Private blood results.... Help

[Purple80]

I have just received my blood results very quick service it went in the post yesterday and I have just received the results.

I only started taking the levothyroxine today 50mcg

I also taking HRT Elleste solo 2mg a day

Venlaflaxine 37.5 mg a day.

I am getting slightly worried about all of this now....

Hoping you guys can help me understand this.

This is the Doctors comments below...

The combination of low TSH and free T4 levels, with a normal T3 level, would be unsurprising if you are taking T3 form of thyroxine - is this the case? If so, it might be a good idea to discuss your ongoing thyroid medication dose requirement with your usual doctor. If not, and you were unaware of any thyroid problem, the low TSH level might indicate a developing hyperthyroid (overactive thyroid) state, or (with the low free T4 level too) even pituitary gland underactivity. Again, discussion with your doctor would be wise if this is the case. The finding of a positive thyroid antibody result in addition increases the possibility of your having autoimmune thyroid disease, such as Hashimoto's thyroiditis or Grave's disease.

A high CRP (C reactive protein) is associated with inflammation from some cause (as seen for example with arthritis or infection). It is not an exact test, and it is nonspecific. An elevated CRP is not a normal finding and its presence should lead to further investigation to establish the cause. If you have any symptoms suggesting either infection (fever, cough, painful urination etc.) or inflammation (swollen painful joints for example), I advise you to contact your usual doctor. In any event, it would be sensible to repeat this test around 4-6 weeks’ time and if persistently elevated it would be sensible to discuss this finding with your doctor.

The ferritin level is also high. In addition to excess iron supplementation, raised serum ferritin can be a sign of inflammation or infection - which, considering the elevated CRP, is possible here. Raised ferritin due to inflammation is not a sign of too much iron, and is not a sign of disease as such. Less commonly, higher ferritin levels can result from damage to bone marrow or liver, genetic conditions, following blood transfusion, and in chronic anaemias such as thalassaemia. Repeat testing in a few weeks’ time will enable you to spot any trends if you wish to be sure the levels are not persisting or rising - but of course you may wish to speak to your usual doctor first.

There is Vitamin D insufficiency. Vitamin D is manufactured in our skin as a direct result of sunlight exposure. One potential complication of prolonged Vitamin D lack is osteomalacia, a disease which causes severe structural deformities to the skeleton. Lower level Vitamin D deficiency can lead to a number of nonspecific symptoms, including possibly chronic fatigue (experts have for many years noted an association between sufferers of chronic fatigue syndrome or myalgic encephalitis (CFS or ME) and low blood levels of Vitamin D). It has been estimated that between 50-70% of people living in the northern Europe (where daylight length reduces your chances of receiving adequate sunlight in the winter) are deficient in this vitamin by March each year. Symptoms of vitamin D deficiency include chronic pain, weak bones, frequent infections (recent research has detected an association between vitamin D deficiency and severe pneumonia), depression and fatigue. Supplementation may be beneficial - please speak to your usual doctor about this result.

[Ruthi]

Before I comment on anything else I would advise posting an image without your personal details!

[Purple80 in reply to Ruthi]

That's not my address it's the labs???

[Justiina]

I think either results or doctors comments are wrong as test shows very high tsh with very ft4 and normal ft3. You should ask which one is wrong.

Naturally if your previous test results are similar then doctors comments are wrong.

[Purple80 in reply to Justiina]

I think its the doctors comments are wrong, I have only had one previous blood test and that was at my doctors which showed high TSH 10.14.

[Ruthi]

Next comment, what a load of tat that doctor is talking. TSH is Thyroid Stimulating Hormone, you make more when you need your thyroid to make more thyroid hormones. You have a high TSH indicating that your are hypothyroid, not hyper. And the low T4 supports that. How exactly you are managing to convert what little T4 there is to T3 is a mystery to me. But it won't last unless this is a blip, which is unlikely with a raised TSH.

I agree you are low in Vitamin D, and that is particularly worrying because you should be at your highest level at this time of year. You need supplements. Good quality cod liver oil is probably the best supplement.

The anti-thyroglobulin antibodies indicate you have Hashimoto's disease, AKA autoimmnune thyroiditis. Your body is destroying your thyroid gland.

Your raised ferritin is most likely due to inflammation - this may just be that caused by your Hashimotos, or there may be other inflammation going on.

What is your history?

[Purple80 in reply to Ruthi]

48 today

I have no real history, hysterectomy at 31, currently on HRT and venlaflaxine (anti depressant, low dose, for panic attacks).

