More blood test results for interpretation

[Kiwidel]

Hello thyroid fans!

I have been to a new haematologist who has carried out a swathe of tests to get a baseline, including some thyroid related ones that I hadn't been able to convince the previous 8 doctors to do!

She said she would get I touch if there were any problems - she hasn't but has referred my to an endo who to my surprise I am going to see next week. Not sure if I should be worried about the speed of referral... They have asked me to get TSH, FT4, FT3 and TSH receptor antibody (TSI) tested before I see them.

Since these tests were done I have started self medicating on thyroid-s which has been going well, other than crashing out in the early afternoons and having to have a sleep. This symptom is more extreme than it has ever been, but has started to improve now I'm up to 11/2 grains. Looking at these results I don't think that's related to switching to NDT, I think it's because I was / am under medicated with a TSH higher than when I was first medicated! So much for the Drs comment that I was over medicated on the 150mg of Levo I had been on previously.

Oddly this seems to indicate I am ANA negative when I have had 2 previous results that have said I am ANA positive - is it possible for this to reverse?

Also, I think this shows I have hashimoto's, I need to cut back on the B12 and I am still low on iron despite taking a prescription supplement - am I interpreting this correctly?

Any thoughts or hints welcome.

Thanks in advance.

Sorry, this is a bit of a long list ...😬

Hospital Blood test results 29th Nov c11am (Canadian)

I had not taken 125mg Levothroxine for 24 hours and had not taken any supplements for 5 days. Had been taking 150mg Feromax (iron supplement), 1,000 Vit C, 5,000 Vit b12, Vit B complex, Vit D3 prior to this since August)

Routine chemistry

Creatine 72 (42-102 umol/L)

Estimated GFR >60 (mL/min/1.73m2)

Total protein serum 73 (60-80 g/L)

Albumin 41 (35-50 g/L)

Globulin, calc 32 (23-35 g/L)

AST 20 (7-40 U/L)

ALT 17 (10-45 U/L)

LD 180 (100-195 U/L)

Bilirubin Total 7 (0-23 umol/L)

Bilirubin Direct <2 (0-7 umol/L)

Iron Total 16 (7-30 umol/L)

TIBC 58 (42-72 umol/L)

Saturation 0.27 (0.20-0.50)

Routine Haematology

WBC 2.88 (4.00-11.00 E9/L)

RBC 4.51 (3.80-5.20 E12/L)

HGB 137 (115-155 g/L)

HCT 0.418 (0.370-0.480 L/L)

MCV 92.7 (82.0-97.0 f/L)

MCH 30.4 (27.0-32.0 pg)

MCHC 328 (320-360 g/L)

RDW 13.5 (11.0-15.0 %)

PLT 321 (140-400 E9/L)

MPV 9.5 (7.0-11.0 fL)

Abs Neutrophils 1.590 (2.000-6.300 E9/L)

Abs Lymphocytes 0.840 (1.000-3.200 E9/L)

Abs Monocytes 0.300 (0.200-0.800 E9/L)

Abs Eosinophils 0.100 (0.040-0.400 E9/L)

Abs Basophils 0.040 (0.000-0.100 E9/L)

Abs IG 0.010 (0.000-0.070 E9/L)

Note - immature granulocytes (IG) include: promyelocytes, myelocytes and metamyelocytes.

Retics 82 (38-116 E9/L)

RET-He 36.5 (29.3-35.8 E9/L).

Note - RET-He and IRF respectively denote reticulated Hemoglobin equivalent and immature reticulocyte fraction

IRF 9.6 (3.0-15.9%)

Special Chemistry

LD 180 (100-195 U/L)

Thyroglobulin 4.42 (ug/L post ablation:<1.00 ug/L, normal population:<50.00 ug/L, circulating thyroglobulin antibodies may interfere with measurement of thyroglobulin)

Anti-thyroglobulin 116 (<115 klU/L)

Endocrinology

TSH 16.01 (0.40-5.50 mU/L)

Free T4. 13.1 (7.5-16.0 pmol/L)

Free T3 - cancelled as only carried out if TSH is low (!)

