Results so far, still awaiting results for thyroid/adrenal...

[AnthonyMs]

I've just received my blood test results checking for anemia including iron, ferritin, active B12, red cell folate, reticulocytes, FBC, ESR, etc.

I'm also concerned I may have a thyroid issue, as another blood test revealed a high/normal TSH.

So thus far, my results of importance are as follows, with lab ranges:

- TSH 3.92 (high/normal) 0.27 - 4.2

- FT4 16.2 (normal/optimal?) 12.0 - 22.0

- Vitamin D 37.2 (low/normal/sub-optimal)

- Active B12 108.5 (normal/optimal?) 25.1 - 165.0

- Iron 18.1 (normal/optimal?) 10.6 - 28.3 (previous - 12.5)

- TIBC 52 (normal/optimal?) 41 - 77 (previous - 54)

- Transferrin Saturation 35% (normal/optimal?) 20 - 55 (previous - 23%)

- Ferritin 180 (normal/optimal?) 30 - 400

- Red Cell Folate 645 (normal/optimal?) 158 - 1099

- Total Testosterone 16.2 (low?) 7.6 - 31.4

- Haemoglobin 13.8 (low/normal) 13.0 - 17.0 (previous - 13.2)

- HTC 0.404 (low/normal) 0.37 - 0.5 (previous - 0.389 (low!) (0.4 - 0.54))

- Red Cell Count 4.58 (low/normal) 4.4 - 5.8 (previous - 4.39 (low!) (4.5 - 6.5))

- MCV 88.2 (normal) 80 - 99 (previous - 88.6 (79 - 100))

- MCH 30.1(normal) 26.0 - 33.5 (previous - 30.1 (27.0 - 32.0))

- MCHC 34.2 (normal/high) 30.0 - 35.0 (previous - 33.9 (32.0 - 36.0))

- RDW 12.9 (normal) 11.5 - 15.0 (previous - 12.7 (11.8 - 14.8))

- Platelet Count 209 (normal) 150 - 400 (previous - 222 (150 - 400))

- White Cell Count 5.31 (normal) 3.0 - 10.0 (previous - 6.9 (4.0 - 11.0))

- Reticulocyte Count (immature red cells) % 0.84 (normal/sub-optimal?) 0.38 - 2.64

- ESR 2 (normal) 1 - 10

- Cholesterol 5.4 (high!) <5.0

- LDL Cholesterol 3.4 (high!) <3.0

- HDL Cholesterol 1.4 (normal/optimal?) 0.9 - 1.5

- Triglycerides 1.3 (normal/sub-optimal?) <2.3

Still to come are the results from the full thryoid screen which includes TSH, FT4, FT3, RT3 and thyroid antibodies and the 24-hour adrenal stress profile.

I'm currently charting my daily temperature using the Dr Rind metabolic temperature graph, sampling up to 3 times daily/3 hours apart and so far my average daily temperature looks to be 36.0 C +- 0.1 C and maximum variation in average temeprature has been ~ 0.3C or ~0.4F. So it looks as though I may have adrenal and thyroid issues, unless I misunderstood something.

Much has been said about the link between cholesterol and thyroid issues, but not much about how testosterone factors into lipid profile? Higher testosterone is supposedly responsible for the leaner fat profiles of men than women. I'm now wondering whether a sluggish thyroid is responsible for the reportedly low testosterone result i've received? Or otherwise could a low testosterone level cause the thyroid to perform less than optimally? Don't post-partum women have lowered testosterone and isn't that the cause of hypothyroid symptoms? I wonder how testosterone factors in here.

[poing]

Your vitamin D might actually be optimal - there's some new research which suggests that lowest mortality is with vitamin D around 35. You can read some more on Chris Kresser's website.

Your iron levels look fine to me. I've done a lot of reading on iron so am on reasonably secure ground with that one - although you shouldn't just take my word for anything!

