The endocrinologist has just called with, quote, 'positive news' about my test results - they are all 'normal', as follows:
TSH 3.14 (0.35 - 6)
FT4 14.2 (9 - 26)
Vit D 51 (50 - 150-something or even more - he spoke so fast I didn't catch what he said. If this is the value in the summer, heaven knows what it is in the winter - may explain the awful hip aches I would wake up to every morning)
I've also had the FT3 result from Biolab:
3.14 (2.63 - 5.70)
Other results from August 2013:
B12 878 (191 - 663)
Folate 5.6 (4.6 - 18.7)
Ferritin 90 (15 - 350)
Currently awaiting the short synacthen test (apparently there is a worldwide shortage at the moment).
I've never been diagnosed (on account of the 'normal' test results), but have many hypo symptoms, the worst being weight gain, inability to lose weight, low body temperature and feeling the cold (e.g. while watching the 2014 men's final at Wimbledon I was wearing a long-sleeved top, fleece, long trousers, wool socks, wool slippers and had a thick pure wool jacket draped across my body - and my feet and hands were *still* cold. The thermometer in the room was registering 21 C / 70 F !!).
I have a history of ME, though over the past seven years I haven't had anything like the fatigue I used to get, so can function fairly well on a daily basis.
I would appreciate it if I could have some help wth interpreting these results and especially advice about the low Vit D and the best course of action - should I go to my GP for further advice, for instance?
Many thanks
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ann_g_k
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Is your endo "normal"? Daft question, of course he is. Your TSH is too high, your FT3 and FT4 are too low and you are Vit D deficient. Your ferritin and folate are too low also.
Get out of your head the idea that you have "ME". That's what doctors want us to believe. It's cheap and easy for them - no tests, no treatment. You have, and have always had, thyroid, possibly adrenal, and vit/mineral problems. That what ME is for the vast majority of people. Doctors are too lazy to diagnose and treat properly so they invented a non-existent disease.
I suggest you order the saliva cortisol test from Genova UK. The short synacthen test only diagnoses Addisons disease. You need to know what your cortisol levels are doing throughout the day.
Many thanks Rosetrees - I have long thought that ME was another name for hypo, but the medics don't believe in ME (well most of them) but won't entertain the idea that it's undiagnosed hypo. So we are placed in the psychosomatic camp and left to fester.
The problem with the saliva test is that the endo pooh-poohs it (he also considers TSH as the 'gold standard'). Do the endos go to a training centre where they learn the latest lingo and come out as carbon copies of one another? What happened to individual medical judgement?
Being a medic is like being a politician. You have to toe the party line - individual judgement is frowned on. Think how many Independents make it to become MPs and think what happens to the few doctors who dare to be different.
Talking of which, if you're interested in details of a couple of private doctors who can help you, send me a PM.
Ann, your vitD is low but in range so it's unlikely your GP will prescribe but you will benefit from supplementing. I supplement 5,000iu daily VitD3 softgel caps which resolved my hip and knee pain. You can buy these on Amazon via thyroiduk.org.uk/tuk/go_sho... 360 Doctor's Best caps were just over £10 with free p&p.
Your FT4 and FT3 are low enough in range for you to be experiencing hypothyroid symptoms but you are unlikely to get treatment on the NHS until your TSH is >5.0. Make sure that your next thyroid bloods are drawn early in the morning when TSH is highest.
Many thanks for this - I'm about to order the Vit D so will see what happens.
Re: timing of tests, I've had bloods drawn at various times - 7.30a.m., 11.45p.m., 1.30a.m. and the results all hover around 3.2 so there is consistency - as we know, if I was in US or Germany then I would be treated.
I took the medical questionnaire test through Pulse (i.e. training for medics) and this states that TSH is highest last thing at night - which is why I had bloods drawn by a private nurse at 11.45p.m. the last time.
ann, I've been wondering about these sorts of test results. If you use a private testing company, is it possible to find out what your iodine urinary excretion level is? If you don't drink milk and don't use iodized salt, these sorts of blood test results can be indicative of an inadequate iodine intake.
I'm asking because my friend's afternoon TSH was 5.2. If she would have had it done in the morning it may have been as high as 7.0! Since I know something about how she eats, I suggested she give iodine drops a try. If her thyroid would be seriously depleted of iodine, then it takes about 6 months of daily drops (she was using 200 mcg per day of potassium iodide which translates to about 150 mcg of iodine. I suggested she increase it now to 3 drops per day for the next three months, test again and if her TSH is in the 1.4 range, use 2 drops per day indefinitely).
Three months later her morning TSH was 2.85. She is continuing with the drops and will test again in September. She began to feel better about 6 weeks after starting the iodine and now 4 months later she has lost weight without changing anything else about diet or exercise. Last time we met, she showed me how her trousers are so loose she was off to buy herself a smaller size. She was thrilled.