5ft 3" and 12 stone.

I started feeling ill in August, tired thought I had a UTI. I was given antibiotics, then urine sample was sent to lab proven to not be UTI, but I still had all the symptoms.

Things have gone down hill fast since then, I'm literally dragging myself around now and feel very low.

[humanbean in reply to Purple80]

Happy Birthday! Let's hope you feel better by the next one.

[Purple80 in reply to humanbean]

Thank you

[Clutter]

Purple80,

The BH doctor hasn't read your thyroid results properly. TSH 9.53 is high not low indicating primary hypothyroidism not hyperthyroidism. FT4 is below range and TSH has risen to stimulate the thyroid gland to produce more hormone. FT3 4.83 is good but is almost certainly only that high due to your high TSH.

I would take the doctor's advice re CRP and ferritin.

VitD is optimal around 100. I would supplement 10,000iu D3 for 6-8 weeks then reduce to 5,000iu and retest in six months. Take vitD 4 hours away from Levothyroxine.

I would prefer B12 at the top of range and would supplement 1,000mcg methylcobalamin with a B Complex vitamin. Folate is good.

Thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism. 100% gluten-free diet may improve symptoms and reduce antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

For maximum absorption Levothyroxine should be taken with water 1 hour before or 2 hours after food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

Most people will find symptoms resolve after their TSH drops to around 1.0 with FT4 in the upper range but symptoms can lag a couple of months behind good biochemistry.

thyroiduk.org.uk/tuk/about_...

_______________________________________________________________________________

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.

[Purple80 in reply to Clutter]

Thank you, I find all of this so confusing.

Should I push to see a specialist? If so what? I have private medical cover...

[Clutter in reply to Purple80]

Purple80,

I wouldn't bother. See how you do on Levothyroxine and how well your GP deals with blood tests and dose adjustments. You should expect some improvement in symptoms in 4-6 weeks but it may take a few months more for most symptoms to resolve.

[Purple80]

I forgot to post the updated Doctor Comments after I told them they were incorrect on your advice ... lol

The Thyroid Stimulating Hormone (TSH) is elevated, and thyroxine levels are on the low side. 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 testing (TFT) in around 2 months’ time. However, if you are not taking thyroxine already, this result is likely to represent a new diagnosis of hypothyroidism (underactive thyroid gland). I advise you to discuss this result with your usual doctor as treatment, or adjustment is indicated.

A high CRP (C reactive protein) is associated with inflammation from some cause (as seen for example with arthritis or infection). It is not an exact test, and it is nonspecific. An elevated CRP is not a normal finding and its presence should lead to further investigation to establish the cause. If you have any symptoms suggesting either infection (fever, cough, painful urination etc.) or inflammation (swollen painful joints for example), I advise you to contact your usual doctor. In any event, it would be sensible to repeat this test around 4-6 weeks’ time and if persistently elevated it would be sensible to discuss this finding with your doctor.

The ferritin level is also high. In addition to excess iron supplementation, raised serum ferritin can be a sign of inflammation or infection - which, considering the elevated CRP, is possible here. Raised ferritin due to inflammation is not a sign of too much iron, and is not a sign of disease as such. Less commonly, higher ferritin levels can result from damage to bone marrow or liver, genetic conditions, following blood transfusion, and in chronic anaemias such as thalassaemia. Repeat testing in a few weeks’ time will enable you to spot any trends if you wish to be sure the levels are not persisting or rising - but of course you may wish to speak to your usual doctor first.

There is Vitamin D insufficiency. Vitamin D is manufactured in our skin as a direct result of sunlight exposure. One potential complication of prolonged Vitamin D lack is osteomalacia, a disease which causes severe structural deformities to the skeleton. Lower level Vitamin D deficiency can lead to a number of nonspecific symptoms, including possibly chronic fatigue (experts have for many years noted an association between sufferers of chronic fatigue syndrome or myalgic encephalitis (CFS or ME) and low blood levels of Vitamin D). It has been estimated that between 50-70% of people living in the northern Europe (where daylight length reduces your chances of receiving adequate sunlight in the winter) are deficient in this vitamin by March each year. Symptoms of vitamin D deficiency include chronic pain, weak bones, frequent infections (recent research has detected an association between vitamin D deficiency and severe pneumonia), depression and fatigue. Supplementation may be beneficial - please speak to your usual doctor about this result.