Help interpreting blood results.: Hi everyone, I... - Thyroid UK

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Help interpreting blood results.

sophiethecat2003 profile image
7 Replies

Hi everyone,

I have been taking I have been taking 150 mcg of Levothyroxine for 16 years and 40mcg of Tertroxine for around 12 years. I am 63 yrs old.

I have Hashimotos.

The Tertroxine was added by Dr Skinner when I consulted with him.

I am taking 20mg of the antidepressant Paroxetine which I have taken for 2 weeks, having been on Citalopram for 7 weeks previous.

I also take a vit d tablet.

I am feeling very unwell and although my doctor said the last test results were fine, they were before taking Paroxetine.

Just wondered if the bloods were okay.

I have blood results from February 2015 and have no idea how to interpret them.

The blood test was a fasting one.

Results as follows :

Serum free T4 level (XaERr) - 16.2 pmol/L (10.0 -19.8)

Serum TSH level (XaELV) - 0.1 mu/L ( 0.3 - 5.5 ) Below low reference limit.

Serum free Triiodothyronine level (XaERq) - 6.2 pmol/L (3.5 - 6.7)

Double dutch to me so any help would be fab.

I also have a Blue Horizon test result to come back so will post when it arrives.

Also...looking for help as to when to take meds. My doctor and chemist say take them all together.

Thanks everyone..

Big hugs

Sophie ☺ x

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greygoose profile image
greygoose

Well, your bloods look good. But, it could be that you are one of those people who need their FT3 a bit higher. Are you buying your Tertroxin for yourself? If so, you could try an increase of a quarter of a tablet and if it helps.

Just to help you understand a bit : TSH is Thyroid STimulating Hormone, secreted by the pituitary, which tells the thyroid gland to produce hormone.

The thyroid, basically, produces two hormones T4 (Levo) and T3 (Tertroxine). T4 is basically a storage hormone which has to be converted into T3, which is the active hormone, which is needed by every cell in the body.

When it comes to tests, the TSH is a diagnosis tool, but is useless when it comes to dosing, so Don't worry if it's below range. The FT4 needs to be in the top third of the range, and the FT3 in the top quarter. But ranges are just guides, they are not set in stone. How you feel is far more important. The idea of thyroid hormone replacement is to eradicate all symptoms. If you still need an antidepressant, then you are not optimally treated.

BUT it's not just about hormones. Have you had your vit D, vit B12, folate, iron and ferritin tested? If any of those aren't optimal, they will not only cause symptoms, but will affect the way your body uses the hormone you're giving it. You could very well have nutritional defficiencies after being hypo for so long because we have trouble absorbing nutrients. So, it would be a very good idea to get those tested - if you haven't already - and supplement accordingly.

I Don't think you've been given very good advise about taking your hormone. The antidepressant can affect absorption, so it's best to take that 4 hours away from your hormones.

You can take your Levo and Tertroxine together, either in the morning, one hour before eating or drinking anything other than water. Or in the evening, two hours after eating and drinking anything other than water.

As for the test, you should leave 24 hours between your last dose and the test, which should be fasting - as you did it - and as early in the morning as possible - at least before nine. :)

sophiethecat2003 profile image
sophiethecat2003 in reply togreygoose

Hi greygoose...

Thanks for your reply and help.

I have delayed replying until I got the test results from Blue Horizon.

They are below.

If you have time to comment I would be grateful.

Thanks again for your time.

Sophie x

Biochemistry

Ferritin H 274.1 20 - 150 ug/L

Thyroid Function

Free T4 21.37 12 - 22 pmol/L

Free T3 H 9.73 3.1 - 6.8 pmol/L

TSH L <0.005 0.27 - 4.20 IU/L

Immunology

Anti-Thyroidperoxidase abs H 87.6 <34 kIU/L

Vitamins

Vitamin B12 192 142 - 725 pmol/L

greygoose profile image
greygoose in reply tosophiethecat2003

OK, so your ferritin is much too high. Have you been supplementing? If so, stop. But the high level could be due to inflammation. I think you ought to talk to your doctor about that and get refered to a hematologist.