She does not consume dairy or wheat products. Milk is the primary source of dietary iodine in both Canada and the UK. In Canada, 40% of people over age 60 are ingesting sub optimal amounts of dietary iodine. The statistics are not available for the UK but it's probably similar. Seems that after age 20, the percentage of people who are either mildly or moderately iodine deficient increases with each decade of life. People tend to not consume as much or any milk after they reach adulthood.
Sometimes I think people who report marginal hypothyroid test results would be wise to check their diets first, then get a urinary iodine test done to find out if there's actually a real thyroid pathology or just a dietary issue. This way if it's just diet, the fix is cheap and easy.
The thyroid gland stores about 20 milligrams of iodine. Years and years of inadequate intake will eventually deplete it.
Your other blood levels are good. The vitamin D3 can easily be raised.
Neither your government nor mine routinely pays for iodine excretion testing. This is really shortsighted.
Marz, Hashimoto is not dietary iodine insufficiency. IN Japan where Hashi was improved by reducing iodine intake happened because people ingest a lot of iodine in seaweed etc. However, the 'improvements' resulted in TSH levels that to us are still way high out of range.
This has nothing to do with adequate amounts of dietary iodine. A patient with Hashi should be on replacement hormone AND should not avoid dietary iodine because this is a requirement for other body parts:
Nutr Health. 2009;20(2):119-34.
Iodine in evolution of salivary glands and in oral health.
Venturi S1, Venturi M.
Author information
Abstract
The authors hypothesize that dietary deficiency or excess of iodine (I) has an important role in oral mucosa and in salivary glands physiology. Salivary glands derived from primitive I-concentrating oral cells, which during embryogenesis, migrate and specialize in secretion of saliva and iodine. Gastro-salivary clearance and secretions of iodides are a considerable part of "gastro-intestinal cycle of iodides", which constitutes about 23% of iodides pool in the human body. Salivary glands, stomach and thyroid share I-concentrating ability by sodium iodide symporter (NIS) and peroxidase activity, which transfers electrons from iodides to the oxygen of hydrogen peroxide and so protects the cells from peroxidation. Iodide seems to have an ancestral antioxidant function in all I-concentrating organisms from primitive marine algae to more recent terrestrial vertebrates. The high I-concentration of thymus supports the important role of iodine in the immune system and in the oral immune defence. In Europe and in the world, I-deficiency is surprisingly present in a large part of the population. The authors suggest that the trophic, antioxidant and apoptosis-inductor actions and the presumed antitumour activity of iodides might be important for prevention of oral and salivary glands diseases, as for some other extrathyroidal pathologies.
Some people who report their test results here are marginal in regards to TSH and etc. If TSH is very high, then definitely thyroid antibodies need to be tested (and clearly they are not). I don't know where the statistic comes from in regards to the percentage of people who require thyroid hormone have Hashimoto seeing as how the vast majority of people do not appear to be getting tested for antibodies and even then the test is inaccurate.
The study done in India on children living in an iodine poor region indicated that mild iodine deficiency resulted in TSH of 3.5 to 5.5. Moderate deficiency was higher still. Children whose parents used iodized salt did not have iodine deficiency. But iodized salt in India is more expensive and poor people buy what's cheapest. Supplementing with iodine brought thyroid function to normal. Goitre takes about 12 months to go away when oil based iodine depot injections are given in developing countries where iodized salt is not readily available.
I think the first questions doctors should ask the patient with marginally poor thyroid function is about dietary habits. In Toronto we have had a veritable epidemic of thyroid cysts and goitre among people who have decided that 'natural' is better and have been using uniodized sea salt for their cooking, avoiding milk ("milk is for calves not adult humans"). People do not have the education to realize that we live in the Goitre Belt where there is no natural iodine or selenium.
My assistant (Hindu from Orissa state, mostly vegetarian but does eat small amounts of meat and is lactose intolerant) has TSH 1.4, fT4 14, fT3 5.4. NO problem, right? She is getting enough iodine because rice, roti and dal are inedible without salt.
Her ferritin was low, her B12 is probably low (not been checked, incredible, but I told her to tick the B12 on the requisition she's got for today's blood testing for hemoglobin and ferritin etc.), her vitamin D was good (she's been taking supplements for a few years now), folate was high. She is balding, has neurological symptoms, fatigue, blah blah blah. Her hemoglobin was low. Now after supplementing iron, last time her ferritin was 66 and her hemoglobin was 11.9 (lower than last year! Which is why I told her to tick the B12 box. She has been screened twice for Thalassemia trait and it was negative.) I'm truly gobsmacked that no doctor has so far tested for B12 when, according to the study done by two Indian doctors here who have a few thousand patients from India discovered that 47% of their patients are B12 low or deficient (and our bottom of range is 134!! They consider a level of around 200 to be fine. Now I'm going to do a faceplant!)
