Concerned and frustrated once again

Hi everyone, can anyone please give me your opinion on these results which we have just received for my 15yr old daughter who has been struggling for some time now-

Crp 0.30 ( <5.0 mg/L ) Ferritin 34.4 (20-200ug/L) Tsh 2.39 (0.28-4.3IuL)

T4total 103.7 (64.5-142.0 nmol/L) FreeT4 16.14 (13-23.2pmol/L)

FreeT3 5.12 (3.7-7.7pmol/L) Serum folate 13.13 (10.4-42.4 nmol/L)

AntiThyroidperoxidase abs 5.6 ( <34 klu/L)

AntiThyroglobulin Abs 12.9 (<115 ku/L) B12 318pmol/L which have all been suggested as normal-if so why is she still struggling?

Her Tsh was 4.66 june last year and has been yo-yoing since unfortunately not all other tests as these have been done til now and these were private.

Help??

Thanks Kaz65

10 Replies

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  • Low antibodies mean not Hashimotos.But Ferritin ,folate and B12 are all low and need supplementing. B12 should be around 1000. Look for Jarrows B12 or Solgar and a B complex to keep the B vits in balance.

    Hopefully others will advise on taking ferrous fumarate with 1000 mcg Vit C to aid absorption.

    It does look as though her thyroid is struggling but GPs are unlikely to do anything with her TSH in range.

  • Thankyou Treepie,

    My daughter has been struggling for a long time now and she has been diagnosed with VitD deficiency and CFS, she has a long list of symptoms and i think the worst of them is fatigue, hair thinning, aches and pains, and anxiety is so high she is seeing a counsellor to help-her confidence is so low. Its frustrating because as i said june last year her TSH was 4.66 and only a few months before we received the result the lab charts were changed from 0.5-4.5 to 0.5-5.0 and since then she has been taking some vitamins but I think lots more vitamins are in order and see more tests in 6 months?

    Thankyou for your opinion, it helps to know there is people you can chat to.

    Kaz65

  • Hi kaz65 As Treepie has said, with her thyroid results all in range no doctor will do anything, however her TSH may be showing signs of her thyroid struggling and her FT4 is low in the range, FT3 just coming up to half way. No positive antibodies which seems good, but although low it would be an idea to get them re-tested at some point, the nature of autoimmune thyroiditis aka Hashimoto's is fluctuation of antibodies. I've had probably 5 low results for antibodies over the years so I have confidently ruled out Hashi's but I wouldn't have ruled it out completely on one low result. The fact that her TSH has been yo-yoing makes me wonder. Do you have any previous results besides the TSH at 4.66 so we can see how they have differed?

    As for vitamins and minerals:

    Ferritin - 34.4 (20-200ug/L) - This is very low and can cause fatigue amongst other things. It should really be nearer half way in range. If she can tolerate ferrous fumerate or ferrous sulphate then she could take those. Doctors usually prescribe 1 x 3 times daily. Take with 1000mg of Vit C to aid absorption and help prevent constipation. If FF or FS is to harsh on her tummy or causes constipation then look for Iron Bisglycinate which is more gentle. Solgar Gentle Iron is one and contains 25mg elemental iron whereas the FF and FS contain about 65mg elemental iron in each tablet. If she's not vegetarian, could you perhaps persuade her to eat liver?

    B12 - 318pmol/L - oh dear, way too low. Anything under 500 may cause neurological problems so try to get that up to 1000 which is what the Pernicious Anaemia Society recommends. Solgar or Jarrows sublingual methylcobalamin lozenges 5000mcg - one daily dissolved under the tongue - should bring that up nicely. After the first bottle is finished (I think 60 lozenges) then she could reduce the dose to 1000mcg daily. You can't overdose on B Vits so nothing to worry about.

    Folate - 13.13 (10.4-42.4 nmol/L) - again too low. Aim for half way through range which would be 26. You will find folate in a good B Complex, which should be taken anyway when supplementing with B12. Thorne Basic B or Jarrows B Right contain 400mcg folate and should bring her folate up nicely. Tell her that taking this supplement probably will turn her pee bright yellow, nothing to worry about, it's the B2 Riboflavin that does that.

    Do you think you could get her Vit D tested? Either GP or through a private test at home, a fingerprick blood spot test from City Assays costs £28 and is very easy to do. I think there's a very good chance that her Vit D is low seeing as the others are.

    PS - sorry Kaz, just seen about the Vit D deficiency. What is being done about that, if something prescribed by her GP I would say it may not be enough. Let us know and we can suggest something.

    Also, you mention hair thinning, this can be a result of low ferritin (as well as a symptom of hypo).

