Lab results

Hi, would someone be able to tell me if these are ok?

TSH 2.610 mU/L (Range 0.270 - 4.200)

Free T4 17.78 pmol/L (Range 12 - 22)

Free T3 4.8 pmol/L (Range 3.1 - 6.8)

Thyroid peroxidase antibodies - Negative <60

Vitamin D - 32.7 nmol/l (25-75 nmol/l : Borderline ranging to insufficiency)

Got primary Sjogren's Syndrome. Concerned about my thyroid as gave some symptoms but gave had to order private bloods as GP highly unhelpful !

Advise would be much appreciated.

Thanks

12 Replies

oldestnewest
  • I am not altogether sure about the FT4 and FT3 with Sjogrens but your VitD is definitely far too low. If your gp is reluctant to prescribe you must get yourself some VitD and take at least 4000iu daily for 50days then get your blood checked again. You might need to supplement Vit D for life depending on where you live. (How much sun there is especially in winter). Some far wiser people on here will give you a lot more help than I can.

    Gp's are woefully ignorant about thyroids, as most of us can tell you, and will tell you everything is 'fine', 'normal', 'in range'. Well things might be in range but that doesn't mean they are optimal. Be prepared for a long slog with this one. Best of luck.

    Barb :-)

  • Thank you Barb. Off to buy Vit D this morning and hopefully new GP will work with me. Soon know !

  • Alison, you are negative for autoimmune thyroid antibodies. TSH is a little higher than euthyroid (normal) and your FT4 and FT3 are reasonable. Sometimes non-thyroidal illness may make FT3 a little low (yours is just under 50% through range) which causes TSH to rise. It's worth repeating TSH, FT4 and FT3 tests in 6-12 months to keep an eye on. As you already have an autoimmune disease it can predispose you to others so an annual thyroid antibody test is probably a good idea.

    Your vitD is very low. I think 5,000iu daily for 6 weeks will boost levels and you can cut back to 2,500 daily after that and retest in 6 months. Good levels of vitamin D aid T4 to T3 conversion.

    thyroiduk.org.uk/tuk/diagno...

  • Clutter thank you for the info. Don't trust the GPs any more so i very grateful.

    Will give results to my new GP though and see how it goes. Will start on Vit D today.

  • Alison, BTA protocols make it very unlikely any GP will consider making a diagnosis and treatment before TSH is >4.2 or FT4 &/or FT3 are below range.

  • Thanks Clutter, I was going by the guidelines that our local health people have recommended. I did think I had read somewhere about 5000 iu being optimal but couldn't find the link. Barb

  • grassrootshealth.net

    The above site gives you a chart showing you the dose to take according to your results. The range used is different so if you divide your result by 2.5 - which brings it to 13 - you can see to reach the suggested level you will need around 5000IU's daily...as Clutter suggests. This is an interesting website to keep you informed about D as well as....

    vitamindcouncil.org

    Don't forget to take K2 with the D. D increases production of calcium and K2 ensures calcium travels to the right places and not remain in the bloodstream....

  • Allison, autoimmune disease if often attributed to "leaky gut" which allows the attack of immune cells to target your particular genetic weakness. Most of these are located in the gut and would be a good place to pursue some healing. Probiotics might be a start and avoiding food sensitivities that don't agree with you. Often gluten is a problem for some, dairy is another, so you may want to avoid one of those at a time and see if it makes a difference. Naturally, highly processed food and taking antibiotics can be a source of leaky gut as well.

  • Hello Alison,

    I've been on my own "vit D" learning curve since August 2010, which started by hearing a fab. Radio 4 prog on it - still available at: bbc.co.uk/programmes/b00t66nr

    If the above link does not work, even with cutting & pasting, do persist to find the prog on the BBC Radio 4's Food Programme site - it was aired on 1 August 2010, initially. [It is STILL available for listening as at Sat 7 March 2015, as are many previous programmes, though I've just had a little difficulty relocating it]. WELL WORTH THE 25 min LISTEN . . . . . . and therefore HIGHLY RECOMMENDED ! ! ! HIGHLY RECOMMENDED ! ! !

    THE 2010 PROGRAMME PREFACE (text) FROM THE Radio 4 SITE ( - for convenience):

    "A growing body of evidence suggests we may need more Vitamin D. But since access to the sun is limited and people are wary of skin cancer, should we be fortifying more foods with Vitamin D or consuming supplements?

