroid phase (too much thyroid hormone), called hashitoxicosis, before eventually becoming hypothyroid.

"Hashimoto's typically involves a slow but steady destruction of the gland that eventually results in the thyroid's inability to produce sufficient thyroid hormone -- the condition known as hypothyroidism. Along the way, however, there can be periods where the thyroid sputters back to life, even causing temporary hyperthyroidism, then a return to hypothyroidism. This cycling back and forth between hypothyroidism and hyperthyroidism is characteristic of Hashimoto's disease. So, for example, periods of anxiety/insomnia/diarrhea/weight loss may be followed by periods of depression/fatigue/constipation/weight gain." This quote is taken from "Hashimoto's vs. Hypothyroidism: What's the Difference? A Look at Autoimmune Thyroid Disease and Underactive Thyroid Conditions" By Mary Shomon,

So going back over your posts you have: (1) both hypothyroid and hyperthyroid symptoms: "my symptoms are very similar to both hypothyroid and hyperthyroid, I am not sure if it is possible to switch between hyper and hypo but the way my symptoms come and go throughout the day I feel like it is happening." (2) your weight loss is a good sign of hyper. (3) "adrenal gland test and I was borderline for adrenal insufficiency" - adrenal gland and thyroid work hand-in hand, if thyroid is out of whack chances are so will your adrenals, (4) "My entire family (the females) have thyroid issues", (5) "I am cold more often than hot now" - are clear symptoms of hypo and hyper respectively. DO YOU CATCH MY DRIFT??

Now turning to lab tests. The reference ranges DO NOT define normal. I consider the median value (50th percentile) to be "normal", rather than the reference ranges which are the 2.5% and 97.5% percentiles. I have found median values by searching the net. (look up 'median' and 'normal curve' if you do not understand this).

OK, what do your lab tests say?
September 20, 2012
Free T4: 1.61 versus median 1.04 ==== 55% above normal
Free T3: 3.8 versus median 2.88 == === 32% above normal
Reverse T3: 40.2 versus median 21 === 91% above normal - nearly 2 times normal.
TSH: 0.671 versus median 1.41 ====== below normal
These result very clearly indicate hyperthyroid and are in agreement with your hypo symptoms of losing weight and intolerance to heat.

antithyroid peroxidase antibodies (TPOab)
TPO: 15 versus median 10.4 for females age 20-29 == 44% above normal (see notes above re Hashi's)

October 24, 2012
Free T4 ------ 1.1 ------- versus median 1.04 ==== very slightly above normal
Free T3 ------ 3.3 ------- versus median 2.88 == === 14% above normal
Reverse T3 --- 19 ------- versus median 21 === probably normal for you
October results are quite normal; you should keep those values for future reference.

So the September results are hyperthyroid, which is certainly not normal, and it is certainly not normal to go from hyper to normal in the period of one month. The October blood tests could have caught you in a period in-between hyper and hypo. The intolerance to cold and rapid heart beat that you are now experiencing (which could be atrial fibrillation or suprvaventicular tachycardia) are symptoms of hypothyroidism.

Frisson - I would say that your symptoms and thyroid tests very clearly indicate thyroid dysfunction of some sort, possibly Hashi's. Obviously we are not doctors here and can not diagnose you. But I am very surprised that your doctor has not said the words "thyroid disease" and that she would say she "is not concerned by my levels so she does not plan to continue investigating my thyroid for the time being."

You MUST get your doctor to recognise that you have a thyroid problem, or go to a new doctor or get a referral to an endocrinologist. You could perhaps talk to other family members to find who is the best doctor they have found for thyroid problems. You MUST also continue to monitor your thyroid levels.

When you have your thyroid resolved, then you can see what else you have left to deal with.

Ultimately you may end up taking thyroid replacement medication, be sure to come back for advice then. Good luck...

 
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Old 11-04-2012, 11:33 AM   #25
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Re: Assistance Reading Lab Work

I second what Finnmaid said.

My doctor said my B levels were good, but I would like to raise that number up. Is this something I should speak with my doctor about first, or can I just start supplementing at home?
your B12 is at quite a good place indeed. That as you wish, I think it's always good to discuss things with your doctor. As such it can be bought freely (so no prescription needed), preferabe sublingual tablets don't go overboard with it though since your levels are good, the ones of 1000 seem more then enough.

Your iron/ferritin is at good place too but your vit D is not (as you probably noticed yourself) did you doctor suggest supplementation? I think you should, preferably vit D3 and those need to be taken in high dosage to bring levels up.

 
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Old 11-05-2012, 10:56 AM   #26
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Re: Assistance Reading Lab Work

Quote:
Originally Posted by telus View Post
Ever seen "Hashi's" mentioned here? You can find much info on it. Some salient points are these: Hashimoto's thyroiditis is the most common cause of hypothyroidism in the United States; is a condition caused by inflammation of the thyroid gland; tends to occur in families; is 5-10 times more common in women than in men; blood drawn from patients with Hashimoto's throiditis reveals an increased number of thyroid peroxidase antibodies, the antibodies cause inflammation in the thyroid gland, the thyroid gland is destroyed, and the patient ultimately is rendered hypothyroid. There are a few patients with Hashimoto's thyroiditis who may undergo a hyperthyroid phase (too much thyroid hormone), called hashitoxicosis, before eventually becoming hypothyroid.