Thank you for your informative reply - phew ! - hope it is helpful for others too. I am aware that Hashimotos is not linked to iodine - it's just that the jury seems to be out as to whether you should supplement when you have anti-bodies for fear of a flare up. I have never avoided salt ( probably adrenals - I no longer dab up the bits on the table from the mill ) I also see that iodine is in my Nutri Thyro Complex. However after diagnosis in 2005 I still have high TPO - around 950 - which is the same as then Nothing has reduced them - but I do feel fine. Maybe there is a link with the Crohns that I have had for over 40 years - still feel fine though I do not drink milk - having grown up on a dairy farm I have never been too keen. Eat lots of sheeps' yogurt here in Crete - ummm !
Marz, have you ever had antibodies to yeast (the kind in bread and beer) tested? The percentage of Crohn's patients who are 'allergic' to this type of yeast is very high but since you've done so much research over the years, I'm sure you don't eat or drink yeasty anything.
There was a study done in Hungary with patients who had been diagnosed with Celiac, Crohn's and colitis. The highest percentage with antibodies were in the Crohn's group. 9 months of zero yeast and the antibodies went away. Re-introduction of yeast immediately raised the antibody level. (I don't know where I stashed that study. I sent it around when I had it but didn't save it on this laptop. My other laptop drowned in olive oil.............no, I'm not going there........urghhhh. Olive oil is good for us, not for laptops.)
One of my friend's who was diagnosed (finally) with Celiac (via biopsy) last year in September has gone gluten free but his naturopath wants him to be yeast free as well. He probably now has permanent neurological damage due to extremely low B12 but is gradually working on raising his blood level. He got some blood taken yesterday but here the antibody test in not available at all. I think he should just go yeast free for months and see if he feels any difference. No harm done if he doesn't. It just means no kefir, no kombucha. He was very antagonistic about everything when still very ill. Now he's gotten more rational and wants to explore the possibilities of being healthier as he is gradually improving from feeling hopeless to hopeful.
Don't do beer or bread - but am off out for Dinner with friends so will enjoy a glass or two of wine - guess that has its problems too with moulds et al....will re-read both your posts again in the morning - when I am at my best ? - and have a good think ! Have only really been learning stuff since being diagnosed with Hashi's in 2005. Before that it was just luck that I chose a few good things
Thanks so much for all your posts. That's a lot of knowledge and information and I'm going to have to read it all a few times.
Like Marz, I too am on Thyro Complex and it has worked wonders for me. I wonder if do need the iodine in it? I eat a reasonably healthy diet, with lots of fruit and veg and fish, minimal wheat. But also very little dairy, which is not intentional but mainly because I drink so much water to take pills that I don't use milk in drinks anymore.
That's the thing though: iodine is needed for more than the thyroid. This is why when someone gets RAI, they have to suck on sour sweeties for a few days to get the saliva flowing and not allow the radioactive iodine to sit in the salivary glands and destroy them too.
I sent Clutter a very interesting lecture from back in 1924. This was given by a doctor to the British Medical Association. He had worked in India. These sorts of documents are absolutely fascinating because they are based on observational skills today's doctors entirely lack. Today it's all about high tech blood tests. In those days there was a lot of other information brought to bear. Enjoy:
I have wondered about iodine deficiency - I should have thought about that when I ordered FT3. I do drink fairly copious amounts of milk so that's not a problem. I'll be ordering iodised sea salt so that may help.
I forgot: breast tissue is an iodine sponge. Fibrocystic breast disease is helped by supplementing iodine. (But I'm not a fan of the large doses recommended.) Probably up to 400 mcg per day is fine although double that is not toxic. I'm leery of Brownstein and some of the older practitioners who recommended milligrams per day. If you read the 1924 article, I referenced above in response to Rosetrees, there's more to thyroid problems than just iodine. And thyroid problems can resolve under appropriate conditions.
We are living in a day and age where pathogens are transported from continent to continent: think influenza. We are a big mashup of all the bacteria (especially those) and viruses that travel around the globe these days at the speed of airplanes. We are exposed and re-exposed to so many things that our distant ancestors would have not experienced. (I mean consider that small pox was never present in North and South America until Europeans arrived. And neither was malaria, yellow fever, measles.............the list is long.)
The doctor who wrote that essay explained how poor hygiene and contamination resulted in goitres which would go away when conditions were clean. What's the deal with dirty water and dirty food? It adversely affects the gut microbiome. And that's a huge big deal.
I watched a lecture given by Dr. Alessio Fasano regarding Celiac disease. He ended his lecture with an acknowledgement that it is the gut microbiome acting in concert with genes that triggers celiac and other autoimmune diseases. He's difficult to understand because of his accent and the recording isn't fantastic. But there are other lectures he's given that are available on YouTube.
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