Please could someone look at my daughter's results? Has she got antibodies or not?

[Katkin1]

I have hashimoto's. My daughter (aged 33 and just had a baby 7 months ago) has just had a very thorough blood test done by the doctor (as she has felt unwell for some time) and I post some of the results below. I would be very grateful if someone could look at these for us please, and let me know what you think (the doctor has put that they are all normal):

TSH 1.06 mU/L (0.35-5.50 mU/L)

Free T4 12.0 pmol/L (10.50 -20.00 pmol/L)

Free T3 4.6 pmol/L (3.50 - 6.50 pmol/L)

Thyroid Peroxidase 35 iu/ml (<60)

Plasma glucose 4.0 mmol/L (3.00 - 5.50 mmol/L)

Plasma creatinine level 53 umol/L (54.00 - 145.00 umol/L)

Plasma potassium level 3.7 mmol/L (3.50-5.00 mmol/L)

Serum iron 13.9 micromol/L (11.00 - 30.00 micromol/L)

Serum folate 10.1 microg/L (3.00 - 20.00 microg/L

Serum ferritin 42.6 microg/L (10.00 - 200 microg/L)

Serum vitamin B12 372 ng/L (180.00 - 900.00 ng/L)

Vitamin D 44 (33-79 insufficiency)

Do these look 'normal' ? The doctor has gone down the route of antidepressants at the moment and my daughter also has other symptoms such as fibromyalgia, extreme tiredness and lack of co-ordination, hair loss. The doctor has told my daughter that she would not treat her for hypothyroidism until her TSH was 6 or over!

Please can anyone help?

[Starfish123]

Hi,

She had TPO ab but not to the level they will treat unfortunately, same as my daughter.

She does appear low in a lot of those results, personally I would supplement the d3 and b12 as she is too low. I recommend the Solgar d3 1000iu softgels, I had one good day on these before I changed to my prescribe d3, no where near as good.

Hope fully someone else will comment soon as I'm no expert.

[Katkin1 in reply to Starfish123]

Thanks Starfish. I will get her some Solgar D3 and b12. I guess we just need to keep an eye on things.

Best wishes

Kathy

[nostoneunturned in reply to Katkin1]

Her B12 and folate are both too low, plus FT4 and FT3 levels lamentable. Doctor should be shot or be given a forcible eye test, but I have been there too. Link below takes you to my posts on raising B12 by DIY method, about 6 posts I think, just keep reading! Make sure she takes enough B12 daily. She will get no help from GP about B12 as she is in range, NHS range goes far too low and is anyway only the serum B12, does not reflect what B12 fraction (Active B12) is available to the cells, link below also leads to info re Active B12 testing. She needs folate also, the supplementary form in called folic acid and 800 units is usually reckoned an adequate supplement. Never take folic acid alone, it goes with the B12 as B12 needs folate (folic acid) to be properly assimilated by the body but taken alone can mask damage by B12 deficiency.

myrios.co.uk

for testing both folate and serum B12 by pinprick test, only £30.

Ferritin is not optimal either, should really be about 3/4 way up range, but taking iron is a matter for monitoring by doctor as too much iron can be dangerous.

Body can handle food sources though, iron, plus folate/B12 at high levels in lamb's liver/chicken liver - tuck in! But she has to supplement (pills) that B12 and folate. Buy ONLY methylcobalamin form of B12, Swansons, Jarrows, 60 x 5000mcg tablets from amazon. 5,000mcg equals 5mg.

pasoc.healthunlocked.com/bl...

[helvella]

In my view, the FT4 and FT3 are low and the TSH is not adequately reflecting their lowness.

It is no surprise she is feeling unwell with those thyroid hormone numbers.

That suggests the pituitary is not (currently, at least) reacting to the thyroid hormone levels as would be expected. That might be due to being hypopituitary.

That needs to be properly investigated by, for example, checking Follicle Stimulating Hormone, Prolactin and Growth Hormone levels.

There are other possibilities.

For reference, this flowchart is where you can see what low FT4 and low/normal TSH could mean:

thyroidmanager.org/wp-conte...

The TPO antibodies test has its positive/negative line at 60 so as to exclude the many people who have some TPOab - but not enough to demonstrate an autoimmune dysfunction. Modest levels are very widespread and very often, they drop down again. Your daughter's test at 35 is negative - but it should be kept as a thought unless and until she has a repeated test which shows it has dropped. Or risen.

At this moment I would be interested in them doing a pituitary antibodies test.

Please note - I am not medically qualified and am merely making suggestions based on sources.

Rod

PS Iron, vitamin D, vitamin B12 and folates could all be a little higher. But don't go mad!

[Katkin1 in reply to helvella]

Thanks Rod. I have just phone my daughter to tell her your comments and now her tongue is swollen and she is having difficulty eating and talking! She has the doctors at 11.45am today. How can she ask for the Follicle Stimulating Hormone, Prolactin and Growth Hormone levels to be tested without getting the doctor's back up - any ideas please.

[helvella in reply to Katkin1]

Ah! You want tact and diplomacy? That, I am afraid, is another department!

Maybe try to ask "How come the TSH is low as well as the FT4? I thought you said that TSH goes up when FT4 goes down?". I.e. try to make it the doctor's idea even if he said nothing of the sort. Massage that ego. Play to the arrogance.

A swollen tongue is very unpleasant (and mine was only slight). Both thyroid hormone and low B12 could contribute to that.

[Katkin1]

Thank you so much Rod. I will let you know how she gets on.

Best wishes

Kathy

[anuska]

my advise kaktkin

i have autoinmune my antibodies where negatives until a year latter that my TGI where OVER 100. My sister was diagnoses with hasimotos with over 1.000.000 TPO antibodies but my symthoms were worse than hers i could not move i was in a lot of pain and the fatigue was terrible.

Please aske the doctor to test dose as they are a sign of hashimotos. Read this i dont agrred with everythign he says. tell your daugther to eat a lot of gluten previous to blood test that will make her autominmen sytem to make antibodies.

Read this link

thyroidbook.com/blog/unrave...

sometimes there could be false negatives. the best thing is to go to a good endocrinologist who sees everything in conjunction.

depression is a symthom of hashimotos. my mad had 4 years of antidepressants. i am on them as well as i feel terrible without them my thryroid medication is not right.

[Katkin1 in reply to anuska]

Thank you anuska. I have printed the article off for my daughter.

[lynmynott Partner Thyroid UK]

There's definitely a problem since both the TSH and the FT4 are low in range. This usually indicates secondary hypothyroidism. However, her iron and ferritin are on the low side and the thyroid needs these to make thyroid hormone. Also B12 could do with coming up a bit in my experience.

A referral to an endocrinologist might be the way to go if your doc would agree.

[Katkin1 in reply to lynmynott]

Thank you Lyn. Please could you tell me what secondary hypothyroidism is?

Best wishes

Kathy

[lynmynott Partner Thyroid UK in reply to Katkin1]

Hi Katkin1, Secondary hypothyroidism, also known as central hypothyroidism, is when the cause of the hypothyroidism is a problem with the pituitary gland. This can give the scenario of low TSH and low FT4 and FT3. Usually if the TSH is low, the FT4 is high and vice versa. See:

patient.co.uk/doctor/hypoth...

ncbi.nlm.nih.gov/pmc/articl...

In the old days a TRH test would be done to check for this. It is still done but not very often.

[Katkin1 in reply to lynmynott]

Thank you very much Lyn. I will pass this information on to my daughter.

Best wishes

Kathy