Newbie

Hi

I've recently had some blood tests done with BH as I have been struggling to lose weight for the past 2 years despite being more active than I've ever been & having a much improved diet . I had TSH tested with my doctor back in February and that came back high, but no T3 or 4 was tested.

I've had the results back and BH have said 'The Thyroid Stimulating Hormone (TSH) is elevated. If you are already taking a form of thyroxine, it is possible that that your dose is too low or that you have forgotten to take it on occasion. It may be that an increase in dose is in order – if adjusted it would be sensible to repeat thyroid function (TFT) testing in around 2 months' time. If you are not taking thyroxine, and this is the first time TSH has been noted to be high, it is possible that 'non-thyroidal illness' or other medication effects are the cause of the elevation. It may be that hypothyroidism (underactive thyroid gland) is about to develop. In these scenarios, it would be advisable to repeat thyroid function tests in 3 months' time. If this a repeat elevated TSH, it would be a good idea to consider checking thyroid antibodies if not previously tested. If antibody testing is positive, an annual check of TFT would be in order as your risk of developing thyroid disease would be higher than average. I would suggest undertaking this repeat test sooner if symptoms develop. The usual advice is to consider commencing thyroxine if TSH rises above 10 mU/L. Some authorities advise commencing thyroxine at lower TSH levels. '

I'm guessing that this is a standard response to these results but i am at a loss as to whether I should be on medication or if there is some other underlying issue causing me not to lose weight.

I have an appointment with my doctor next week to discuss the results but would really appreciate any advice on whether I'm 'barking up the wrong tree thinking it's thyroid related.

I've put the results below, any comments would be appreciated.

Thank you.

Biochemistry

CRP 4.40 (Range <5.0 mg/L)

Ferritin 80.3 (Range 20 - 150 ug/L

)

Thyroid Function

TSH H 4.66 (Range0.27 - 4.20 IU/L)

T4 Total 100.5 (Range 64.5 - 142.0 nmol/L)

Free T4 16.22 (Range 12 - 22 pmol/)

Free T3 5.40 (Range 3.1 - 6.8 pmol/L)

Immunology

Anti-Thyroidperoxidase abs 6.4 (Range <34 kIU/L)

Anti-Thyroglobulin Abs 11.4 (Range <115 kU/L

)

Vitamins

Vitamin B12 256 Deficient (Range <140 pmol/L Insufficient 140 - 250 Consider reducing dose >725)

Serum Folate 13.41 (Range 10.4 - 42.4 nmol/L

)

9 Replies

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  • Welcome to the forum, Justliloldme.

    Good news is that thyroid antibodies are negative for autoimmune thyroid disease (Hashimoto's).

    TSH 4.66 is over range and flogging your thyroid gland to produce hormone which is why FT4 and FT3 are currently good. If this is the first abnormal TSH result you have had your GP will probably want to retest in 2-3 months to rule out non-thyroidal illness such as an infection or virus raising TSH. When you have a repeat thyroid test arrange it early in the morning when TSH is highest and fast, (water only) as TSH drops after eating and drinking.

    B12 is very low, PA Society recommend 1,000 is optimal. Supplement 5,000mcg methylcobalamin for 6-8 weeks to raise levels and then reduce to 1,000mcg daily to maintain. Take a B Complex vitamin too boost folate and the other B vitamins.

    ________________________________________________________________________

    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.

  • Thank you for your advice - this is all new to me so I really appreciate your response x

  • Justliloldme Yes, they do put standard phrases in so don't worry too much about that. As for your results:

    TSH H 4.66 (Range0.27 - 4.20 IU/L) - yes that's rather high, it shouldn't be over range but getting a GP to treat at that level isn't easy.

    Free T4 16.22 (Range 12 - 22 pmol/) - unfortunately not low enough at the moment to aid a diagnosis of hypo.

    Free T3 5.40 (Range 3.1 - 6.8 pmol/L) - again not low enough for a diagnosis.

    With a highish TSH you'd need very low in range or under range FT4 and FT3 for your GP to take any notice, and you'd probably need a TSH much higher. It's not right, but that's the way it is with most GPs. The only thing that isn't particularly good at the moment is your TSH. It looks like you're on the way to hypothyroidism. What time did you do your test? Did you do it first thing in the morning, fasting (breakfast after) or was it done later in the day?

    The good news is your antibodies are not positive for autoimmune thyroid disease.

    Vitamin B12 256 - this is a big problem. Anything under 500 can cause neurological problems, and you will probably be feeling the effects of low B12. I doubt your GP will prescribe supplements, maybe he will, wait and see what he says. If he doesn't offer you anything then come back and members will advise about what supplements to get, dosage and the cofactors that need to be taken when supplementing B12.

    Serum Folate 13.41 (Range 10.4 - 42.4 nmol/L) - this is too low. Folate needs to be at least half way through range. I don't know if your doctor will take any notice, probably not because it is in range. However, when supplementing with B12 we need a B Complex to balance the B Vits and this contains Folate so will take care of your poor folate level. Come back and get a recommendation after you've seen your GP.

    Ferritin is good, half way through range is where you need to be and you're there. Lucky girl :) .

  • Thanks for the response Susie, I really appreciate it. Do you think that low B12 & serum folate would affect my trying to lose weight?

    When I saw the doc last she just said it was the menopause - I'm 43 & didn't feel like she was taking it too seriously. I've always been able to lose weigh easily before which makes me think there is something 'amiss' somewhere.

  • Possibly not Justliloldme , It's more likely that you're on your way to hypothyroidism that's affecting the weight. Menopause - oh well, they like to blame that for a lot of things!

    I think you might just have to bide your time (I know, it's hard :( ) but a retest in 2 or 3 months as Clutter has suggested is probably the only way to go at the moment. You need a rising TSH to show your GP because those figures just wont do it at the moment :(

  • Thanks Susie.

    I think I'm going to cancel my docs appointment for now (I found her less than helpful) & try the sublingual methylcoalamin and b complex to get the B12 & serum folate up. Then maybe try to get the doc to retest me around November/December time & see where I'm at then.

  • Unfortunately the general rule of thumb is if you are within a vitamin or mineral test range then the NHS will not treat you.

    You need to be below the range to be treated by the NHS and even then some GPs say it doesn't matter (or even worse).

  • Also, I did the test first thing in the morning before any food & drink.

  • Be a good idea to also check your vitamin d - either ask BH (if they still have your blood stored from recent test) or get it checked via city assay - costs £28

    vitamindtest.org.uk/index.html

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