Ferritin 38 (12-192 ug/L)

Vitamin B12 level >1107 (110-630 pmol/L)

RBC Folate 2,483 (>1,475 nmol/L)

Thyroglobulin 4.42 (ug/L post ablation:<1.00 ug/L, normal population:<50.00 ug/L, circulating thyroglobulin antibodies may interfere with measurement of thyroglobulin)

Anti-thyroglobulin 116 (<115 klU/L)

Anto- TPO 240 (<40 klU/L)

Immunology

Total protein serum 73 (60-80 g/L)

Albumin 44.0 (39.0-51.0 g/L)

Alpha 1. 2.2 (1.0-2.3 g/L)

Alpha 2. 7.4 (5.0-10.0 g/L)

Beta 6.7 (4.0-11.5 g/L)

Gamma 12.7 (5.0-13.0 g/L)

Anti-DNA ELISA 11 (negative: <25 IU/ml, Equivocal: 25-30 IU/ml, weakly positive: 30-60 IU/ml, positive: 60-200 IU/ml, strong positive: >200 IU/ml)

IgG 15.60 (7.51-15.60 g/L)

IgA 1.70 (0.82-4.53 g/L)

IgM 1.13 (0.46-3.04 g/L)

Free Kappa 15.60 (3.30-19.40 mg/L)

Free Lambda 19.70 (5.71-26.30 mg/L)

Free Kappa / Lambda ratio 0.79 (0.26-1.65)

C3. 1.28 (0.79-1.52 g/L)

C4. 0.25 (0.16-0.38 g/L)

Haptoglobin 1.82 (0.36-1.95 g/L)

Rheumatoid factor <20 (<20 klU/L)

Anti Nuclear Ab. 0.9 (<=1.0 NEG)

[Clutter]

Kiwidel,

You were very undermedicated on 125mcg Levothyroxine to have TSH 16. I think it is very likely you are undermedicated on 1.5grains NDT. I would increase to 3 grains in 1/2 grain increments at two week intervals, hold at 3 grains for 6-8 weeks and retest. Most people adequately dosed on NDT will have low or suppressed TSH, low to mid range FT4 and mid to upper range FT3.

Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroiditis (Hashimoto's).

There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

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

Ferritin is optimal halfway through range. You may want to increase the dose of iron you are taking and take each dose with 1,000mcg vitamin C which aids absorption and minimises constipation.

B12 and folate are good. You can probably maintain B12 levels if you reduce dose to between 1,000mcg and 2,500mcg.

WBC are deficient which means you will be prone to infections. Your GP should keep an eye on WBC.

labtestsonline.org/understa... will explain what low and high evaluations in a full blood count may mean.

You can also enter the other results into Labtestsonline search to see what the tests are for and why they are ordered or Google them.

[Kiwidel in reply to Clutter]

Thanks for responding Clutter.

Re the NDT increase, I am following the STTM approach and am planning on increasing to 2 grains just before Xmas.

I am tracking resting am heart rate and waking temp - whilst I've still got a low temp it's definitely increased and stabilised since starting the NDT, and I feel on a much more even keel. It's tough to stick to waiting for an increase when the little bit you're taking is making you feel better but I get that the tortoise definitely wins in this case.

Thanks!

[Kiwidel in reply to Clutter]

Hi again Clutter, sorry another question ... Do you think I need to be worried about RT3 with these results or is there no way of telling without T3 /RT3 testing?

The only way to get the RT3 test here is to pay for it, so if possible I'd like to avoid the expense until I need to get the testing done at 6-8 weeks.

Thanks

[Clutter in reply to Kiwidel]

Kiwidel,

I wouldn't worry about rT3 with FT4 13.1 which is less than halfway through range.

[Josiesmum]

Well done on getting such a comprehensive range of tests! I noticed your neutrophils and ferritin are low, I've read that colostrum is good for these:

healthy.co.nz/ailment/2032-...

Are you gluten free?

thyroidpharmacist.com/artic...

[Kiwidel in reply to Josiesmum]

Hi, thanks for the tip 're colostrum, I'll add it to the list of research topics.

I'm not gluten free. I think I might try eating more gut health promoting food first to see if that helps as I think I'll struggle with Gf, plus I think that removing something completely from your diet is a good way to increase an intolerance... Just my view of course.

Re the tests, I think I just lucked out on the Dr I saw plus I had walked in with a spreadsheet of all of my test results since diagnosis from both the UK and Canada. She seemed shocked that no one had really explained some of the previous test results to me or referred me to an Endo. Fingers crossed the luck continues with the Endo.

[SlowDragon Administrator]

Like you I was extremely sceptical that gluten free would make any difference. I had no gut issues. But much to my amazement it was a fantastic transformation.

I would strongly suggest at least trying it for 2-3 months. If it makes you feel so much better, as it does for very many of us with Hashimoto's, then it is not difficult to stick too & there are lots of GF alternatives available now

Lots about thyroid & gluten connection on masses of websites, here's just a few

chriskresser.com/the-gluten...

naturalendocrinesolutions.c...

Thyroid pharmacist- Isabella Wentz

The Immune Recovery Plan by Susan Blum