blue horizon thyroid bloods, feedback rapturously received!

[thunderthyroid]

Greetings,

I wonder if I might possibly trouble any of you awesome self-empowering endocrinal autodidacts for feedback on my thyroid bloods from Blue Horizon? The range is different but essentially it's the same story as the NHS bloods, that my TSH is elevated to a clinically significant but not extraordinary death's door degree and vice versa for T3 & T4 isn't it? The superfluity of B12 is because I've been supplementing over the last month as I was deficient before, tho' I might reduce it now.

As i relayed before, my symptoms are occasional brainfog, fatigue tho' not flat out exhaustion and low libido, all quite generic and also potentially age-related (I'm 38 1/2 and male) tho' I'm not kidding myself that my sluggish thyroid isn't major factor . Where I am with this is that I'm unsure as to whether I want to become reliant on thyroxine just yet if it's not absolutely essential, after all my body's still producing enough for me not to have some of the more severe symptoms, such as uncontrollable weight-gain and ME-levels of tiredness. Of course, I would very much like to be more peppy and the fact I can't manage sex happily more than once a week and am zonked beyond useless by 9pm isn't exactly optimal, but I don't know if I'm convinced I'm unwell enough at mo' to start mudwrestling with my GP lol. Some of you peeps sound a lot more concrete poorly than me. But then again I'm kinda playing into the GP's (idle) hands by just hanging back until my thyroid really does pack up. Anyhoo, results:

Biochemistry

CRP 0.20 <5.0 mg/L

Ferritin 72.6 30 - 400 ug/L

Thyroid Function

TSH H 4.41 0.27 - 4.20 IU/L

T4 Total L 58.6 64.5 - 142.0 nmol/L

Free T4 12.95 12 - 22 pmol/L

Free T3 4.91 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs 12.9 <34 kIU/L

Anti-Thyroglobulin Abs 17.4 <115 kU/L

Vitamins

Vitamin D (25 OH) 97 Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 H 870 Deficient <140 pmol/L

Insufficient 140 - 250

Consider reducing dose >725

Serum Folate 24.87 8.83 - 60.8 nmol/L New Range

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. I would suggest undertaking this repeat test sooner if symptoms develop.

The total thyroxine level is low but is of unlikely significance as the FT4 is within normal range - and this is the more accurate representation of the level of thyroxine in the blood.

The Vitamin B12 level is elevated. This is not likely to represent significant overdose, as B12 is well tolerated by the great majority of people even in very high concentrations (as indeed are most water soluble vitamins). Excess levels are usually a result of supplementation or from following a diet rich in the vitamin. A few exceptions to this rule include those who suffer from a rare hereditary eye complaint known as Leber’s disease. Too much vitamin B12 in these individuals can lead to damage of the optic nerve, which might lead to blindness. Anyone who is allergic to cobalt should also avoid taking vitamin B12 - as the vitamin contains a significant amount of this element. Rarely, high dose supplements or injections of Vitamin B12 cause diarrhoea, itching, blood clotting and allergic reactions. Liver disease and myeloproliferative disease (disorder of the bone marrow) can lead to elevated levels of B12. Some practitioners advocate high doses of Vitamin B12 to help sufferers from Chronic Fatigue Syndrome (CFS) and to combat the development of Alzheimer's disease, amongst other conditions.

[Clutter]

Thunderthyroid,

I would show the results to your GP. TSH is over range and although FT4 and FT3 are within range FT4 is very low in range. Your GP may want to retest via the lab the practice uses as many doctors are not happy with private results and the TSH will need to be over range in the NHS results before a diagnosis is made. Arrange an early morning and fasting (water only) blood draw when TSH is highest.

Thyroid antibodies are negative for autoimmune thyroid disease (Hashimoto's).

CRP is good.

Ferritin is optimal >100 through to halfway in range. You might consider supplementing iron with vitamin C to aid absorption and minimise constipation for a few months to see whether fatigue improves.

VitD 97 is optimal. You could supplement 2,500iu daily to maintain level until April when ultraviolet light is strong enough to stimulate natural vitD.

B12 830 is fine. There's no evidence that you can over dose on B12 or that high levels are harmful unless you have Leber's disease, of course.