  • Hi Seaside susie, doc prescibed 10,000 units per day of vitD3 she has only just started her second box of them, so i suppose its early days..

    Shes not completely vegetarian but will only eat chicken and the odd egg but as for fish or any other kind of meat she wont touch it, shes been struggling also with nausea and stomach cramps.

    Her other Tsh results after 4.66 have been 2.89, 1.59, 2.39. Thankyou for all your info, its a great help.

    Kaz65 x

  • kaz65 That's good that the GP prescribed 10,000iu D3 per day. It isn't cyanocobalamin is it? Is it one with calcium in? I hope not unless she is deficient. Was her calcium tested?

    Now, I'm guessing that the GP didn't mention Vit K2, they don't seem to know about it. When taking D3 we also need K2. Vit D aids absorption of calcium and K2 directs the calcium to bones and teeth rather than arteries and soft tissues. K2-MK7 is the one to get.

    Her TSH has danced about a bit, some fluctuation will be natural and unless the blood draw was at the same time of day each time then there will be a difference and can't really be compared. TSH will always be highest in the morning and lower in the afternoon. Unfortunately it doesn't look as if it's ever gone high enough to be over range. If you get them done in the future try to make the earliest possible appointment for the blood draw, get your daughter to fast, water only, and have breakfast when she gets back home, that will ensure as high a TSH as possible.

  • Hi Seaside susie again, could you also perhaps help with my results-i was diagnosed with under active thyroid some years ago as border line with a Tsh of 4,5 and have been on the same 75 mg levo since then, my Tsh has stayed under 4.5 since but i havent felt well for a good couple of years so i had these tests done at the same time as my daughter, oh just to let you know we have 9 members of close family with under active ???

    Crp 5.00 (<5.0 mg/L) Ferritin 50.1 (30-400 ug//L) Tsh 0.55 (0.27-420 lu/L)

    T4Total 142.1 (64.5-142.0 nmol/L) FreeT4 20-16 (12-22pmol/L)

    FreeT3 5.54 (3.1-6.8pmol/L) AntiThyroidperoxidase abs 7.1 (<34 klu/L)

    AntiThyroglobulin abs 14.1 (<115 ku/L) Vitamin B12 143 pmol/L)

    Serum folate 11.04 (10.4-42.4 nmol/L)

    When i received results from Blue horizon the flagged B12 as too low and T4Total as questionable???

    Hope you will be happy to give your opinion.

    Thankyou

    Kaz65 x

  • kaz65 With your thyroid tests your antibodies are nice and low so no worries about Hashimoto's.

    FT4 at 20.16 (12-22) is 81.6% through range.

    FT3 at 5.54 (3.1-6.8) is 65.9% through range.

    The aim of a treated hypo patient is for TSH to be 1 or below (so yes, tick that!) and for FT4 to be in the upper third of the range (so around 19+) and FT3 to be in the upper quarter of the range (so 5.8+), if that is where you feel best. So your FT4 is a bit high and FT3 very close.

    Ferritin is low at 50.1 - it should be at least 70 for thyroid hormone to work properly, preferably 100+ to half way through range.

    Folate very low at 11.04. As mentioned above aim for half way through range so 26.

    B12 is seriously low at 143. BH classes <140 as deficient (unless they've recently changed their levels) and you are seriously close to that. I think you should discuss that with your GP because you could be a candidate B12 injections. I don't know what the result would need to be for those but you need something to be done. Anything under 500 and there's a risk of neurological problems.

    So as well as some kind of B12 supplement there's the need for a B Complex as explained above in answering your daughter's results as well as the suggestions for the other supplements.

    What about your own Vit D?

    If you get all your vitamins and minerals at their optimal levels and your thyroid hormone works as well as possible then your conversion might be better and you could see your FT3 come up to be more in balance with your FT4. However, you could also supplement with selenium as that aids conversion.

    I can't comment on total T4 I'm afraid.

    I hope I've covered everything.

  • Hi seaside susie, i cant thankyou enough you have so much knowledge, im afraid in the last five years my memory is not what it was and i cant hold all the info so i write it all down.

    Thankyou

    Kaz65

  • Not really kaz65 I've been pretty ignorant for most of the 40+ years I've been hypo. I just decided 12 months ago to make one last ditch attempt at trying to feel better and I've tried to learn as much as I can. I know what you mean about writing things down, I have to too although some things do stick in my mind :)

  • I think that I may have replied to a previous post, but your 9 members of close family with under active would confirm to me that the issue is genetic.

    Both you and your daughter have good Free T3 levels. Since T3 is the active thyroid hormone which controls the metabolism and therefore the symptoms you both are not hypothyroid.

    If I can be of any help please let me know.

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