Results (or some) have come back - any advice?

Hello

I am seeing my GP next week to discuss some results she has had back from the hospital lab, and the ones I had done privately (she doesn't know yet)

Private results are:

Thyroid Peroxidase Antibodies 149.8 IU/ml <60 negative 60-100 equivocal >100 positive

TSH 3.330 uIU/ml (0.270 - 4.200)

T4 11.9 pmol/L (12 - 22)

T3 2.8 pmol/L (3.1 - 6.8)

Active B12 22 pmol/L No reference ranges given & no reply to email

UIBC 62.9 umol/L (20 - 62)

Iron 6.1 umol/L (6.6 - 30.4)

TIBC 44.5 umol/L No reference given

Transferrin saturation 12.7 %

The hospital ones have apparently not all come in even though they were taken two weeks ago. The ones I have are as follows -

Haemoglobin estimation 109 g/L (115-165) Low

MCV 78.7 fl (80-100) Low

Haematocrit 0.344 Low

MCH 24.9 pg Low

Plasma fasting glucose 7.3 High

Serum Albumin 32 g/L Low

Sorry it's a bit long winded. I take 50mcg of Thyroxine, Iron tablets, folate tablets, B12, Omeprazole and now fluoxetine and Ramipril.

Any help would be appreciated so I can go in with some knowledge.#

Thanks

8 Replies

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  • Hi Sitrog, you must be feeling pretty awful?

    Whilst your TSH is in the lab range, your antibodies, T4 and T3 are not. I'm not hypo but looks to me like you need an increase in Thyroxine.

    Your Active B12 result shows that you are B12 deficient. The lab ranges used by St Thomas' are:

    <25 pmol/L - vitamin B12 deficient

    25-70 pmol/L - samples are referred for confirmatory MMA analysis

    >70 pmol/L - vitamin B12 replete

    On your result you need treatment via B12 injections. You say you are on B12, do you mean sublinguals? The BNF / NICE guidelines allow for injections every other day until no further improvement where there are neuro symptoms, then 2 monthly maintenance for life. If no neuro symptoms, you should get a loading dose of 6 injections over 2 weeks, followed by 3 monthly maintenance. These guidelines are shown here:

    cks.nice.org.uk/anaemia-b12...

    To establish what symptoms you have, look at this link:

    b12deficiency.info/signs-an...

    Have a read around the website, it's full of useful information and links. There is a link to a Facebook group for Pernicious Anaemia (PA) / B12 deficiency which you could join.

    You need to ask your doctor to check for the autoimmune antibodies found in PA, these are anti-intrinsic factor and anti-parietal cells. The fact that you are on Omeprazole could actually be the cause of your B12 deficiency, particularly if you have been on it a long time. It also causes Magnesium deficiency incidentally, you should ask your doctor to test Red Cell Magnesium (not Plasma/Serum Magnesium).

    Your iron levels are appalling and you are anaemic on your hospital results. How long have you been on iron tablets and at what strength? Without improving your iron you won't get the full benefit from thyroid meds or B12 injections. Did you have Folate and Vitamin D tested? You must ask for them if not, because they are likely low as well. You should also be tested for Coeliac, Crohns etc, have you seen a Gastro before?

    I don't know much about glucose but I'm assuming they might want to run more tests to rule out diabetes.

    Hampster

  • Apart from endorsing hampster1's reply, yes, you DO need more thyroid hormone.

    You might also have problems trying to take that lot within the 24 hours we have in each day!

    You must take thyroid hormone at least 4 hours away from levothyroxine. Indeed, you should be trying to take levothyroxine away from everything else - food, drink (other than water), supplements and other medicines.

    I cannot say what else needs to be taken with food/away from food/away from other medicines. All I can say is that you possibly need some help in working that out.

    No wonder you feel bad.

    Rod

  • Hello.

    Yes you are right in saying there are not enough hours in the day to take all this. I did wonder if I was causing problems myself, but GP says it's fine....

    I usually get up around 5am and take the Levothyroxine then go back to bed for a while as I know how important it is to keep it separate.

    The omeprazole is a new one until I have the gall bladder operation, but I don't think it works. Something to mention to GP.

    Many thanks

    Sandra

  • I wonder how an acid reducing medicine will play with iron supplements which require acidity to be absorbed? Which is why we often see suggestions to take some form of acid such as vitamin C along with the iron.

    You might find this old post and the comments of some interest:

    healthunlocked.com/thyroidu...

  • Hello.

    Thank you for replying. Yes I do feel inhuman at the moment.

    Sorry, you are right I am on sublingual B12 as the GP wouldn't agree to injections (hence the private test). Both Intrinsic factor and anti parietal cells came back positive - this is the second time they have.

    I have been on Iron tablets for 10 months now on maximum dose three times a day.

    Crohns disease and diabetes runs in the family, but GP says they are within tolerance.

    Still waiting for the rest of the tests to come in, so I may have to go in fighting with half the info.

    Best wishes

    Sandra

  • Positive IF antibodies are diagnostic of PA and you should be on B12 injections for life as per the guidelines. I would be demanding to know why I wasn't getting treated and complaining vigorously to the Practice Manager, this is a disgrace.

    Please come join us on Facebook:

    facebook.com/groups/1749289...

    In fact you should get completely away from this GP, and also seek referrals to a Haemo and/or a Gastro. Disgusted on your behalf. Within tolerance, what does that mean? It's not the GP that has to walk around feeling as you do.

    H x

  • Hi you definitely have an underactive thyroid,and by the looks of it it is caused by hashimotos. But a positive thyroid peroxidase antibodies can sometimes indicate another autoimmune disorder.