Blue Horizon Results

[Dahlia17]

My results have just arrived, that was quick! My CRP is raised 7.80 (<5). I expected that as still have cough and Vaginal inflammation (untreated).

Ferritin looks on low side 67.2 (20-150)

TSH is really suppressed 0.01 (0.27 - 4.20)

T4 total 136.9 (64.5 - 142)

Free T4 21.10 (12 - 22)

Free T3 4.86 (3.1 - 6.8)

Anti-Thyroidperoxidase abs 28.4 <34 kIU/L

Anti-Thyroglobulin Abs H 686.8 <115

Vit B12 199 (low)

Serum Folate 12.71 (8.83 - 60.8) Low

Dr's notes say "The thyroid stimulating hormone (TSH) level is low. If you are already taking thyroxine, dose adjustment may be necessary - you should discuss this with your usual doctor. If you are not taking thyroxine, it would be wise to keep an eye on this level - either by reference to previous results if known or by checking TSH again in 6 months’ time or so. There is a possibility that hyperthyroidism (overactive thyroid gland) will develop if the TSH fails to rise (a low TSH implies excessive thyroxine production from the thyroid gland). 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."

He also references the low B12. I have bought some which arrived today. Should I start supplementing straight away or see GP first?

[Marz]

How much B12 are you intending to supplement with ? Which type is it ? Are you a vegetarian ? I think it would be helpful if you had your LOW B12 investigated - could it be PA ? So further testing is important to establish this.

When supplementing B12 you also need a GOOD B complex to keep all the B's in balance and to provide Folate - B9 - which works with the B12 in the body .....

[Dahlia17 in reply to Marz]

Hi Marz. No I'm not vegetarian. I have bought Solgar sublingual Methylcobalamin 5000 mcg & Solgar Vit B Complex with vit C to take together. I won't take them if wrong, not bothered about costr at moment, just want to feel well

[Marz in reply to Dahlia17]

It is not wrong to take them - I think you need to go to the PAS Forum here on HU and ask for advice. Certain tests for Pernicious Anaemia are not affected by supplementing - others are. I am not an expert. Your result is cause for concern as it is near the bottom of the range when it needs to be near the top

Are you taking any medications that could be preventing the uptake of B12 in the stomach ??

[Dahlia17 in reply to Marz]

I am on Metformin 1,000 mcg twice a day

[Marz in reply to Dahlia17]

Ah - well that is your answer. Were you warned ? Let's hope the sub-lingual works ....

[Dahlia17 in reply to Marz]

Really? No one said a word, not GP nor Diabetic Nurse. To be honest, I really do not believe that I have full blown Diabetes. None of this happened until I started to pile on midriff weight. I have a huge tummy but small hips, thighs and shoulders. I swear this Thyroid problem was the start of a slippery slope towards all my other ailments.

[Marz in reply to Dahlia17]

Excess cortisol and insulin resistance can be the cause of mid-riff issues. I too am FAM - fat around the middle and hate it If you read the Patient Information Leaflet of the Metformin - it may mention about B12.

Have you read Ruthi's post today - about fat and carbs ? You may find some of the information useful

[Dahlia17 in reply to Marz]

I'll look for it. So do you suggest that I start supplementing the B12 & B vits now then?

[Marz in reply to Dahlia17]

As I said earlier I think you need to seek advice from the PAS Forum here on HU. I think your LOW B12 issue needs investigating. How long have you been on Metformin ?

[Dahlia17 in reply to Marz]

about 4 or 5 years. I was initially on 1,000 mcg a day but she upped it last year

[Marz in reply to Dahlia17]

mhra.gov.uk/home/groups/spc...

The above link takes you to the Patient Information Leaflet which is inside the box of pills. Scroll down for possible side effects and the effect on B12 reserves and Folate. It also mentions the maximum dose which is LESS than yours.

I would try diet and try to replace the Metformin. High Fats - low carbs - do read Ruthi's post if you wish to be informed ....

[Dahlia17 in reply to Marz]

I just read that other link and I'm horrified. No one has ever discussed this with me and made a link between the Metformin and possible B12 deficiency. I am so angry with Dr at the moment. I have only one fully functioning Kidney as well and I am sure he ignores this when prescribing certain meds as well.

[Marz in reply to Dahlia17]

I do feel your pain and anguish. Am afraid these days we have to read and learn as much as possible to take good care of OURSELVES. Docs just write the prescriptions. You and only YOU care about YOU.

How is your VitD level ? - I have read you also have COPD ....

I was prescribed a drug for Crohns in the last few years - came home and researched it and have NOT taken it. The side effects were pretty awful - even if you didn't have them ALL

So what other drugs are you taking ?

[Dahlia17 in reply to Marz]

Just the Levo 150 and the Metformin, oh nearly forgot Ramipril 1.25 mg for Blood Pressure (never ever had high blood pressure, even when pregnant). He tried to put me on Statins but I refused.

[Marz in reply to Dahlia17]

Raised blood pressure is usually a symptom and not in itself a condition or illness. Have you tried Magnesium to relax the arterial system and the heart muscles. Carolyn Dean wrote an excellent book - The Magnesium Miracle.