    Health professionals have been appalled at the return of rickets in some communities and studies have shown that infants can be at risk of heart failure if the mother is lacking in Vitamin D. Current guidelines are based on the avoidance of rickets rather than on an optimal amount of Vitamin D for health. Why is the UK apparently behind other countries in its recommendations and in supplementation and fortification of foods - and does this need to change?

    Producer: Margaret Collins."

    ---------------------------------------------o0o----------------------------------------------------------

    From the information I have gathered, including from the above, I STRONGLY suspect you will be FINE supplementing with "vit D3" ( - which is actually a "pro-hormone") at 25mcg/day ( = 1000IU/day). I elevated my levels QUITE SUCESSFULLY (from 26nmol/L) with this dose some 4.5 years ago, after getting a test ( - only just available then via the NHS).

    25mcg/day is the "maintenance dose" Prof Veith on the programme says he uses . . . . . . . and I have found that DOSE is TOO HIGH for me for maintenance ( - I do NOT FEEL WELL on levels ABOVE 70nmol/L; see the details in MY other "vit D"-related posts). ADEQUATE blood levels (of the marker, 25(OH)D3 ) CAN be taken as 50nmol/L (for the WHOLE population) as a guide/rule of thumb ( - with YOUR test ranges interpreting that 50nmol/L as "Borderline ranging to insufficiency", or perhaps (not least for me!) "misinterpreting" it ! ! !

    We do NOT know and CANNOT tell where ANY ONE PERSON'S OPTIMUM "vit D" level might be ( - including yours). If you want to take a 25mcg TWICE a DAY for 3 to 4 weeks, that would be fine too, I suspect, but as your blood level rises, I FEEL its VERY IMPORTANT to proceed SLOW & STEADY at say 25, or 20, or 15mcg/day ( with this pro-hormone - NOTE THE SIMILARITIES with thyroid hormone supplementation, esp. Levo). It IS slow TO ACCUMULATE in the blood and get levels of 25(OH)D3, "25 hydroxy-D3" to rise - SIMILAR to taking Levo and getting T4 (thyroxin) blood levels to rise.

    I know the above guidance/suggestions DIFFER from other viewpoints on this forum and elsewhere. However, I know as A FACT, daily doses of 125, 250mcg (5000 & 10,000IU respectively) and HIGHER continued on a LONGER TERM basis ( - and WITHOUT retesting) CAN BE PROBLEMATIC for some (more than others) from PERSONAL experience and collected anedotes.

    As with thyroid hormones, AS WELL as RETESTING, its VITAL to ask one question:

    HOW DO YOU FEEL at this (tested) LEVEL ? ? ? How WELL do YOU feel ? ? ?

    Many WILL be fine at 125nmol/L ( - as Prof Holick says he does) WHERE AS others can & DO feel ILL/UNWELL at approaching or above 75/80nmol/L. [This is WHY the "newer/more recent" reference ranges, with the lower (guidance) VALUE of 75nmol/L had better be taken with a "pinch of NaCl (salt)"].

    So, a dose of 25mcg per day ( - or 2 such doses for the first FEW weeks, followed by 25mcg or lower daily thereafter) I suggest will be fine/optimum for many ( - and therefore perhaps you) [- with 5mcg/day ( - the RDA of "vit. D") being too LOW and doses MUCH higher, especially if continued, likely to cause unwellness ( toxicity ?) in a proportion of the people taking this].

    DEGREE OF DEFICIENCY: Taking the lower reference level as 50 nmol/L ( - and not 75, as per your results), a result of say 33nmol/L is 66% of the lower ref. value - this could reasonably be described at "mild or moderate inadequacy (or insufficiency)" - nothing much to be concerned over ( - having been identified) and EASILY ( & cheaply) corrected. On this reference range (with lower figure of 50nmol/L), levels below 25nmol/L would be classed as "DEFICIENT". Your result (of ~33nmol/L) is ABOVE "deficient levels" and would be logically classed as a "mild or moderate inadequacy".

    The CORRECT supplement, as Prof Veith explains, is that containing "vit D3" or cholecalciferol (chemical name) now available as tablets, capsules, sprays, chews and drops ( . . . . at least !).

    I believe the above gives A BALANCED view - & I'm aware that many practitioners ( some of them very "experienced", such as Holick, Cannell etc) do recommend higher doses, which I feel are well meant, but sometimes OVER-ZEALOUS. However, there are ( - and WILL be) people who ONLY FEEL at their best with blood levels of 100nmol/L and OVER. [We ALL have to find our own OPTIMUM level by trial and error ( - which for the whole population is likely to be between 50 and 200nmol/L)].

