Greetings, i wonder if any of the compassionate cognoscenti on this wonderful humane resource of a site could confirm or critique my doctor's opinion that thyroid peroxidase levels of 8.6 ku/L are okay (range 0.0-34.0)? Also:
serum adjusted calcium 2.29 mmol/L (2.1-2.6)
serum albumin 43 g/L (35.0-50.0)
serum ferritin 46 ug/L (23.0-300.00)
serum folate level: 8.0 ug/L (2.7-15.0)
serum b12: 492ng/L (130.0- 1100.0)
Am I right in thinking there isn't much to get my knickers in twist about here?
Background: last thyroid results approx 3 weeks/ month ago were: TSH: 3.21 (range: 0.35-3.5); my serumfree T4: 10 (8-21) & my T3, which I know is the most important of all being the bioavailable hormone was 3.4 (3.8-6). A few weeks earlier they'd been similar which is what convinced me to badger doc to investigate further.
Muchas gracias in advance for interest and assist.
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thunderthyroid
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Hi thunderthyroid Your TPO antibodies are low in range and do not indicate autoimmune thyroid disease (Hashimoto's). However, although high, over range, antibodies confirm Hashi's, one result low in range does not rule it out. You would need a few over time to be sure you do not have Hashi's, I've had four altogether over the years, all low in range so I am happy that I don't have Hashi's and I have no fluctuations in symptoms or results either.
However, there are also Thyroglobulin (TG) antibodies and although you are in range for TPO, you could possibly have high TG antibodies so it would be wise to test for those too.
Calcium and albumin are both in range and are fine.
Ferritin is too low, ideally it should be half way through it's range.
Folate is slightly low, it should be at least half way through it's range and that would be 8.85+
B12 should be at the very top of it's range.
As you know from your thyroid test results, your FT3 is below range, your FT4 very low and TSH too high. If you weren't in the UK (assuming you are) you would probably have a diagnosis of Hypothyroidism and be on Levothyroxine.
Cheers for taking the time to compose such an insightful reply, suze. Yes, I live in England indeed. What would you suggest my next move should be in light of these results, may I ask?
I would start supplementing to get your vitamins and minerals to optimal levels.
For ferritin you can buy some Ferrous Fumarate from Amazon and take 1 tablet twice daily with 1000mg Vit C to aid absorption and help prevent constipation. Finish the packet then retest, it is important not to go too high, stick to half way through range. Take iron 4 hours away from other supplements and medication as it affects absorption. You can also eat liver regularly (say once a week) as this is good for helping to raise ferritin.
For B12 you can get Solgar or Jarrows sublingual methylcobalamin lozenges 5000mcg daily for a couple of months then reduce to 1000mcg daily as a maintenance dose. As they are sublingual they will get directly in the bloodstream so let them dissolve, don't chew or swallow as stomach acid destroys it. You can take this without food.
When taking B12 we need a B Complex to balance all the B vits. Make sure you get one with methylfolate which is natural rather than folic acid which is synthetic. Take with food. B vits should be taken on the morning, no later than lunchtime as it can be stimulating.
As Slow Dragon has mentioned, it would be an idea to test Vit D too as this could also be low. You can do this with City Assays for £28 (easy fingerprick blood spot test) vitamindtest.org.uk/vitamin... but if you want to test for TG antibodies (which the NHS don't seem to do) you could get a complete thyroid/vitamin/mineral bundle from Blue Horizon bluehorizonmedicals.co.uk/T...
Once all these are optimal then your own thyroid hormone has the best chance to work properly.
However, because of your thyroid test results I doubt that optimal levels of vits and mins is enough, I think you need some thyroid hormone replacement. If you can't persuade your GP to prescribe then you could push for a referral to an endo, find a functional doctor or other private thyroid specialist (ask louise.roberts@thyroiduk.org.uk for a list of thyroid friendly doctors) or you could consider self medicating with self sourced meds and monitor with self testing.
The Blue Horizon Thyroid 11 tests pretty much everything you would want to test. B12, vit D, thyroid antibodies and T3 among other things.
I use their home fingerprick version. Costs £99 - you order it one day, it arrives through your letterbox next morning, I always make sure I return it on a Monday so that it doesn't lie in a sorting office over the weekend - post it off and get the results delivered to your in box in a couple of days.
No more begging your doctor for tests they don't want to do and you will know exactly where you are. You will find a link in the ThyroidUK.org.uk website. You can choose other companies but I've always used BH and I'm very happy with them.
When I went to see my regular doc, and tbf she wasn't as recalcitrant and heeldragging as the other one at the surgery, she remarked that 'this was things from her perspective' and showed me basic TSH & T4 results since 2011. Essentially, the numbers were year-on-year in the same subclinical bracket that the recent ones quoted above were but they hadn't deteriorated or fluctuated much and that,she implied, was why she wasn't banging out a prescription for thyroxine. I'm not sure I've got the money to be wholly financing my own thyroid treatment and regular testing, particularly with overseas Levo or DTH, as I'm on benefits due to a mental health condition, tho' I could prolly stretch to a private test now and again at £99, at least for time being.
But to a major extent, I'll HAVE to rely on NHS. Symptomwise, apart from fatigue & low-ish mood, a little weight gain, slight optic fuzziness from time to time and a relative loss of libido, I'm not sure I could pinpoint an absolutely concrete manifestation of hypothyroidism. But obvs I want to be optimally well, who doesn't? Your advice has all been fandabbyawesome, but I'm not sure how to proceed given that I might not have hundreds of pounds to spend on self-financing thyroid treatment and aren't on death's door yet.
In that case I would optimise your vitamins and minerals to start with, get Vit D, B12, ferritin and folate where they need to be - not just in range bit properly optimal, then see how things are.
Also, if you are on any medication for anything else, check the patient information leaflet (and possibly do a search on the internet) to see what side effects can happen just to see if anything is causing you problems.
Just so you are aware, natural dessicated thyroid (NDT) can be obtained from a recommended, reliable supplier for less than £40 for 1,000 tablets.
Would I need prescription? Am I right in assuming that NDT is a lifetime commitment like Levo? That my body's inadequate tho' still active natural production of thyroid hormone would cease once my body received enough thru external source?
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