[Dahlia17 in reply to Marz]

Started Magnesium, Selenium and Vit C today. I was sent for Ultrasound and ECG over a year ago. He told me I have Fatty Liver, cysts on ovaries and enlarged heart. All this when my weight ballooned by several stone with no change in diet. I joined Gym and bought a bike. I am still about 4 stone overweight having taken nearly 2 years to lose a stone and a half.

[Marz in reply to Dahlia17]

Have you thought about going gluten free and giving up anything with sugar or that turns into sugar .....

[Dahlia17 in reply to Marz]

Yes I have already started checking foods for gluten content. My husband is Greek and we follow a mainly mediterranean diet. Plenty of fresh foods, salads, olive oil etc

[Marz in reply to Dahlia17]

Dahlia17 - you didn't answer my enquiry about your VitD. Very useful in the treatment of COPD I have read ....

[Dahlia17 in reply to Marz]

No I am getting it done. Clutter gave me a link for blood test

[Marz in reply to Marz]

ncbi.nlm.nih.gov/pmc/articl...

A piece of research above from 2013 explaining B12 deficiency with T2D and the mention of Metformin.

[Dahlia17 in reply to Marz]

Marz while I have you captive LOL Can I ask, if as it seems I have Hashis, should I be looking at taking T3 as well as Levo?

[Marz in reply to Dahlia17]

Yes your FT3 could do with being a little higher - but then the conversion from T4 could be hampered by Low B12 etc.

chorobytarczycy.eu/kalkulator

Click onto the link above - its in Polish ! Put your T4 result in the first box followed by the range in the next two. Same for the T3. Then press the button at the bottom to learn at what % to total your results are

[Dahlia17 in reply to Marz]

Thank you. You have been brilliant today

[Dahlia17 in reply to Marz]

Did it. T4 came out at 91%. T3 came out at 47.57%. Does that look like it can be tweaked a little?

[Marz in reply to Dahlia17]

So it looks as if you could have a conversion issue going on - so yes adding T3 could help

[Dahlia17 in reply to Marz]

Thanks again, you are a star. I have appointment with GP on Friday morning, I'm not expecting much joy judging by past experience though

[Marz in reply to Dahlia17]

No but people here on the forum will help you. Start with a new post. I am T3 only but live in Crete - so things are different 😊

[SeasideSusie Remembering]

Dahlia17 Personally I would hold off with the B12 supplement until you have spoken to your GP. It is low but not in the Deficient range, plus your Folate is low. As these work together it may be an idea for your GP to test for Pernicious Anaemia. To get more advice, pop over to the Pernicious Anaemia Society forum here on Health Unlocked healthunlocked.com/pasoc

Ferritin isn't dire but needs to be at least 70 for thyroid hormone to work properly (our own or thyroid hormone replacement). I've seen it said that for females 100-130 is best. Rather than faff about with iron supplements, which are tricky to fit around thyroid meds and other supplements and can cause constipation and tummy upset, you can eat liver once a week and that will do a very good job of raising your Ferritin level.

As your FT3 and FT4 are within range, don't worry about your TSH being suppressed.

Dr Toft, leading endocrinologist and past president of the British Thyroid Association, states in a Pulse Online magazine article

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can get a copy of this article by emailing [e-mail] and show it to your GP.

What does need addressing are your very high TG antibodies. This confirms that you have autoimmune thyroid disease aka Hashimoto's. Ways to reduce the antibodies are by adopting a strict gluten free diet and supplementing with selenium L-selenomethionine 200mcg daily.

Gluten/Thyroid connection:

chriskresser.com/the-gluten...

Hashi's Information:

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

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

[Dahlia17 in reply to SeasideSusie]

I actually started supplementing with selenium today before results came through. I had read about it on another post, looked into it and decided it wouldn't hurt.

[SeasideSusie Remembering in reply to Dahlia17]

That's fine

Just take further advice on the B12 and folate before doing anything about supplementing those

Did you have Vit D tested?

[Dahlia17 in reply to SeasideSusie]

No I just took the Thyroid +10

[SeasideSusie Remembering in reply to Dahlia17]

As your B12 and Folate are low, I'd check Vit D as well. You can get a fingerprick blood spot test from City Assays for£28 vitamindtest.org.uk/index.html

Recommended level for Vit D is 100-150nmol/L.

[Dahlia17 in reply to SeasideSusie]

Thanks will do

[Clutter]

Dahlia17,

150mcg is a suppressive dose so no surprise your TSH is suppressed at 0.01. You aren't over medicated though because FT4 and FT3 are within range. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

Thyroid peroxidase antibodies are negative but thyroglobulin antibodies are positive for autoimmune thyroid disease (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_...

Before you supplement B12 ask your GP to test intrinsic factor antibodies. Positive antibodies denote pernicious anaemia which causes B12 deficiency and means you will require B12 injections.

[Marz]

Read through this thread carefully - checking the links people have posted and make notes before you see the Doc on Friday. Hope you will let us know how things go .......

[Dahlia17 in reply to Marz]

I will. I feel so much better informed now, I just used to accept that the Dr knew his job.

[Marz in reply to Dahlia17]

There are lots of good Docs but many go by the Guidelines that are laid down by various bodies - otherwise they lose their licence to practice. Also there is the influence of Big Pharma ....

[Angel_of_the_North]

High CRP indicates inflammation, which could just be a result of your high antibodies, vaginal problems or cough (infection). If you are taking PPIs, it could indicate early stage kidney problems.