Your cholesterol is average, and to my way of thinking average is usually a good place to be. The lower recommendation doesn't really have a lot of basis in science, I think, and just gives doctors an excuse to prescribe statins. The LDL cholesterol does seem a bit high, but I think that's a calculated number, not a measured one, so it's not always accurate and who knows what it really means anyway. There's a new school of thought that says its the particle number, not the total amount of LDL cholesterol that matters anyway... cholesterol tests are hard to understand.

The only thing that really stands out to me is the raised TSH... the upper limit of the normal range is lower in other countries and there's some question over where it should be.

Where did you get your tests carried out in the end?

[AnthonyMs in reply to poing]

Hi I got my tests for anemia done at Blue Horizons.

Interesting counter-arguement regarding vit D, but part of me is inclined to believe i'm sub-optimal purely for reasons of living on an island at high latitude with low levels of sunlight, spending 90% of my time indoors and covering my whole body apart from my face with clothing. When in human evolution has that occured except in modern times? I definately agree though with the idea that what's optimal for one is sub-optimal for another depending on genetics, latitude, lifestyle, etc. and it's not just as simple a case as hitting the optimal range 50-70 ng/ml as suggested.

I was taking a 8 ug daily supplement for ~60 days prior to this test (however, no iron supplement for more than 24 hours before the test), so I wonder just how much an effect that would have had on the result. I don't know what the usual normal ranges of ferritin for young men are and presumably the range associated includes adults of all ages and genders. What is normal isn't the same as what's optimal and what's optimal for one isn't necessarily for another. The reason I took this test was partly for standalone concerns of anemia and partly for the possible confounding effect on thyroid function. I have some symptoms of anemia: fatigue, exhaustion, shallow breathing, hypotention (low blood pressure), cold hands?, lower leg stiffness/pain especially after waking?. I also had a low/normal hemoglobin on one FBC test of 13.2 (again adult ranges used) and low Red Cell Count (marked as 'low'). However, the GP wasn't concerned and didn't think it warranted anymore investigation. But it looks as though if I have anemia, it can't be explained as a nutritional problem given my "normal" ferritin, active B12, red cell folate, TIBC, etc. Also since my reticulocyte index % appear normal/low? It apparently can't be because of blood loss/red cell destruction, in this case you'd expect an index of >=2.5% arupconsult.com/Algorithms/.... So I'm left wondering if I'm genetically predisposed to having lower number of red cells or else whether production has been suppresed by other factors. Now i've read that low thyroid can also suppress red cell production healthtap.com/#user_questio...

This would also tie in with the high cholesterol evident.

You're right about the cholesterol particle number mattering most, I wonder if I can have that tested on the NHS? My GP didn't do anything and just told me to go on a mediterranean diet, despite that I have a BMI of just over 21 and probably eat healthier that most people because of my ill health.

I really wouldn't be suprised if I have hypothyroid and wouldn't be sad or angry because it'd all make sense finally after all these years.

[poing in reply to AnthonyMs]

If you were truly anaemic, then I think you would feel lightheaded and dizzy, and get very out of breath with even minor exertion... I've experienced iron deficiency without anaemia while my friend developed out-and-out iron deficiency anaemia (iron stores/ferritin of 3). They were completely different experiences!

It's not well known - although it probably should be - that many of the symptoms experienced by people with anaemia are caused by the underlying problem (iron, B12 folate, whatever, there are many causes of anaemia) rather than by the actual anaemia. Many health problems have symptoms of fatigue, feeling cold and fuzzy headed etc. whether or not they also present with anaemia.

In your case, you're not currently anaemic, you have plenty of iron, and your B12 and folate look okay too. Maybe they weren't optimal before you started to supplement, but they are fine now. Ferritin is a measure of iron stores, as I'm sure you know, but it can be artificially raised by inflammation, and that's why you need to look at serum iron too. Serum iron tells you how much iron is available to the cells to use, and I believe this number has more of an influence on how well you feel. Your serum iron is middle of the range, which seems ideal to me as higher numbers lead to overload disorders, oxidative stress (heart disease) and predispose a person to more serious infections (pathogens love iron).

