new BH results: Hello:) I’ve just had my results... - Thyroid UK

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new BH results

winallthethings profile image
34 Replies

Hello:) I’ve just had my results back and would love some input from this wonderful community. I’ve been on 75mg levo for the past 6 weeks and taking iron, VitD, B12, selenium and B complex.

I can see my iron is still not great despite taking 80mg every day. I take 5000mg B12 lozenges every day so I don’t understand why my b12 is still so low. Could this be an absorption issue?

I know I have Hashi’s so antibodies aren’t a surprise. I’m surprised at the supressed TSH (although I’ve heard this is possible on medication) and the very high FT4. T3 isn’t in the upper quarter of the range but the ratio is dead on 4 so I’m assuming that’s ok?

I feel fine most of the time. Not completely “normal” but fine, compared to when I was on no meds at all or even 50mg levo before the increase to 75. I’m able to lose weight with a healthy diet.

Any input is very welcome. Thank you!

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winallthethings
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34 Replies
winallthethings profile image
winallthethings

These are my results from 6 weeks ago, after which my levo was increased from 50 to 75mg.

Biochemistry

CRP 0.30 <5.0 mg/L

Ferritin 28.8 20 - 150 ug/L

Thyroid Function

TSH 2.97 0.27 - 4.20 IU/L

T4 Total 100.6 64.5 - 142.0 nmol/L

Free T4 13.87 12 - 22 pmol/L

Free T3 4.03 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs H 295.2 <34 kIU/L

Anti-Thyroglobulin Abs 25.5 <115 kU/L

Vitamins

Vitamin D (25 OH) 64 Deficient <25 nmol/L

Vitamin B12 252 Deficient <140 pmol/L

Serum Folate 33.54 10.4 - 42.4 nmol/L

greygoose profile image
greygoose

Your FT3 isn't even mid-range, so you aren't converting very well. That could be because of the low B12 and ferritin, but it might help if you could add in some T3.

gabkad profile image
gabkad in reply togreygoose

Goosie, her range is weird. Ends at 9.0. Usually end of range is in the 6s. I think she's okay where she is. She says she feels fine and that's important too.

winallthethings profile image
winallthethings in reply togabkad

I did think it was strange because I used BH for my test 6 weeks ago and the range ended at 6.8 - I might e-mail them to clarify.

gabkad profile image
gabkad in reply towinallthethings

Who did this test?

winallthethings profile image
winallthethings in reply togabkad

Blue Horizon lab in Tavistock, the same one that did my last test.

gabkad profile image
gabkad in reply towinallthethings

You wouldn't think they'd have a typo in their test results, would you? I guess when you call them they'll clarify. As far as I am aware, your fT3 result based on the 'usual range' is excellent. You feel well and that's what counts.

There's some argument about what exactly is a good ferritin level. Yours would be considered to be just fine by those who consider anything in the 100s to be indicative of excess iron or inflamed hepatocytes. I wouldn't stress too much about it. If you are vegetarian, increase iron containing foods. If you are a meat eater, have some liver once a week or so. That way you get copper too.

winallthethings profile image
winallthethings in reply togabkad

Yes, I'd be extremely worried if it turned out to be a typo! I will clarify and report back. Re ferritin - my understanding is that good thyroid function requires a read of 70 so that's what I'm aiming for. I'm still supplementing.

Very worried about the low B12, as I've been supplementing 5000mg for the last 6 weeks - its obviously not absorbing. I have a GP appointment in 2 days' time - really hoping she will have some ideas...

gabkad profile image
gabkad in reply towinallthethings

Your antibody level is high which unfortunately means your bile production is adversely affected. This may be why your response to supplementation is compromised.

winallthethings profile image
winallthethings in reply togabkad

Oh? I had no idea about the bile thing - there is so much to learn! Would that not mean that all supplements wouldn't be absorbed properly? My vitD has gone up fine and ferritin has doubled (although still not optimal)

gabkad profile image
gabkad in reply towinallthethings

From Oxord University Press:

