Hospital Blood test results help!

[nikki2975]

Finally got a copy of my blood results that were done on the 15th March and need some help and advice with reading them as i don't know/understand what they all mean and what i have and don't have?

15/03/2016

Urea & Electrolytes

Estimated Glomerular Filtration Rate - >90     [>90mL/min/1.73m2]

Urea (Serum) - 4.5       [2.5-7.8 mmol/L]

Creatinine - 62             [44-97 umol/L]

Sodium (Serum) - 140    [133-146 mmol/L]

Potassium (Serum) - 4.1   [3.5-5.3 mmol/L]

Free T3, T4, TSH, TPO, TSH Receptor

Free T3 - 6.2         [3.5-6.5 pmol/L]

Free T4 - 18.2       [10.0-20.0 pmol/L]

TSH - <0.01         L[0.35-5.50 mU/L]

Thyroid Peroxidase AB level -  >1000      H [<35 IU/mL]

Anti - TSH Receptor AB - 1.1       H [0.0-0.04 U/L]

FBC

Haemoglobin - 129         [115-165 g/L]

RBC - 4.64                        [3.80-5.80 x10^12/L] 

HCT - 0.39                        [0.37-0.47 L/L]

MCV - 84.8                       [84.0-105.0 fL]

MCH - 27.8                      [27.0-32.0 pg]

MCHC - 328                    [305-350 g/L]

RDW - 16.1              H    [11.5-14.5]

WBC - 9.5                       [4.0-1.0 x10^9/L]

NEUT - 5.2                     [1.8-7.5 x10^9/L]

LYMPH - 3.4                  [1.0-4.0 x10^9/L]

MONO - 0.6                  [0.2-0.8 x10^9/L]

EOS - 0.1                       [0.0-0.4 x10^9/L]

BASO - 0.0                    [0.0-0.01 x10^9/L]

PLT - 330                      [150-450 x10^9/L]

Thanks 

Nikki

[Roadrunnergreg]

Looks mostly good, my only thoughts are your antibodies are high TPO thyroid peroxidase and TSH antibodies, are you hashimotos? N do you take thyroid meds like levo, your thyroid levels look spot on IE TSH FT4/3 have you had nutrient levels checked, like B12 D3, iron and zinc 

[nikki2975 in reply to Roadrunnergreg]

don't really know for sure... my old and current consultants said i was and diagnosed me with it but my doctor thinks i'm hyper and i'm having symptoms of all 3. i was on 20mg Carbimazole but not had to take them for a while as it goes normal to high and back by itself. I have a doctors appointment on Thursday so i'm not sure if they will put me back on them or not. The only ones i have had checked are Vit D & Iron and these were low at the time and was put on supplements for it but i had another blood test last week to update them so i guess i'll find out on Thursday. 

[Roadrunnergreg in reply to nikki2975]

Did you get your results Nikki so you have a couple of autoimmune issues then, work on firing up the immune system IE feed it/build it up... 

[nikki2975 in reply to Roadrunnergreg]

Hi, yes i did...I have been re-diagnosed with subclinical Thyrotoxicosis and Hashimoto's. At the moment i don't have to go onto medication but have to have my levels retested in 6-8 weeks. 

Still being looked at for the problem with my Liver... my out of range Red and White blood cells have all gone back into range apart from one which seems to show that there is an infection or has recently been an infection in my Liver. the symptoms seem to come and go and have done for at least 3 years now and the same marker has been there in my last 2 FBC tests which i had in Jan and March not sure if there was a marker in previous FBC tests. I also have a high range for Alkaline Phosphatase and have had that for the same last 2 tests.

My Vitamin D & Iron levels are back in range but i have to keep taking them for 3 months and see where they are after that. 

I have a form to check my B12 and Folate as i have a lot of the deficiency symptoms but never thought to check them before as most of them could also be thyroid related. My Red blood cell distribution width is out of range too which suggests a deficiency in B12.

How do i build up my immune system?

