Latest blood test results - would love some insight

[Nadpa]

I'm a 39 year old woman who was diagnosed with Hashimoto's and Pernicious Anaemia in May 2015. However the thyroid results did not yet show hypo, but actually that I was slightly hyper.

My symptoms were anxiety/depression/fatigue. And not getting pregnant.

(Worth noting that I wasn't trying to get pregnant while having the depression / anxiety. That was several years of trying leading up to the mental collapse)

I started on the SSRI sertralin which I have taken before (age 34) due to stress related anxiety/depression of which I have in severe form once it hits. It helps me with the anxiety/depression and I'm now more or less back to normal. Though I can get the occasional wobble. Still not back to work though since May 2015. I have a demanding job with long work hours and lots of responsibility and I feel I need to be totally fit for fight before throwing myself into it.

Depression runs in my family. But so does Addison's - a severe autoimmune disease. My mother had both.

It seems like my THS is stabilising. However the antibodies keep rising.

I suppose I'm curious to know if any of you have any comment on my results and how it is progressing.

Is my TSH going up because of the antibodies for example? - It started off being suppressed and is now within ranges. Is this the early progression into hypo from hyper? Or is it the b12 injections helping? Also my Ft4 and T3 are plummeting.

The blood results have been taken at different labs by different doctors as I've moved from UK to Denmark, therefore ranges vary and what I'm being tested for.

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May 15th, 2015

FT4 20.8 (9.0-22.0)

FT3 5.79 (2.63-5.70)

TSH <0.01 (0.35-4.94)

Anti-thyroglobulin abs 361 (0-40)

Anti-thyroperoxidase 391 (0-35)

Anti-TSH receptor antibodies 0.98 (0-1.75)

B12 257

Homocystiene 18 (<12)

Intrinsic Factor POSITIVE

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June 26th, 2015

FT4 14,4 (10-22)

T3 1,5 (1,0-2,6)

TSH 0,06 (0,20-5,0)

Anti-thyroperoxidase 1300 (<60)

After one injection of 1000mg b12 since diagnosed deficient in May 2015

Taking 400 Folic Acid:

B12 285

Homocysteine 10,3 (<15)

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Sep 3rd, 2015

FT4 14,5 (14,0-23,0)

T4 86 (70-140)

T3 1,4 (1,4-2,8)

TSH 1,14 (0,65-4,80)

Anti-thyroperoxidase 2470 (<60)

After three monthly injections of 1000mg b12 since diagnosed deficient in May 2015

Taking 400 Folic Acid:

B12 493

Parietal cell POSITIVE

Intrinsic Factor POSITIVE

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Thanks very much for reading!

[shaws Administrator]

I am sorry you are still not feeling well. I believe your doctor hasn't yet prescribed levothyroxine for some reason unknown to me. Some mistakenly believe you don't need levothyroxine if you are 'hyper' (ie with an Autoimmune Thyroid Disease - (also known as Hashiotos).

Because your antibodies will wax and wane, sometimes you will feel more hyperactive than hypothyroid. The doctor should be treating your antibodies with levothyroxine as your thyroid gland is under attack from them. Levo can help to control the antibodies and members have also found an improvement when there food has become 'gluten free'.

Your T3 is very low and your GP should do a Free T3 test and I'll give an extract of why you should have it done. Cursor down to Free T3:-

thyroiduk.org.uk/tuk/testin...

Someone who has hashimotos will also respond. Dr Toft of the British Thyroid Association says people with antibodies should be given levothyroxine.

[Nadpa in reply to shaws]

Thank you! I'm actually feeling pretty good. Which I imagine is the sertralin creating neurogenesis, hence recovering from the anxiety and depression. But it could of course also mask the symptom of hashimotos and pernicious aneamia, which both cause psychological symptoms.

Also it might be the B12 injections. Or both.

What I don't quite understand is how the THS, FT4 and T3 is changing over these months. From suppressed THS to now fine and within range. But FT4 and T3 from borderline top of the range and even over range to now borderline low. Is that because I'm heading towards a hypo condition from slightly hyper? My antibodies are raising drastically as you can see.

I have never taken any meds for the thyroid. And don't have a doctors appointment till December to discuss the blood results from September.