Folate is good.

thyroiduk.org.uk/tuk/diagno...

____________________________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical advice from your own doctor. Please check with your personal physician before applying any of these suggestions.

[thunderthyroid in reply to Clutter]

Thanks for your response, Clutter. I decided to get these private bloods done by means of a 2nd opinion & further exploration of some NHS bloods which were done about 2 months ago. Those results 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), so just 'below range', but not enough that my GP thought it yet actionable, only worth monitoring, which to them means perfunctory yearly TSH tests.

[Clutter in reply to thunderthyroid]

Thunderthyroid,

Have to wonder why your GP ordered FT3 if s/he takes no notice of a below range result. Your TSH is over range in BH results so it may be worth asking your GP to retest in a month or two.

[thunderthyroid in reply to Clutter]

Well, she wouldn't have, I had to press her armed with info from 'Thyroid UK'. From her readiness to tell me everything was fine once the further tests I insisted on showed that my peroxidase antibodies weren't elevated, I don't think she's aware you can be hypo without hashi's.

[Clutter in reply to thunderthyroid]

Thunderthyroid,

Around 10% of hypothyroidism is due to thyroidectomy, RAI, and the rest is idiopathic.

It is possible to be sero-negative Hashi's. Not so common but it does happen and patients may be diagnosed by ultrasound scan showing textural damage to the thyroid gland typical of Hashimoto's.

[Hidden]

Age-related? You are a Spring Chicken!

From your TSH and low T4 I'd say your thyroid is starting to struggle. Fortunately you don't show any thyroid antibodies. Clutter gives great advice as usual, low ferritin will add to fatigue.

[thunderthyroid in reply to Hidden]

Spring chicken? maybe a spring onion lol. Don't suppose you would have any inkling about why my thyroid would be struggling if it wasn't an autoimmune disease? My GP's loathe to do owt until I either present with anitbodies or am more drastically out of range. She showed me several annual TSH scores on the 'puter screen which indicated that my thyroid, tho' borderline underactive for some years in a row, is stable and she wasn't alacritous regards remedial intervention under those circumstances.

[Hidden in reply to thunderthyroid]

No sorry I do not. I am a recent unwilling recruit to the world of Hashi's so it'll be new info for me as well.

[Justliloldme]

Hi thunder

My TSH was quite similar to yours - FT4 & FT3 not so.

TSH 4.66 (0.27-4.20)

FT4 16.22 (12-22)

FT3 5.4 (3.1-6.8)

My GP has refused to see an issue & to be honest I felt so bad I have begun to self medicate. I feel so much better, even thought I've only been taking the pills for 3 weeks.

I suppose it's all down to how you feel. I was sluggish, short tempered, making mistakes at work, no energy etc & didn't want to carry on feeling like that, so I self medicate.

It's a personal choice, personally I'd rather feel 100% & take the meds

[Ruthi]

About 15% of people are hypothyroid without autoimmune disease.

I am one of those, although I know that a drug I took for 5 years probably caused the decline. Be grateful, you are less likely to suffer the awful swings of Hashimoto's.

[thunderthyroid]

So, seeing as my mum is hypothyroid (as well as diabetic) without hashi's as far as I know, and my sister had a thyroidectomy in her mid-20s because of hyperthyroidism, would it most likely be just a hereditary thyroid frailty? Are there any pros of leaving medication til later on or am I just pointlessly diminishing my quality of life ?

[Clutter in reply to thunderthyroid]

Thunderthyroid,

As you are symptomatic you should be started on medication as soon as you can persuade your GP to do so. TSH being over range means you have primary hypothyroidism and there is no point in delaying medication until symptoms are worse.

[puncturedbicycle in reply to thunderthyroid]

It is interesting. Thinking about the gene mutations for breast cancer, there are currently (I think) two but there may be many more, as yet unidentified. They have a lot of material to work through before they'll know.

I wondered if there is a different indication (other than the antibodies we look for now to indicate Hashi's) for that small number of cases of what is now known as idiopathic uat, and we just don't yet know what that is. Perhaps it is genetic. We know that some thyroid cancers come from a gene mutation.