    I will be MOST INTERESTED to learn of ANY EVIDENCE that people(s) with higher optimums (100, 125 and higher, say) are MORE LIKELY to require lower & declining levels from "such heights" for at least a few months a year ( - as would be the case in nature, with seasonal changes); OR whether they can artificially through supplementation, maintain their "endocrinological summer" all year long, year after year, withOUT detriment to themselves. Big "PROSPECTIVE studies" would be required to determine this, which probably will NOT be done for awhile. However, we have more than enough to go on, for now.

    IMPORTANT: Levels NATURALLY acquired by SENSIBLE SUN-EXPOSURE are said to be superior to those obtained by supplementation ( - which remain a good second option in the absence of enough sunshine, as in many months of the year in the UK).

    Do see my other ( - lengthy-ish) posts concerning this powerful pro-hormone which we've come to (incorrectly) call "a VITAMIN" due to a historical medical misconception.

    Finally, I recommend getting your "vit D" levels comfortably into the 50s and 60s FIRST before TINKERING with thyroid hormones ( - which you may or may not then need). I will also be keen to know whether upping the "vit D" REDUCES your TSH - it may well.

    Good luck Alison - I hope you have ALL you need ! ! !

    Blessed be !

  • Wow! So many knowledgable replies. I have started on DLux spray today and will do 5000iu.

    I am hoping my new GPs will work with me as opposed to brushing me off. I only got diagnosed with Sjogrens after just about 12 mths of my GP brushing aside symptoms then basically telling me there was nothing wrong with me and intimating that I'm a hypochondriac ! There followed 8 mths of me refusing to go to the GPs and putting up with my pains. Then I was so ill whilst abroad at my in-laws in July on my return I had to go in. Flu like symptoms, given antibiotics told it was a virus, every week for 4 weeks I went in. Desperate for an answer to my crippling muscle tightening, stiffness, fatigue, it had been getting worse over a period of at least 5 yrs. On the fourth visit I I broke down begging her to do something, she pulled a blood sheet ticked everything and passed it me telling me she would prove there's nothing wrong. I was dreading going back so delayed it and after a week and a half got a call to go and see her. Sjogrens or SLE, she was rather sheepish! Private Rheumy and got Sjogrens which is more systemic, dryness only been bad this last 4-5 weeks. GP gone back to normal, lack of interest! Gone through all three at the practice this past 5 weeks and all think I should just have dryness! Put on 60mg prednisolone for inflammation, which I told him wouldn't work! Four days later told to taper by 5mg every 3 days (2 mths to stop something I shouldn't have been put on), he had no answers for me! Another crying dicky fit last week when told I had no inflammation and just offered pain killers when I went in due to increased inflammation all over and because for best part of three mths my sleep pattern has been horrendously bad, lump in throat, breathless, constipation. Sleep for average 3:40 and no more that 1:15 straight ! Told 3rd GP to shove his painkillers and pointed out I would never return there. Low and behold the day after he rang me to ask me to go in, like hell ! The day after that he rang again, had spoken to my Rheumey who had pointed out I'm more systemic in symptoms and needed IM steroid. Begrudgingly went in for it! What an attitude change! "Yes Mrs, Yes Mrs, Yes Mrs". Changing GP, can't work with people who won't listen to me, I'm living with my body and know it best after 47 yrs!

    I had the TSH/T4/T3/TPA done myself as I have so many symptoms of thyroid and can't tell if it's my SS playing up more or not. Only tagged on Vit D as it was free if ordered test cost more than £60, which it did. Glad I did. Hopefully, thanks to all the help desiphering the tests on here, I can get back to normal and find out if my Hydroxichloroquine is working on SS.

    Bit if sun on hols in a weeks time might give it a boost as well. Thank you all so much xx

  • Anyone can see you have been going through a challenging time, Alison.

    However, its A HUGE step forward to finally get a CORRECT diagnosis - WELL DONE !

    Which company is giving FREE VITAMIN D tests, with orders over £60, please ?

    These tests cost over £25 each. One private source of postal tests is City Assays, interestingly part of the NHS ( - easily found).

    Also struck by: "Flu like symptoms, given antibiotics told it was a virus, . . . . . "

    WHICH GP does NOT know that ANTI-BIOTICS don't TOUCH viruses ? ? ? VERY ODD ! ! !

    "Curiouser, and curiouser" ( - said Alice).

    Take care Alison - one day and one breath at a time (for ALL of us).

  • Thank you Epictetus. The tests were done through Blue Horizon Medicals and I linked to them through either Arthritis UK or Throid UK for special prices as well.

You may also like...