Please can someone help me interpret my results?

[PiggySue]

My TSH is checked every 6 months, because I have antibodies. The TSH is normally around 3.8 so I am not medicated.

In desperation I have had a private blood test (Blue Horizon) Please can someone help me to interpret the results? I can see that the TSH is better than I think I have ever had before (the test was at 9.30am - not sure if that makes a difference).

Free T4 13.3 (Ref range: pmol/L 9.0 - 20.0)

TSH 2.47 (Ref range: uU/mL 0.3 - 6.00)

Free T3 3.8 (Ref range: pmol/L 3.1 - 6.8)

Do I also need the T3 and T4 to get real info or is this enough and I am fine? I do wonder if my problem is conversion, but don't know how to interpret.

At the moment I feel well, better than I have for years, but am not working and my 3 kids are still at school (I normally work term time).

I feel tired all the time, try to keep fit and practise yoga every morning to try to keep the aches and pains in the joints and limbs at bay (I am a qualified yoga teacher but had to stop). Sometimes the pain in my hip and knee are so bad that I cannot walk. I also cannot lose weight despite dieting and exercise (obviously I would like to for vanity reasons, but mainly as I figure the less weight I carry the better for my joints, and I also have border line hypertension). I also have incredibly heavy and long periods (does anyone else wonder at what point it becomes a haemorrhage?)

A recent FBC blood test showed that

HB 12.0

WBC LO 3.58

Platelet count 303

Serum ferritin 13.6 (10 - 200)

Serum iron level LO 6.1 (11-30)

transferrin saturation index LO 8% (16 - 50)

I was tested for Celiac disease and was fine. So despite having taken Ferrous Fumarate EP 322mg every day pretty much for the last 3 years (which rather shocked the doctor) I have been put on a double dose of the Ferrous fumarate and now feel warm for the first time in years! I am less muddled in my thinking and seem to be worrying a bit less, and I am less bloated, my hands and feet look like my own again. My eyebrows have grown back again (I had the typical 3rd missing) and I am now able to grow my hair which is no longer showing bald spots on my scalp (I hope)!

So I guess that I would like to know if I was just anaemic?

(Sorry for such a long post - my first - I will try and keep it short in future!)

Thank you for your help.

[shaws Administrator]

Welcome Piggysue

Someone more experienced in blood tests will respond but I will say that if you have antibodies your GP should have prescribed levothyroxine for you. This is an excerpt from Dr Toft who was President of the British Thyroid Association. Most doctors are not very good at thyroid gland conditions and yours may be waiting until your TSH reaches 10, as that is the guidelines but not if you have antibodies:-

2 I often see patients who have an elevated TSH but normal T4. How should I be managing them?

"The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2

But if it persists then antibodies to thyroid peroxidase should be measured. If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up.

Treatment should be started with levothyroxine in a dose sufficient to restore serum TSH to the lower part of its reference range. Levothyroxine in a dose of 75-100µg daily will usually be enough.

If there are no thyroid peroxidase antibodies, levothyroxine should not be started unless serum TSH is consistently greater than 10mU/l. A serum TSH of less than 10mU/l in the absence of antithyroid peroxidase antibodies may simply be that patient’s normal TSH concentration."

Your iron/ferritin levels are too low. GP should supplement. The symptoms you have appear to be clinical symptoms of hypothyroidism, particularly about disappearing eyebrows female problems, weight gain for no reason, etc. You need to be medicated. If your GP is reluctant you can have a copy of the Pulse Article of Dr Toft answering questions if you email [e-mail].

If you have your antibodies results, it would be helpful to post them with the ranges as well.

[shaws Administrator]

A link which may be helpful:-

web.archive.org/web/2010103...

[PiggySue in reply to shaws]

Shaws, thank you so much for this. I was working from home and unfortunately the doctor's could not get through with the results from 2009 on the peroxidase antibodies, so I did not get back to you. I apologise!

In 2009 the Peroxidase antibodies reading was 365 although I don't have the range.

Thanks for you help. The other article was interesting as I am considering an ablation at the moment, but don't want a hysterectomy even though I have finished my family.

By the way, I am very lucky that I have a good doctor's surgery - the last time I went in to complain about my excessive bleeding the doctor straight away said that she thought that we should check my thyroid again, and I have 6 monthly test on TSH because of the Peroxidase. But I suppose that they are working within the constraints of the NHS.

[shaws Administrator in reply to PiggySue]

I am pleased you have a helpful doctor.

I think in general our doctors are good, except when it comes to the thyroid gland. They either don't think to test and/or diagnose only by the TSH by following the guidelines.

[PiggySue]

I was surprised that she (the doctor) put 2 and 2 together so quickly! 'Excess bleeding - hypothyroid'. I think that you are right and because I am showing symptoms and have the antibodies (although not sure if the number is high or low? - 365) I should go back and start to press for treatment. Or perhaps I should try T3 on it's own first? A lot of Hashimoto's patients seem to find that most helpful - and that is the only number that is close to the low range?

[Marz]

Need to take Iron with VitC to aid absorption. Ferritin way too low. Once you have anti-bodies you should be treated - if only to support the thyroid whilst under attack. All my TFT's were in range here in Crete but anti-bodies sky high - so was treated.