"Hashimoto's typically involves a slow but steady destruction of the gland that eventually results in the thyroid's inability to produce sufficient thyroid hormone -- the condition known as hypothyroidism. Along the way, however, there can be periods where the thyroid sputters back to life, even causing temporary hyperthyroidism, then a return to hypothyroidism. This cycling back and forth between hypothyroidism and hyperthyroidism is characteristic of Hashimoto's disease. So, for example, periods of anxiety/insomnia/diarrhea/weight loss may be followed by periods of depression/fatigue/constipation/weight gain." This quote is taken from "Hashimoto's vs. Hypothyroidism: What's the Difference? A Look at Autoimmune Thyroid Disease and Underactive Thyroid Conditions" By Mary Shomon,

So going back over your posts you have: (1) both hypothyroid and hyperthyroid symptoms: "my symptoms are very similar to both hypothyroid and hyperthyroid, I am not sure if it is possible to switch between hyper and hypo but the way my symptoms come and go throughout the day I feel like it is happening." (2) your weight loss is a good sign of hyper. (3) "adrenal gland test and I was borderline for adrenal insufficiency" - adrenal gland and thyroid work hand-in hand, if thyroid is out of whack chances are so will your adrenals, (4) "My entire family (the females) have thyroid issues", (5) "I am cold more often than hot now" - are clear symptoms of hypo and hyper respectively. DO YOU CATCH MY DRIFT??

Now turning to lab tests. The reference ranges DO NOT define normal. I consider the median value (50th percentile) to be "normal", rather than the reference ranges which are the 2.5% and 97.5% percentiles. I have found median values by searching the net. (look up 'median' and 'normal curve' if you do not understand this).

OK, what do your lab tests say?
September 20, 2012
Free T4: 1.61 versus median 1.04 ==== 55% above normal
Free T3: 3.8 versus median 2.88 == === 32% above normal
Reverse T3: 40.2 versus median 21 === 91% above normal - nearly 2 times normal.
TSH: 0.671 versus median 1.41 ====== below normal
These result very clearly indicate hyperthyroid and are in agreement with your hypo symptoms of losing weight and intolerance to heat.

antithyroid peroxidase antibodies (TPOab)
TPO: 15 versus median 10.4 for females age 20-29 == 44% above normal (see notes above re Hashi's)

October 24, 2012
Free T4 ------ 1.1 ------- versus median 1.04 ==== very slightly above normal
Free T3 ------ 3.3 ------- versus median 2.88 == === 14% above normal
Reverse T3 --- 19 ------- versus median 21 === probably normal for you
October results are quite normal; you should keep those values for future reference.

So the September results are hyperthyroid, which is certainly not normal, and it is certainly not normal to go from hyper to normal in the period of one month. The October blood tests could have caught you in a period in-between hyper and hypo. The intolerance to cold and rapid heart beat that you are now experiencing (which could be atrial fibrillation or suprvaventicular tachycardia) are symptoms of hypothyroidism.

Frisson - I would say that your symptoms and thyroid tests very clearly indicate thyroid dysfunction of some sort, possibly Hashi's. Obviously we are not doctors here and can not diagnose you. But I am very surprised that your doctor has not said the words "thyroid disease" and that she would say she "is not concerned by my levels so she does not plan to continue investigating my thyroid for the time being."

You MUST get your doctor to recognise that you have a thyroid problem, or go to a new doctor or get a referral to an endocrinologist. You could perhaps talk to other family members to find who is the best doctor they have found for thyroid problems. You MUST also continue to monitor your thyroid levels.

When you have your thyroid resolved, then you can see what else you have left to deal with.

Ultimately you may end up taking thyroid replacement medication, be sure to come back for advice then. Good luck...
I have read a little about Hashi's but I assumed since my antibodies were at 15 and not above range that I did not meet the criteria for Hashi's. From what I have read everyone can have the hashi's antibodies, but only the people who have antibodies above range actually have hashi's. If my understanding is incorrect please feel free to correct me. My doctor is a great woman but she is not specially trained to deal with thyroids or adrenal glands, so as much as I really like her I just don't think she will be able to help me. I can't afford to see an endo until the first of the year when my insurance starts over though so I guess I will just have to deal with it until then. I wish I had waited to get my lab work done a week or two later than I did because the last few days my hyper symptoms have been coming back full force (specifically the late night rushes--anxiety--rapid heart rate--chest pain--insomnia).

I bet if my labs had come back showing the same readings that I had in September she would have referred me immediately to an endo, then I wouldn't have to waste my last appointment of the year trying to convince her to refer me to one.

If I had tested today I have a feeling they would have matched my September labs (based on how I felt than compared to how I feel today).

Thank you for all of the information it is greatly appreciated. I will bring my concerns to my next appointment and request a referral, which she hopefully will give to me.

 
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Old 11-05-2012, 11:01 AM   #27
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Re: Assistance Reading Lab Work

Quote:
Originally Posted by lisa789 View Post
I second what Finnmaid said.

My doctor said my B levels were good, but I would like to raise that number up. Is this something I should speak with my doctor about first, or can I just start supplementing at home?
your B12 is at quite a good place indeed. That as you wish, I think it's always good to discuss things with your doctor. As such it can be bought freely (so no prescription needed), preferabe sublingual tablets don't go overboard with it though since your levels are good, the ones of 1000 seem more then enough.

Your iron/ferritin is at good place too but your vit D is not (as you probably noticed yourself) did you doctor suggest supplementation? I think you should, preferably vit D3 and those need to be taken in high dosage to bring levels up.
My doctor has instructed me to take 5000 IU D3 daily which I have already started taking, and I did start taking some timed release B12 but I can't remember how much.. it might have been 1000. I might just take the B12 every other day until I see her to see if it makes any difference in my energy levels.

 
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