There is also evidence that hypothyroidism may directly affect the liver structure or function. Hypothyroidism has been associated in a few case reports with cholestatic jaundice attributed to reduced bilirubin and bile excretion. In experimental hypothyroidism, the activity of bilirubin UDP‐glucuronyltransferase is decreased, resulting in a reduction in bilirubin excretion.55 The reduction in bile flow may be in part due to an increase in membrane cholesterol‐phospholipid ratio and diminished membrane fluidity,55 which may affect a number of canalicular membrane transporters and enzymes, including the Na+, K+‐ATPase. The triad of reduced bilirubin excretion, hypercholesterolaemia and hypotonia of the gall bladder seen in hypothyroidism increases the incidence of gallstones.56 Recent studies have shown that the hepatic abnormalities associated with hypothyroidism can be reversible over a matter of weeks with thyroxine replacement, with no residual liver damage.57,,58

.......I've read someplace else that antibodies to thyroid have an adverse effect on liver cells but I haven't had time to search it out again.

greygoose profile image
greygoose in reply togabkad

Yeah, gabbie, that makes mid-range 6.25. She's under-mid-range. But the FT4 is right up at the top of the range. So, there's all that unconverted T4 floating around causing problems - or with the potential to cause problems. That's not good.

gabkad profile image
gabkad in reply togreygoose

She's going to call BH because the test she had done by them 6 weeks ago had top of range 6.8.

greygoose profile image
greygoose in reply togabkad

Wow! It would never have occurred to me that it might be a typo! That doesn't seem possible, does it. If it is, I think they owe her a free test!

winallthethings profile image
winallthethings in reply togreygoose

Well, BH got back to me with a massive apology and a corrected FT3 range ending at 6.8! I'm not cheeky enough to ask for a free test in the future lol

Am I right in thinking that this means I'm a touch overmedicated? (apart from low iron and b12)

greygoose profile image
greygoose in reply towinallthethings

Your FT3 is 5.64, so no, I wouldn't say you were necessarily over-medicated. But, it depends how you feel. Some people need it even higher than that.

I would never have imagined such a thing from BH! I am truly shocked. I thought you'd had your test done somewhere else, with a different range! So, that means we've all got to be extra careful, from now on, I suppose.

winallthethings profile image
winallthethings in reply togreygoose

Absolutely - I'm currently e-mailing back and forth with them to find out exactly how this happened. The explanation they have me in the original reply was that I'd put in an incorrect date of birth which made me an infant (this is true so my fault completely) and I guess the ranges differ? But then all the ranges would be different, not just FT3. I've written back for further clarification, pointing out that had I not noticed the range, I might well have ended up taking extra T3 tablets which I didn't need!

greygoose profile image
greygoose in reply towinallthethings

Yes, that excuse seems a bit lame. lol

winallthethings profile image
winallthethings in reply togreygoose

One final update -got a reply from BH adn am decidedly unimpressed: All the ranges are fine. Your Doctor wouldn’t prescribe based upon the reference ranges of an external laboratory, but I do understand your concern.

Please let me know if I can help any further.

greygoose profile image
greygoose in reply towinallthethings

What does that mean? All the ranges are fine? They made a mistake in the FT3 range. Are they now saying they didn't make a mistake? And, if they think a doctor wouldn't take any notice of the results, what is the justification for their existence???

BlueHorizon are on this forum, take it up with Paul, and tell him just how unimpressed you are!

healthunlocked.com/user/blu...

winallthethings profile image
winallthethings in reply togreygoose

It's Paul I've been e-mailing this whole time! Really unimpressed.

greygoose profile image
greygoose in reply towinallthethings

oh, gosh! I didn't realise that! I'm not impressed, either!

