Thyroid test results could anyone explain please

[LynneG]

Hi, I have my results back from Blue Horizon and wonder if anyone can explain if all ok?

I had the tests taken because I have started with what seems to be nerve issues. Burning mouth, lips, gums, sore tongue, burning fingers and hands, toes and feet spreading up limbs and waking me at 3am.

I had active B12 test because I thought my active B12 may be low and causing my issues.

A few years ago my serum B12 was191 and classed as normal by my GP but I started supplementing anyway on and off over the years as I knew from what I had read that it was too low. The highest I managed to get my total B12 with supplementation was 550 last April and total had fallen in November to 474 without any supplementation. It appears to have fallen again even tho I panicked and supplemented for a couple of days with daily dose about 3 weeks ago when symptoms started. I stopped as knew i did not want to skew a blood test.

I have not recieved any comment at all with the Blue Horizon Blood test re thyroid tests. All that was commented on was that Active B12 was high but not worryingly so and most probably high due to supplementation - which I did for 2 days a few weeks ago. So I presume from this result that I am at least converting B12 to active and deficiency is not an issue? or at least not a problem if I supplement?

My thyroid results, I have no idea what they mean other than my TSH is still creeping up. In November my TSH was 3, which concerned me. And then with my symptoms really hitting me jan 1st, thought Thyroid may be causing. I have never discussed thyroid with my GP other than I wished to keep monitoring as my TSH kept rising and obviously am on no medication

My Blue Horizon Blood Test Results 23rd Jan 2017 Fasting 9.20am

Haemoglobin 135 g/l range (120-160)

MCV 85 fl (81-98)

Thyroid Function

TSH 3.53 mlU/L (0.27 - 4.20)

T4 Total 98.0 nmol/L (64.5 - 142)

Free T4 16.83 pmol/L (12 - 22)

Free T3 5.14 pmol/L (3.1 - 6.8)

Anti TPO abs 19 klU/L (<34)

Anti TG Abs 12.1 kU/L (<115)

Vitamin B12 392 pmol/L (deficient < 140)

(insufficient 140 - 250)

B12 Active H 209.6 pmol/L (25.1 -165)

Serum Folate 24.88 nmol/L (8.83 - 60.8)

[Clutter]

LynneG,

My understanding is that there is unlikely to be B12 deficiency when Active B12 is >35. It would be better to check with PAS.

Folate is adequate.

MCV is within range.

TSH 3.53 indicates your thyroid gland is struggling but NHS won't make a diagnosis and prescribe Levothyroxine until TSH is over range or FT4 below range. Thyroid antibodies are both negative for autoimmune thyroid disease (Hashimoto's).

[bluebug]

Have you had your ferritin level and vitamin D levels checked?

Ensure your ferritin is at least halfway within it's range and your vitamin D is around 100nmol/L. (It is possible to have good within range haemoglobin levels and low ferritin levels.)

Other than that as @Clutter stated you need to have a TSH of 10+ and a FT4 below range to be diagnosed by the NHS with hypothyroidism. Even then some GPs refuse to diagnose you for a few months. The NHS is in the dark ages when it comes to thyroid issues and nutrients.

[LynneG in reply to bluebug]

So are you saying that my FT3 and FT4 are Ok and the only sign is TSH showing thyroid struggling. Why should it be struggling if FT3 and FT4 are OK - have you any idea. Just wish to understand.

Yes my iron is complicated. My ferritin was 139 in Nov and has been 140 since menopause. I wanted to donate blood to replace bleeding loss of periods Best advised way of reducing ferritin - as is too high. But I thought that I had better have a full iron panel taken (NHS) my (MCHC has been abnormal low for years Nov 2016) because I don't want to make myself feel ill with having low useable serum iron.

325 g/L lab range (335 - 370)

Iron Panel

Ferritin 139

Serum Iron 10.9 umol/L (6.6 - 26)

Serum TBIC 59.9 umol/L (45 - 81)

Transferrin saturation index 18.2% (15 - 45) but anything below 20% has been deemed in Dec 2016 studies to be significantly low

So with my low iron but high ferritin I presume that I am bordering on anaemia of inflammation. My body is not releasing the iron but increasing iron stores.

[bluebug in reply to LynneG]

If you go to the main website of the charity who runs this forum there are links on the LHS and explains how the thyroid works with some diagrams. The site is thyroiduk.org.uk

One common thing seen here is that posters with struggling thyroids frequently have high ferritin levels. However doctors particularly GPs don't tend to understand about ferritin so showing them that test result will not yield anything.

[Clutter in reply to bluebug]

Bluebug,

I've never stated that TSH has to be >10 to get a diagnosis. I know some people have had to wait until then but I believe most will get a diagnosis when the second TSH is over range.

[helvella Administrator Thyroid UK in reply to bluebug]

Not so - at least for me.

I was diagnosed with a TSH of almost exactly 5 (tiniest bit over the local range at the time). Admittedly, because I pushed, and had a clear history of climbing TSH, and an amenable GP.

[LynneG]

Oops Sorry - My vit D is 117 November. But try to keep in 120's so supplementing a little just in the winter.

[bluebug in reply to LynneG]

Then it seems clear the problem is your thyroid. Unfortunately the NHS doesn't diagnose thyroid issues on symptoms but from the results of your blood tests.

[LynneG]

Thanks everyone I will check out the Thyroid Uk site explanation bluebug. Does anyone understand Reverse T3. I thought that I had a vague memory of Chris Kresser stating that if Free T4 was high and Free T3 was low then this indicated Reverse T3 conversion? Or is it the other way round? I can't find the article now.

However I have no idea if my test FT3/FT4 result shows anything but in normal range. But normal lab range for anything eg TSH is found to be wanting, so what is a range to trust.

My FT3 looks in the mid to highish end of range and my FT4 looks mid range. So I hope then that I can rule out Reverse T3? Does anyone know?

If my FT3 and FT4 are in good range then why can't my pituitary gland see this, why is it making/raising TSH to stimulate my thyroid to produce more hormone? Or are my FT3 +4 only at good levels (if they are?) because of the over stimulation. My head is spinning

[SlowDragon Administrator]

When supplementing vitamin D, Dr Gominack suggests that we can then need/run short of B5, possibly then getting peripheral neuropathy - "burning skin", feet especially.

drgominak.com/vitamin-d-hor...

I sufferd this "burning" feet (mainly) about 2 months after starting supplementing quite high dose vit D (I have Hashimoto's).

Supplementing good quality vitamin B complex is suggested by Dr Gominack.

[SeasideSusie Remembering in reply to SlowDragon]

That's an interesting article SD, I've bookmarked it. I get the burning feet thing sometimes. Off to check what B vits are in my supplements.....

[SlowDragon Administrator in reply to SeasideSusie]

Adding Jarrows B-right complex gave total improvement for me.