Reasurance required... blood test

Like many i struggled with my doctor understanding, that im neither depressed, or suffering with sleep apnea...about 8 yrs ago i tried to convince my doctor i had an underactive thyroid, and in the end he did the test to prove i was wrong...guess who was wrong, since then its a constant battle to get my levothyroxine increased, even when my TSH was in the high teens

At my last test all he wanted to talk about was my weight (which is high) and took my blood pressure 3 times as refused to believe it could be 120/80 at my weight, thank goodness for this forum, although i got a basic understanding of the test can you please expand my understanding, and what i need to do

Biochemistry

CRP 2.40 <5.0 mg/L

Ferritin 61.1 30 - 400 ug/L

Thyroid Function

TSH H 4.42 0.27 - 4.20 mIU/L

T4 Total 76.9 64.5 - 142.0 nmol/L

Free T4 13.63 12 - 22 pmol/L

Free T3 4.63 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs H 282.7 <34 kIU/L

Anti-Thyroglobulin Abs H 728.5 <115 kU/L

Vitamins

Vitamin D (25 OH) L 34 Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 L 169 Deficient <140 pmol/L

Insufficient 140 - 250

Consider reducing dose >725

Serum Folate 17.86 8.83 - 60.8 nmol/L

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4 Replies

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  • Americus,

    Have you considered changing GP? It shouldn't be a constant battle to get requisite tests and medication.

    TSH 4.42 is over range which means you are under medicated. Being under medicate on Levothyroxine will make it nigh on impossible to lose any weight and will usually cause weight gain.

    The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.roberts@thyroiduk.org.uk if you would like a copy of the Pulse article to show your GP.

    Thyroid peroxidase and 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_...

    Ferritin is optimal halfway through range ie 200. You could supplement iron along with 1,000mcg vitamin C which will aid absorption and minimise constipation.

    Vitamin D is insufficient. It needs to be 75 - 200. Most people are comfortable around 100. I would supplement 10,000iu D3 daily for a couple of months and then reduce to 5,000iu daily for another couple of months and retest in May.

    I think folate is probably adequate.

    B12 is very low. Ask your GP to test intrinsic factor antibodies to rule out pernicious anaemia. If PA is confirmed you will require B12 injections. healthunlocked.com/pasoc is the best forum for advice on PA, B12 deficiency and folate.

  • americus Your doctor is a total twonk (and I had to restrain myself from using the word I was thinking of, it might have got me banned).

    Clutter has covered everything about your test results. I would just add that Folate is recommended to be at least half way through it's range, so that would be 34.81 with your range. When you pop over to the PA forum that Clutter has linked to, mention your folate result as well. You may need to have the PA test done and sort out what is to be done about your low B12 before doing anything about supplementing folate.

    You haven't got much Total T4 there, and your FT4 is low but is converting well to FT3. Good conversion takes place at FT4: FT3 ratio of 4:1 or less, and yours is a very nice 2.94:1

    As for your Hashi's, as well as adopting a strict gluten free diet, which many members have found helps, supplementing with selenium L-selenomethionine 200mcg daily and keeping TSH very low or suppressed also can help reduce antibodies.

    You most definitely need an increase in your Levo. It should be increased in 25mcg increments, retesting 6-8 weeks after each increase, until you feel well and your symptoms abate.

  • It sees your GP is deliberately penny pinching as s/he knows that complaints go nowhere, so change GP asap and don't wait until s/he maims you for life by ignoring your serious vitamin deficiencies.

    You can change your GP now without giving a reason, and your GP can be near your workplace rather than your home.

    Talk to people and ask around family, neighbours and friends particularly any who had problems with their GP who they go to.

  • Tick off your clnical symptoms from the following page. Take to GP and ask why you have all of these symptoms when you are taking levothyroxine and your understanding from NHS Choices for information on the thyroid gland, the aim of taking levothyroxine is to relieve patients of all clinical symptoms. Most times when on too low a dose we develop more but they don't know this fact.

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

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