[Roadrunnergreg in reply to nikki2975]

Hi with your red blood cell distribution width I'm guessing you mean your MCV level, if it is then usually it's down to inflammation and or candida. I'll bet the candida us in the Liver migrating from the lower intestine to the Liver via the Portal Vein, and can cause NASH IE the dying /toxins from the candida cause a fermentation non alcaholic, so diet may well need addressing IE reducing simple carbohydrates IE sugar, bread, and starches like White potatoes etc low Neutraphil count IE below range leaves you open to bacterial infections, low neutraphil =low folate levels, ie neutropenia... Hope that helps... 

[helvella in reply to Roadrunnergreg]

Roadrunnergreg,

You have confused me there. Red blood cell distribution width is a measure of how varied the sizes of the red blood cells are - rather than the mean of their sizes.

The MCV can look entirely acceptable - but at the same time RDW can be high. The classic explanation is something like: iron-deficiency reduces MCV and low B12 increases MCV. If you have both then some red blood cells will be small (due to iron deficiency) as others are larger (due to low B12) so they cancel each other out.

[Roadrunnergreg in reply to helvella]

Err your right done some checking up, so it's getting to the bottom of it, but also copper is a factor in iron regulation too, IE low copper can cause low iron... As for building up the immune system, it's done via diet and supplementation that feeds the immune system, there's mushrooms like Chaga, Ganoderma, and herbs like Bacopa 

[nikki2975 in reply to Roadrunnergreg]

Got some more blood test results back from bloods i had on Wednesday. My Vit B12 is normal but my Folate is low. My Iron levels were low too during my last test in March but are back within range. I have to retest my Vit B12 & Folate once i had added some leafy greens to my diet. I'm really struggling to start it. I have made some changes but i'm guessing nothing that's really helped as i haven't lost anything.

[Roadrunnergreg in reply to nikki2975]

Got to ask B12 being normal? Where is it in the range ideally needs to be at the top end, also low folate, below range is mild neutropenia, neutrophil count about 1.8 can equal low neutraphil count, and neutraphils are used to fight bacteria 

[nikki2975 in reply to Roadrunnergreg]

I couldn't get copies of the results when I went in but I have to go again tomorrow so I'll get them then. I know during my last fbc my neutraphil was within range but I have had another fbc since that one so I'll check and post them tomorrow. 

[Roadrunnergreg in reply to nikki2975]

Your entitled to a printout for personal use free of charge 

[nikki2975 in reply to Roadrunnergreg]

Yeah, I meant they were busy and I couldn't be bothered waiting as had other things to do but I will get them tomorrow as I had Ferritin, Fsh/ lh, Hepatic profile, Fbc, ESR, CRP tested too. I have to retake the B12 and Folate when I have added and eaten leafy greens in my diet. If I hadn't of asked for the Folate to be checked we would all still be thinking the symptoms were down to my thyroid which is within range so I knew I couldn't have that many symptoms as I do with it. Luckily we know it's the Folate and hopefully get the problems under control. I want to be fully aware of all my health problems and have them under control by the end of the year. I'm sick of it being one problem after another 

[Roadrunnergreg in reply to nikki2975]

Sorry I can't emphasise enough being in range ain't good enough, it's where you are in the ranges that count the most if you want to feel well, I speak from experience myself also not everyone well not many do well on levothyroxine alone without lingering symptoms that NDT can get rid of if the accompanying nutrients are taken. Just because you eat a food even veggies doesn't mean your getting the nutrients, remember they have to be in the soils their grown in to be taken up into the foods to be used by the body... 

[Roadrunnergreg in reply to Roadrunnergreg]

Being in range can be like wearing size 5 shoes on a size 6 foot I'll leave that to your imagination 

[nikki2975 in reply to Roadrunnergreg]

I don't really understand the ranges apart from to be within them is better that out of them. I don't have to take any meds for my thyroid at the minute but if I do it's Carbimazole. The more I think I know the more I find I know nothing at all  

[Clutter]

Nikkie2975,

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's) and TSH Receptor antibodies are positive for autoimmune Graves Disease.