[shaws Administrator in reply to Nadpa]

The TSH varies throughout the day. I think because you aren't on thyroid hormones to help with the antibodies' attack on your thyroid gland that's the cause that you suggestabove about your present results.

[Marz]

Having tests for B12 once on treatment is really meaningless. Sadly Docs do not know this. May I suggest you also post on the Pernicious Anaemia Society forum here on HU. They have a wealth of very knowledgeable people who can advise.

I personally think you need a greater frequency of injections - did you have daily loading doses ? Also there is an auto-immune procedure that can happen in the body that can prevent B12 getting into the cells where it needs to be.

Only about 20% of the B12 in your Blood test result can reach your cells. I am hoping for you that when your B12 deficiency/PA is adequately treated you will lose many of your symptoms you mention. You need a GOOD B Complex to ensure all the B's remain in balance. High Homocysteine is as you know a sign of B12D.

VitD levels also need to be good.

Your FT3 is on the floor - and needs to be towards the top of the range. There are more T3 receptors in the brain than anywhere else in the body - could this explain your symptoms ? Second highest amount in the gut....

Talking of the gut - do you suffer with any issues ?

[Nadpa in reply to Marz]

Thanks Marz. Yes I've already been given great info on the PA forum. I think doc checks b12 just to be sure that it's at least not still as low. But like you say probably useless. However the first endo who diagnosed me in May suggested that once my b12 was in order then the thyroid might also settle. I wonder if that's what is going on. However seems a bit drastic. From over the range FT3 and suppressed TSH to T3 right at the bottom and a normal TSH.

The thing is I do actually feel pretty fine, except occasionally still a bit shaky. But nothing near as bad as it was in May and June. I'm sure that's down to anti-depressants, mindfulness and therapy. But wonder if I'm now masking symptoms of thyroid issues.

I never had the loading doses of b12.

My 25 hydroxovitamin D is 105 (>50)

So that's all good.

No gut issues.

Anyway thanks for responding. I find the thyroid testing so confusing.

[Marz in reply to Nadpa]

With anti-bodies so high it won't be long before your thyroid is far from functioning. You have at least had full thyroid testing - which is good. I do not understand the Medical people thinking your thyroid will settle down when the B12 is fixed. You will have to treat the PA/B12 for the rest of your life - as you may the thyroid. Of course B12 is involved in the intricacies of the thyroid metabolism. Also Ferritin - Folate - Iron. Have those been tested too ? Hopefully you are still taking VitD as your level needs to be a little higher.

Maybe when you are on adequate/optimal thyroid treatment you may find depression a thing of the past. There are so many people with low thyroid and low mood/anxiety - also with Low B12. Symptoms as you know often overlap....

I only asked about gut issues as problems are often implicated in auto-immune issues and mal-absorptions. I would be trying to reduce those anti-bodies if you can. Some people give up gluten and it helps the reduction of anti-bodies.

Glad you are feeling OK ....

[Nadpa in reply to Marz]

Thanks Marz!

I actually don't take any D-vit supplement. So I probably should. Any recommend on what to take? On my blood test result I noticed I was just below range on Free Calcium-ion. A bit of googling and I found that is called hypocalcaemia. And again - symptoms include depression and anxiety. However the low level seem to often have a connection with low D-vit. But at 105 (>50) you think it should be a bit higher?

Sorry for all the questions. Really appreciate the knowledge from all you people who has been dealing with all this longer than I have.

And like you say - I should go gluten free. Sigh

I might very well have gut issues other than the PA. But just don't have any pain.

Thanks again

[Marz in reply to Nadpa]

OK so if your D result is in nmol/L then convert to ng/L by dividing by 2.5 = 42 and then look at the website below Yes you need to be supplementing - at least 2000-3000iu's daily - taken with fatty meals.

grassroothealth.net

To find out more about gluten and what it does to the guts then have a read on-line - Dr David Perlmutter and Dr Sarah Myhill - I have read both their recent books. Also Datis Kharrazian has lots to say about brain health.

As you know serotonin is made in the gut - so the microbiome is crucial - read David Perlmutter and others....

[Nadpa in reply to Marz]

Thanks so much for all this! I'll dive into it now!