Your FT3 is much too high. It would suggest that you're over-medicated. Being over-medicated would also make you feel bad. If I were you, I would try reducing your T3 by 5 mcg, give it two weeks, and see how you feel. Then, reduce your Levo by 25 mcg. That is higher than it should be in someone taking T3.

Your TSH is low because your FT3 is so high. It should rise when you reduce the T3.

You do have Hashi's - autoimmune thyroiditis. The antibodies could also be making you feel bad. Your doctor won't do anything about those, but you could try going gluten and/or dairy free (a bit of trial and error there). You could also take a little selenium. A lot of people find that reduces antibodies.

And another thing that is undoubtedly making you ill is your very low B12. You really ought to ask your doctor for testing to see if you have Pernicious Anemia - intrinsic factor and parietal cell antibodies. If you have PA, you will get B12 injections on the NSH. But if not, you need to supplement about 8000 mcg sublingual methylcobalamin daily for a couple of months, then reduce to 1000. You can't over-dose on B12 because it's water-soluble. But you need to get your B12 up to over 500, because otherwise, you are at risk of irreversable neurological damage.

But whether you have injections or take tablets, you need to take a B complex at the same time to keep your Bs balanced, because they all work together.

Did you not manage to get your vit D tested?

sophiethecat2003 profile image
sophiethecat2003 in reply togreygoose

Hi greygoose

Bit of a technophobe, wondered if you got my last message.

Sophie ☺ x

sophiethecat2003 profile image
sophiethecat2003

Hi greygoose,

Thanks for your help.

Don't take ferritin.

I take a Vit D tablet - Fultium - D3 800 IU one a day.

My doctor is away for another 2 weeks, should I see someone else to get this moving?

Do I need to see the doctor about the B complex?

I take the anti-Depressant Parroxetine. Reading up on this it has been connected with Graves Disease (see below)

I have sent you the comments about my tests from Blue Horizon.

It mentions Graves Disease, and that I have been Hyperthyroid for a few weeks. This coincides with me starting the Paroxetine.

Interesting...

Thanks for your help and advice.

Sophie x

The ferritin level is a little high. In addition to excess iron supplementation, raised serum ferritin can be a sign of inflammation or infection (quite commonly), and less commonly from damage to bone marrow or liver, genetic conditions, following blood transfusion, and in chronic anaemias such as thalassaemia.

Raised ferritin due to inflammation is not a sign of too much iron, and is not a sign of disease as such.

Thyroid function tests show a hyperthyroid result (overactive thyroid gland). The high free T3 level is diagnostic, and the low TSH level suggests that the hyperthyroid state may have been developing over several weeks. You may have symptoms already - including weight loss, rapid heart rate, sweating and anxiety, amongst others.

The high anti-thyroid peroxidase antibody test suggest an autoimmune cause such as Grave's disease.

If you are already taking thyroxine medication, you could be taking too much and downward dose adjustment may be in order.

I advise you to contact your usual doctor, with these results to hand.

greygoose profile image
greygoose in reply tosophiethecat2003

No, I didn't didn't see this because you didn't click on the 'Reply' button. I only get and alert if you do.

So, I very much you have Graves or that you're over-active, my guess is that you have Hashi's and are just taking too much thyroid hormone replacement. Look at it logically : if you had Graves and were taking all that hormone on top, you'd have felt very ill a long time ago - and I do mean VERY ill! But BH didn't know what you were taking, did they, so they just covered all angles in their summing-up.

But it does mean that you need to lower your T3, as I said above. Taking too much is as bad as taking too little.

I think you should see a doctor - any doctor - about the high ferritin as soon as possible. Just to make sure. There are other tests they can do. Oh, and the supplement one usualy takes that raises ferritin, is iron. Are you taking iron?

For the B complex, you can buy that yourself OTC. I doubt any doctor would prescribe it, anyway. They just Don't know about these things.

Take care. :)

sophiethecat2003 profile image
sophiethecat2003 in reply togreygoose

Hi greygoose

Sorry about that, I told you I was a technophobe.

No not taking iron.

I will make an appointment to see a doctor soonest.

Thanks again

Sophie ☺ x

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