Help in understanding Blue Horizon Blood Tests and the doctor's comments.

[Vanillaberry]

Hi All. I have had my blood results back from Blue Horizon. I would really appreciate any comments to help me fully understand them and maybe point me in the right direction regarding necessary adjustments to improve nutrient levels as shown on the tests. It seems to me that Folate and B12 are low and Ferritin could be better although not too bad. The thyroid hormone results confuse me as T4 and FT4 are low in the range but TSH is also low. The T3 and RT3 results leave me totally confused. I am pleased however to note that I do not appear to have an autoimmune component to my condition. Healthwise my biggest problems are my inability to lose weight and my permanently reduced body temperature which has gone as low as 34.5. It rarely gets above 36 although I can appear overheated and dripping in perspiration with normal exertion. I am 61 now and have had thyroid problems for over 20 years. Currently I am taking 100 mcg Thyroxine which has been reduced, about 4 mths now, from 100 and 125 on alternate days . I am sorry this post is so long but I am trying to give a full picture. It seems to me that the more I learn the more confused I get. Below is the comment from the Lab doctor and my results. I would really appreciate any comments. Thank you all so much.

"Please find attached your results in PDF format, and our Doctor's comments directly below.

The thyroid stimulating hormone (TSH) level is low. If you are already taking thyroxine, dose adjustment may be necessary - you should discuss this with your usual doctor. If you are not taking thyroxine, it would be wise to keep an eye on this level - either by reference to previous results if known or by checking TSH again in 6 months’ time or so. There is a possibility that hyperthyroidism (overactive thyroid gland) will develop if the TSH fails to rise (a low TSH implies excessive thyroxine production from the thyroid gland).

The elevated level of reverse T3 and low reverse T3 ratio are unlikely to be of clinical significance. There is much controversy about the role of reverse T3 in thyroid illness. Conventional endocrinologists (hormone specialists) generally believe that knowing of the level of this substance does not influence thyroid treatment decisions. The alternative view however is that reverse T3 is effectively 'antithyroid' - T3 is the active thyroid hormone that stimulates the body's energy system (metabolism). Reverse T3 is a mirror image - it goes into cells, and instead of controlling metabolic processes it blocks the effect of T3. In this model, reverse T3 is effectively a hibernation hormone - in times of stress and chronic illness it lowers energy release from the cells - so normal thyroid levels with high reverse T3 may still result in hypothyroidism".

Biochemistry

CRP 5.00 <5.0 mg/L

Ferritin 101.2 20 - 150 ug/L

Thyroid Function

TSH Low 0.20 0.27 - 4.20 IU/L

T4 Total 86.5 64.5 - 142.0 nmol/L

Free T4 15.54 12 - 22 pmol/L

Free T3 4.56 3.1 - 6.8 pmol/L

Reverse T3* High 26.0 10 - 24 ng/dL

Reverse T3 ratio Low 11.42 Normal >15 Borderline 12-15 Low <12

Immunology

Anti-Thyroidperoxidase abs 10.7 <34 kIU/L

Anti-Thyroglobulin Abs 20.1 <115 kU/L

Vitamins

Vitamin D (25 OH) 149 Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 451 Deficient <140 pmol/L

Insufficient 140 - 250

Consider reducing dose >725

Serum Folate 16.16 10.4 - 42.4 nmol/L

[radd]

VB,

Your doctor is medicating you by the TSH and probably doesn't understand the remaining results.

Your TSH is fine but total T4 is low indicating you are under medicated. FT4 & FT3 are both under half way through range and members usually function better with these in the top third of range.

RT3 is over range, meaning meds aren't working as they should and too much T4 is converting to RT3 instead of the biological T3 that will give you well being. Elevated RT3 is thought to prevent further meds from working.

The RT3 ratio is low but because you aren't medicating enough thyroid hormone, this result is not credible and should be ignored. You have no thyroid antibodies. Vit D is too high and probably needs to be stopped throughout summer if you are supplementing. Ferritin is fine.

Vit B12 and folate are too low. Members supplement Methylcobalamin and Methylfolate which is the easiest form to absorb.

Low temps and weight gain are classic symptoms of low thyroid hormone as the body's metabolism slows. Explain how ill you feel and ask your doctor for a med dose raise.

[Vanillaberry in reply to radd]

Hi Radd.

Thank you so much for your reply. I am taking steps immediately to introduce folate supp. and increase my Vit B12 supp.

I still have worries about the Reverse T3 as I have read elsewhere that my problem might be that I am bypassing the T4 to T3 conversion and going straight to RT3 production. The suggestion was that the real issue is one of conversion or rather lack of conversion to active T3 and that adding more synthetic T4 to the mix further aggravates the poor balance I have at the moment.

I have also read that it is possible that my body doesn't like synthetic T4 and is converting it to RT3 to try to avoid build up of what it sees as a toxic substance. I am sure you can see why I am so confused. I have read an awful lot of books and articles and am a bit blinded by the science of it all at this stage.

Any further input you have, or anyone else, would again be gratefully received. Many thanks.

[radd in reply to Vanillaberry]

VB,

You are right and both scenarios could exist with your results, possibly one leading to the other.

Optimising thyroid meds, all nutrients and ensuring adrenal health is sound will help meds to work better and you may find the possible conversion problem resolves itself.

Supplementing 110 -200 mcg Selenium is good for T4 - T3 conversion.

.

Selenium helps thyroid hormone function.

ncbi.nlm.nih.gov/pubmed/161...