Blood results. Please help

[sueoathall]

Hi I have an under active thyroid but today I'm asking for advise for my daughter, she's got a lot of the symptoms too. She's 25.

The doctors reckon her blood results are fine, usual story! They have not given her any levothyroxine. A few months back they asked her to take some B12 and then do another test. Here are her results;

I don't know her original B12 result, assuming they did one!

her latest result is serum vitamin B12 317 ng/L range 197- 771ng/L

Serum folate 9.3 ug/L 4.60 - 18.70ug/L

Back in May she had thyroid tested, here are the results ;

Serum free T4 level 13.9 pmol/L range 12.00-22.00

Serum TSH level 2.32 mu/L range 0.30-4.20

I would appreciate any comments. Thank you

[shaws Administrator]

Doctors in the UK have been told not to prescribe levothyroxine until the TSH reaches 10. This takes no notice of very unpleasant symptoms with no relief.

This is from Thyroiduk.org.uk our website:-

thyroiduk.org.uk/tuk/testin...

Your daughter's B12 is low as the new recommendation is around 1,000 and she can supplement with methylcobalamin sublingual B12. Her doctor should test the intrinsic factor for pernicious anaemia but it might not be low enough for that.

In many countries they would prescribe when TSH is around 3 but your daughter's is lower and they dont consider her clinical symptoms which doctors used to before the blood tests were introduced.

Her serum FT4 is so very low I doubt she can convert to sufficient T3. T3 is the only active hormone required in our billions of receptor cells and we struggle if it is low.

We have recommended labs if you wished to get some more blood tests.

Others will also comment on the other blood tests.

(I am not medically qualified. I have hypothyroidism and was undiagnosed for a long time.)

[bluebug]

@shaws is correct the NICE guidelines mean you have to be at 10 to be treated as hypothyroid. If you are above the lab range but below 10 sometimes you can argue your case with some GPs but as your daughter is within the lab range she has absolutely no chance. There is a belief amongst some GPs that prescribing treatment means that you will get heart disease or some other such rubbish when in fact it is the other way round.

As a starting point your daughter should get her haemoglobin, ferritin and vitamin D levels tested as these need to be optimal not just within the lab range to help the thyroid. Once they are tested get a copy of the results and ranges. This is because the NHS often has strange lab levels that mean they are happy to leave people mildly anaemic/iron deficient plus they will not prescribe supplements unless you are severely deficient.

The best way of arguing to get your vitamin D level tested is stating that you are housebound or due to work/illness spend the majority of your time inside. If the GP refuses to test these, and some will just mislead patients and do a full blood count instead of the proper tests, then you will need test what the GP doesn't do privately.

In regards to the test results which shaws hasn't mentioned but you have reported now, your daughter should take a B complex tablet daily to get her folate level to around 10 and ensure her other B vitamins are balanced.

In regards to what the other things I mentioned:

Haemoglobin - iron containing protein in the blood that carries oxygen

Ferritin - a protein that stores iron. Most GPs don't know it's significance but in menstruating women a very low ferritin level often means the woman will end up with iron deficiency anaemia within a year.

Vitamin D - you would have heard about this in the news and like with T3 receptors there are vitamin D receptors on almost all cells of the body. If you don't understand about thyroid hormones it is worth reading going to the main thyroid UK site at thyroiduk.org.uk and reading up about the thyroid

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Do a private Blue Horizon full thyroid panel to check nutrients and antibodies. The NHS won't do that for her. Then post here.

[sueoathall]

Thanks everyone