SlowDragon profile image
SlowDragonAdministrator

Have you adopted gluten free diet yet? This may help reduce symptoms, lower antibodies and improve nutrient absorption.

winallthethings profile image
winallthethings in reply toSlowDragon

No, I haven't gone gluten-free. Partly because I'm dreading it and partly because the people I know who have done this, don't report much change and I haven't seen any conclusive scientific studies. I've read about the science behind it but it wasn't a medical source. If you know of any such studies, I'll be very grateful for links!

gabkad profile image
gabkad in reply towinallthethings

That is correct. Some people benefit and some don't. And even those who appear to benefit, who knows. Dr. Alessio Fasano (Dr. Coeliac...;)) does not recommend gluten free but does not oppose trying it. He's gone a bit extreme recently stating that no one can digest gluten etc. Probably true but this doesn't mean necessarily that everyone has an adverse reaction to the stuff.

SlowDragon profile image
SlowDragonAdministrator

There are plenty of us on here who have found it extremely beneficial. (See my profile)

consider reading Susan Blum - the immune recovery system diet.

Or Isabella Wentz - the thyroid pharmacist

Nothing to loose by trying it. I just wish I had done it 20 years ago instead of believing the negative coeliac test.

Just had my "gluten intolerance" officially confirmed by eminent NHS gastroenterologist who said, and I quote "gluten intolerance, without any obvious symptoms, is much, much more common than we realise"

Trouble being, you can have gluten intolerance with no apparent problems, until you have to take thyroxine, then the underlying low nutrients (due to gut/gluten issues) hinder the thyroxine being used in cells

If your b12, folate, ferritin and/or vitamin D are low, and you have good, healthy, varied diet, you have to wonder why.

Like you, I was also dreading going gluten free, but to be honest it has been really easy. There's lots of alternatives. It does have to be 100%, or it's a waste of time. I have found it a great excuse to try new recipes and choose healthier options. Eating out is a doddle. Hardest thing is eating at freinds - especially if they secretly think it is some "faddy" lifestyle choice!

humanbean profile image
humanbean in reply toSlowDragon

I had a negative coeliac test and thought I could carry on eating gluten. It was 5 years before I finally decided to experiment and give it up. I wish I'd tried it much earlier.

I manage to hang on to iron with more success than I used to have, and although the improvement in my gut health has been slow, it is real!

Unlike you though, I've found going gluten-free has not been easy, and it doesn't come naturally. I still make stupid mistakes.

SlowDragon profile image
SlowDragonAdministrator in reply tohumanbean

My gluten intolerance was stopping me use my legs.......walking was real struggle......hard to believe but true!

So I have had huge incentive to get it right.

humanbean profile image
humanbean in reply toSlowDragon

Wow! What did your doctor attribute your walking and leg problems to, just out of interest?

SlowDragon profile image
SlowDragonAdministrator in reply tohumanbean

Well you can imagine.....it wasn't them that worked it out!

See my profile

Gastroenterologist been brill, such a change 😃

Looking back over last 20 years I now realise I often attributed my poor mobility to inadequate thyroxine......but it was gluten all along

humanbean profile image
humanbean in reply toSlowDragon

I thought they might have some theory that blamed you though. They usually do.

SlowDragon profile image
SlowDragonAdministrator in reply tohumanbean

Yep.....my endo thought it a preposterous suggestion!

Gastroenterologist was "totally onboard" from the start.

Oral vitamin d spray has been brilliant. Suggested by a friend who's a endoscopy nurse.

Marz profile image
Marz in reply toSlowDragon

SlowDragon - so glad you found a GOOD Gastro. For 30 years I saw someone from the Gastro Team every 6 months - who inadvertently missed the fact that I did not have a Terminal Ileum due to surgery for TB and Crohns - or more accurately missed the fact I would not be absorbing B12. The results of that have been pretty horrid :-)

I too think gluten creates problems and have been GF for over 3 years. Anti-bodies greatly reduced :-)

My poor mobility is due to SADSC - Sub-Acute Degeneration of the Spinal Cord due to LOW B12.

Marz profile image
Marz

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