Advice on my latest results please

[2pence]

I would be grateful for some thoughts on my recent blood results posted below.

Date                    TSH         Dose          FT4(9.01-19.05)              FT3(0.35-4.94)

09/10/2014        1.22        112             16.95                                3.67

01/12/2014        0.52        125

12/05/2015        0.02        150             20.50                                4.80

23/09/2015        0.02        150             22.80                                4.70

04/01/2016        0.01        150             18.30                                4.00

22/04/2016        0.03        150             17.30

I saw my GP today and this time the lab had only done TSH and FT4 not FT3 as requested nor VitaminD, B12, folate or ferritin.  My antibodies were tested many years ago not long after diagnosis as negative but it doesn't say whether both were done or what the result was.  I was originally diagnosed hypothyroid in 2000 but the surgery's records are not complete.  My cholesterol has gone back up to 5 from 4.3. The slightly higher FT4 in September is due to the fact that I forgot not to take my levothyroxine before going for the test. 

In January I had an appointment at Oxford having asked to see an endo from Louise's list but when I was there I saw someone else and the doctor I asked to see doesn't seem to be there any more.  The professor I saw was only interested in the TSH measurement which he said was too low and that I was over replaced but he didn't want to look at the list of symptoms that I have.  He was very interested in the timeline that I had prepared as I believe that my hormones have never been right.  My GP has said that she will refer me to another endo and I can let her know a name but that she cannot do anything further.

Before I left I queried the HB1aC result that I had having seen an answer by a magazine doctor that seemed to say I was in the diabetic range.  She told me that my result was done using the new method and that the magazine was using the old method.  She explained that her husband has the same result as me and he is very fit and lean.  My result shows that my body is using the food I put into it very efficiently -  I came out wondering why then am I struggling with putting weight on when records show that I am eating less calories than I need.  Can any of you more clever people offer an explanation?

Thanks Penni

[Clutter]

2pence,

Can you check the FT3 range?  It looks like you've put the TSH range.

TSH 0.03 is suppressed so I'm surprised the lab didn't test FT3.  FT4 is close to top of range which is good but as it has dropped to 17.30 it is likely your FT3 has also dropped and it has steadily been dropping since May 2015.

[2pence in reply to Clutter]

Hi Clutter, 

Yes you're correct I put the TSH range instead of the FT3 range which is 2.63 - 5.70.  I queried that the FT3 hadn't been done when requested and my GP said that the chemist doing the test would have made the decision whether it was necessary dependent on the other results.  I pointed out that a chemist did not know me as the patient or why she had asked for it so as a Doctor requesting tests I would be disturbed if what I requested was not done because the chemist decided it was not necessary when said chemist was not the Doctor and was not treating the patient.  

I understand why my results went up when the Levothyroxine was increased but not why they are now reducing on the same dose.  My vitamin results have been good but were not done this time despite being requested.  I am on Vit D from the GP as I was deficient and supplement myself with B12 and B Complex as although within range they were not as high as recommended.  Ferritin has been a little down and was asked for so that I could see where it was and supplement so will do so anyway.

Penni

[greygoose]

I can't offer an explanation, but i would like to ask a question... Where in your results does it show that your body is using the food you eat efficiently? I didn't know they'd invented a test for that! Blood tests only show what's in your blood, not what your body is doing with it.

However, you could be putting on weight because you are eating less calories than your body needs. That is never a good idea because the body goes into starvation mode and stocks everything it can as fat.

Or, you might be putting on weight because you have some kind of hormone resistance, meaning that although you have quite a good level of T3 in the blood, it's not getting into the cells, so you remain hypo.

The fact that your cholesterol has gone up a bit shows that something's not quite right - and that has little to do with what you eat. You really do need those nutrients tested. If your lab won't do them, then getting them done privately would be an investment in your future health. A 24 hour saliva cortisol test would be a good idea, too. But, you won't get that done on the NHS! Nor would your doctor know anything about it. She doesn't sound very clued up on anything!

[2pence in reply to greygoose]

Hi GG

My GP said that because my HBA1C done last September was 7 in the new test range it showed that I used my food very well just like her husband who is very lean and fit.  Under the old test 7 would have been diabetic which is something that I am wary of being hypo and I also have Polycistic Ovarian Syndrome.  To my mind if I am using my foods so efficiently and eating approximately (according to recording via My Fitness Pal) and using approximately 2000 calories daily then my body should be taking the supposed stored fat to make up the difference as I am overweight by at least 6 stone.  They cannot explain why in 2011 I lost around 3 stone without changing anything and in fact being less active due to undergoing knee replacement surgery in the May.  I also saw a dietician yesterday and she has asked me to  make a small change to my diet by having an open sandwich at teatime of something like homemade mackeral pate with a salad topping and to use my trampet more along with walking.  I see her again in a couple of months and she said that if I have followed that and still not lost any weight then she thinks there is a good argument that my weight is down to hormones.  I will do as she asks continue to record my food intake via my fitbit dashboard so that I have printed evidence gathered.

Penni 

[greygoose in reply to 2pence]

But, just because they've changed the range, doesn't mean that the results have changed. If you go by percentages, you will probably find that you are the same percentile through the range. I think, quite honestly, your doctor talks a lot of rubbish. She doesn't know much about it, so is making it up, thinking that you Don't know enough to challange her!

It could be the fact that you were less active in 2011 that led you to losing 3 stone. Any form of activity uses up your T3, so not doing anything would mean that you had more T3, were therefore less hypo, and could therefore lose the weight.

Or, perhaps you have Hashi's. With Hashi's you can swing from hypo to hyper, and with the hyper, you would more than likely lose weight. Have you had both sets of antibodies tested? TPOab and TgAB?  

Be careful with using your trampette too much, because that, as i said, will use up your T3 and make you more hypo. Or, is that what you want to happen, so that they will see that your weight gain has nothing to do with calories - which it hasn't!?!   

[2pence in reply to greygoose]

I don't think that I was bothered about the change in range once I had confirmed that it was the same result.  I was lost for words over the way she explained how efficiently my body uses the food when we had been discussing the weight gain I have as one of the distressing symptoms of being hypo.

My boyfriend brought up private testing using Blue Horizon as it had come up on his diabetic sensor newsfeed as he self funds this to ensure his insulin levels are known.  I think that I will probably do a BH test and make sure that I get all the vitamin results along with the thyroid.

I will be careful using my trampette as although I do have a background of gymnastics I have also been diagnosed with Elhers Danlos Syndrome.  I normally pace myself and when on holiday look carefully at what we are doing as I need to be active/ doing something interesting on one day followed by at least one easy day.

[greygoose in reply to 2pence]

Yes, as I said, your doctor talks a lot of rubbish! Sorry about the EDS diagnosis.