Unfortunately, although I wouldn't go as far as to say you've been looking in the wrong places, I don't think this is giving you the answers you're seeking. The slightly reduced red blood cell production that you had before could be the result of an overall slower metabolism. Hopefully your complete thyroid results will shed some light on things.

I don't know anything at all about testosterone, that's the only reason I haven't mentioned it.

Hope this is helpful!

[AnthonyMs in reply to poing]

Hi, your responses are always very helpful, i'm always so grateful for them, thanks a lot!

I do get light-headed fuzzy thinking, I’m not sure if I can attribute that to anemia though. Sometimes when I get up I feel dizzy which usually occurs after I’ve been exercising more than usual, which made me think that I’m losing iron and it’s causing anemia-like symptoms.

Some other symptoms, I urinate frequently which I can’t seem to control. I’ve had tests done to check kidney/renal function, I’m not sure if they’re normal or not. I had a creatinine of 93 umol/L and urea 5.6mmol/L, which I think are the main biomarkers of kidney function. At first I thought I was diabetic but I’ve had an HBa1c test which was 32 mmol/mol or 5.1% which appears to be a sign of good glucose control i.e. not diabetic. I’m not sure if/how frequent uncontrollable urination relates to thyroid function. Also, you lose iron through urine, sweat and GI tract so I thought I might be iron-deficient.

Of course I had no idea of what could be causing these anemia-like symptoms which was why I took this anemia-profile test. It’s good to know that I appear to be nutritionally ok. I should mention that I was taking 8mg/day iron, 125 ug/day B12 (holo) and 800 ug/day folic acid for 4-6 weeks prior to the test. It looks like I’ll need to take these supplements in future if I’m to maintain these levels.

I’m still concerned about the low red cell count/lowish haemoglobin, but it can’t be related to nutrition. I thought it might have been because of blood loss/red cell destruction, which was why I ordered a reticulocyte test. If I understand correctly, I can’t be losing blood since that would raise the reticulocyte index and mine looks somewhat suppressed at 0.84%.

I understand what you’re saying that anemia is more of a characteristic of underlying conditions rather than a standalone condition. Still, if my symptoms are attributable to a thyroid condition, I’d had to carry out these tests anyway in order to optimise biomarkers implicated in thyroid function.

Interestingly, since I’m an amateur, I don’t know the reasons why people with thyroid conditions are so concerned about B12, iron, folate, vitamin D, etc. Perhaps someone could shed some light on that? But I’m guessing that they impact thyroid function , so I decided that if I’m going to test for thyroid function, the results couldn’t be interpreted fully without knowing values of these other biomarkers.

I didn’t know that being hypothyroid could suppress red cell production. I’d be interested to know if hypothyroid patients on this forum have also encountered ‘low’ red cell counts and whether they were nutritionally normal or not.

[poing in reply to AnthonyMs]

Men don't really lose a lot of iron... for the obvious reason that they don't menstruate. For that reason, men have to be cautious about taking extra iron. With iron stores (ferritin) of 180, I really don't think you need extra iron - anything above 70 usually excludes the possibility of iron deficiency.

Most nutrients seem to have a U-shaped curve, with better health in the middle and worse health on the edges. I think with a ferritin of 180, you're either in the middle or on the uphill side of that curve.

Iron competes with other nutrients for absorption, and so taking iron when you don't need to is setting yourself up for other deficiencies. I desperately needed iron, but became (even more) zinc and possibly copper deficient by taking it.

Plus, iron pre-disposes a person to infections, heart disease, etc etc (sorry, repeating myself).

The safer option is to stay off the iron, and if you're still concerned then measure it again to see what's happening. I personally don't think ferritin tells us the whole story... the serum iron is important too.

It was actually a bit of a guess, but thyroid hormone levels do appear to affect blood parameters:

ncbi.nlm.nih.gov/pubmed/219...

The dizziness thing could be due to low blood pressure, which could in turn be due to electrolyte imbalances - we lose a lot of electrolytes when we exercise, which could make it worse! Have you looked at your magnesium/potassium levels?