I have Hashimoto's and hypothyroidism. My daughter is 21yrs old, slim, hair falls out, foul tempered, very unhappy/depressed, sleeps for 15hrs a day if given the chance, looks generally unwell, catches and holds onto bugs. I bought her private bloods as part of her Christmas present!
I can see that she is B12 insufficient. Everything else is 'in range' and looks OK to my knowledge but does the presence of some TPOab and TGab mean that a repeat test if symptoms persist after B12 treatment (and some lifestyle changes) would be warranted? My TPOab was over 1100 so easier to see my problem.
CRP 0.20 (<3.0)
Ferritin 59.5 (20-150)
Serum Folate 16.71 (10.4-42.4)
FT4 17.94 (12-22)
FT3 5.78 (3.1-6.8)
TSH 2.16 (0.27-4.20)
TT4 98.9 (64.5-142.0)
TPOab 10.9 (<34)
TGab 13.6 (<115)
B12 169 Deficient <140, Insufficient 140-250
Comments anyone?
Merry Christmas 😀
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ClaireandBosch
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The antibody figures seem typical for most people, meaning she is ok at the moment. I have never seen anyone with zero antibodies, so i think we all have them. So i don't think she has hash's.
Folate can come up, what about iron levels ?? Typically they will be low in hypoT patients, certainly woman. Worth getting ferritin tested at the least.
The thyroid panel looks good. Ft4 is in the high teens (tick), FT3 is pushing towards the higher end (tick). So these look good, but her TSH is raised at 2.16. Docs will look and say all is perfect. With these good free figures i would expect a lower TSH, so this may indicate she is not absorbing the T3 as well as can be.
I would have thought the adrenals will be under pressure and she has stress as a main factor as to why she is not doing so well emotionally. This is so typical for young people with the pressures ahead of them. If this isn't sorted out it can lead to more problems and then the thyroid system will start to suffer and you end up on a downward slope.
A 24h saliva panel would be could to see how cortisol and dhea are working.
I would look into food and approach it from a Ray Peat perspective. He has a forum dedicated to his papers and has quite a following. Avoid sunflower oils, for example. His forum can give you a lot of good info.
He is also an advocate of using a little T3 to boost metabolism. A short cut to getting on top of the emotional problems could be to try small amounts of T3. It can be amazing what 5mcg per day of T3 will do.
Pregnenalone is the main precursor hormone we make from cholesterol. It can be very effective in helping stressful problems. See ray peats paper of pregnenalone.
There is a lot we can do to improve metabolism and when i say metabolism i also mean mental and emotional health. These aspects of the health circle are just parts of the overall metabolism, including physical health.
Nutrition, vits and minerals sups and a little thyroid hormone are keys ways to get the metabolism back on track.
I think this looks mostly like a B12 deficiency issue, rather than a thyroid one. B12 deficiency symptoms are very similar to hypothyroid ones and that B12 is very very low.
So the things to consider go along the lines of "Why?" Does she have a poor diet? Is it possible she has Pernicious Anaemia (that's an autoimmune cause for low B12). Or is it possible she has Coeliac Sprue?
Before starting to supplement B12 and fuzzying up the picture, it would be worth getting her to the GP and asking him to test intrinsic factor and the blood test for Coeliac.
Claire, your daughter is definitely low B12. This causes all sorts of problems among them lack of energy and emotional issues. In re: infections: she needs vitamin A (retinol). Back in the olden days, kids got cod liver oil which is a rich source of vitamin A and a so so source of vitamin D (at least it prevents rickets). Good levels of vitamin A are necessary for prevention of respiratory tract infections. This was 'discovered' in England back in the early 20th century.
ClaireandBosch, most people have a few thyroid antibodies but your daughter's are below range which means she is negative for autoimmune thyroid disease (Hashimoto's). I don't think it is worth retesting antibodies within 12 months. TSH >2.0 may be a sign that her thyroid is beginning to struggle but currently her FT4 and FT3 are very good.
Ferritin is a bit low, optimal is 75-100. She could supplement iron with 500mg-1,000mg vitamin C to aid absorption and minimise constipation. Retest 4-6 months after supplementing.
B12 is almost deficient. I agree with JazzW that pernicious anaemia should be ruled out before supplementing.
Folate looks good. Avoid taking a B Complex which has folic acid in it until B12 is treated.
I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.
Lovely, lovely people - thank you so much for taking time out of your Christmas' to comment for me. You have confirmed what I thought our course of action should be and settled my mind re her thyroid.
Diet and stress are definitely an issue for her (though the stress is from the effort of working whilst so run down). I shall accompany her to the GP and make sure we get some action at last.
Poor daughter, and poor you. Speaking from experience I am sure your daughter will feel much better when her B12 comes up. From my own experience it affects our emotions very much as well as making us tired, it's hard to cope with everything, including people. (As a vegan therefore susceptible I have almost ever day Engevita yeast flakes, the ones fortified with B12, and it seems to work brilliantly, they are delicious on baked potatoes and in many other foods. I didn't start this deliberately for the B12, just because they taste good, but a recent blood test showed remarkable good B12 levels for a vegan).
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Blood tests - do I need TGAb and TPOAb checking?
New Bloods
Blue Horizon results-help please?
Advice would be appreciated on latest results please. 