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

TSH 0.01 is suppressed but because FT4 and FT3 are within range the diagnosis is likely to be subclinical hyperthyroidism.  It's actually a bit tricky because when Hashimoto's first presents it's not uncommon to have transient hyperthyroidism until the disease damages the thyroid gland causing hypothyroidism.  I think you are likely to be in a watch and wait scenario until FT4 or FT3 either climb above range when you will be considered overtly hyperthyroid, or FT4 and FT3 drop until TSH rises above range and you become hypothyroid.

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

Estimated Glomerular Filtration Rate - >90 means you have good kidney function.

Your other results with the exception of RDW are within range.  labtestsonline.org/understa... will explain what all the full blood count tests are for and what a high RDW means.

Type the names of the other tests into labtestsonline.org.uk to find out what they are for.

_________________________________________________________________________________________

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.

[nikki2975 in reply to Clutter]

Thank you for your help again.

I was originally diagnosed with Hashi's in July 2014...if it was gonna eventually cause hypothyroidism wouldn't it of done so already? I'm still trying to work out how it all works but 2 years seems like a long time without it doing enough damage to the gland to go one way or the other.

As for the fbc..i noticed that a few of them that had markers in my last post seem to have gone back into range now which is great. I'll get the results from the Celiac's & Crohn's disease tests on Thursday to see if i have tested positive for either of them or whether it needs looking into further as on the labs online link you gave me it says that some of the out of range bloods could be due to an inflammatory disease like Celiacs or IBS and there is a problem with my Liver or at least around that area so fingers crossed i'm finally getting to the bottom of everything i have so i can start getting my health back on track.

Do you think i need to go back on medication for the sub-clinical Hyperthyroidism? when i was diagnosed with that they said i didn't need to go back on Carbimazole and that the results from the Ultrasound would determine the long term management but i haven't had an ultrasound this time and don't know whether i should be taking my meds again or not? they said they would consider an ultrasound if my AB's came back negative.

[Clutter in reply to nikki2975]

Nikki2975,

It can take years/decades for Hashimoto's to cause hypothyroidism and some Hashi patients don't become hypothyroid.  Having Graves and Hashi may mean you become hyperthyroid rather than hypothyroid.  If you are feeling very hyper then Carbimazole may be helpful. 

An ultrasound shows the size and condition of your thyroid gland.  I don't know whether it can determine whether enlargement or damage is due specifically to Hashimoto's or Graves.

_______________________________________________________________________________

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.

[nikki2975 in reply to Clutter]

Received a letter from my consultant today to say i have Subclinical Thyrotoxicosis and that i don't need to take any medication at the moment but to retake the TFT in 6-8 weeks and fax the results over for them to look at. nothing was mentioned about having the ultrasound. 

[Clutter in reply to nikki2975]

Nikki2975,

Watch and wait monitoring to see whether your FT4 and/or FT3 rise.

[nikki2975 in reply to Clutter]

I've had a few people tell me that getting doctors to check your FT4 is hard. Should i insist on checking both everytime i have my TFT?

[Clutter in reply to nikki2975]

Nikki2975,

FT4 and FT3 should be tested as you are subclinically hyperthyroid.  Yours were tested and reported in your original post above.

[nikki2975 in reply to Clutter]

That was done by the hospital not my doctor though and it will be mostly my doctor that requests the TFT alonth with the FT3 & FT4. my next hospital appointment is end of June.

[Clutter in reply to nikki2975]

Nikki2975,

It's your FT4 and FT3 which need monitoring so your GP should request TSH, FT4 and FT3.

[nikki2975 in reply to Clutter]

Thank you.

[nikki2975]

My consultant says i don't need to be on medication at the moment and to check my levels again in 6-8 weeks but i am getting some symptoms still. I have a blood form to check my B12 & Folate as a lot of them could also be caused by a deficiency in one or both of these. If i don't have a deficiency in either i might go back to my doctor and see what they think about me going back on medication. I don't feel ill with it but my hair is falling out, my insomnia is really bad at the minute along with my anxiety and irritability.