Could I have Hashimoto's?

[rebs48]

I've been given some very useful information about possible B12 deficiency by the Pernicious Anaemia community, but I'm wondering whether I could have Hashimoto's which is causing deficiency in Vit D, Vit B12 and ferritin. I have Rheumatoid Arthritis, and neurological symptoms (pins and needles in feet, legs, hands and a little on scalp). I take 5mg folic acid, I am having regular B12 injections and have just started on ferrous fumarate as my ferritin is so low. I've tested negative for Instinsic Factor Antibody and my recent TSH and T4 levels are within normal range (most recent blood test results below). I would appreciate any feedback. Thanks!

Serum TSH level 3.67 mU/L [0.35 - 5.5]

Serum free T4 level 12.7 pmol/L [10.0 - 19.8]

Serum C reactive protein level < 4 mg/L [0.0 - 6.0]

Erythrocyte sedimentation rate 11 mm [3.0 - 9.0]

Total white blood count 4.7 10*9/L [3.9 - 10.2]

Red blood cell count 5.00 10*12/L [3.9 - 5.2]

Haemoglobin concentration 126 g/L [120.0 - 156.0]

Haematocrit 0.396 L/L [0.355 - 0.455]

Mean cell volume 79.6 fL [80.0 - 99.0]

Mean cell haemoglobin level 25.4 pg [27.0 - 33.5]

Below low reference limit

Red blood cell distribution width 14.5 % [11.0 - 16.0]

Platelet count - observation 269 10*9/L [150.0 - 370.0]

Plateletcrit 0.210

Mean platelet volume 7.9 fL

Neutrophil count 2.28 10*9/L [1.5 - 7.7]

Lymphocyte count 1.89 10*9/L [1.1 - 4.5]

Monocyte count - observation 0.26 10*9/L [0.1 - 0.9]

Eosinophil count - observation 0.12 10*9/L [0.02 - 0.5]

Basophil count 0.05 10*9/L [0.0 - 0.2]

Serum magnesium level 0.85 mmol/L [0.7 - 1.0]

Serum ferritin level 7.5 ug/L [10.0 - 291.0]

Serum total 25-hydroxy vitamin D level 22.6 nmol/l

[rebs48]

BTW, I should say that my Serum vitamin B12 level was 228.0 ng/L [211.0 - 911.0] before I started on the B12 injections, so low normal.

[greygoose]

What time of day did you have the blood drawn? Was it fasting? Is this the first time you've had a TSH test? No FT3 done?

If you want to know if you have Hashi's, you need to have your antibodies tested : TPO and Tg antibodies. Nothing on that list of tests will tell you.

[rebs48 in reply to greygoose]

Thanks for this, greygoose . I had the most recent blood test in the morning, but it was not fasting as I had breakfast (I wasn't told that it should be fasting). I did not have FT3 although I had asked the GP for this. It is not the first time I've had my TSH done - a fortnight before, it was 1.67 mU/L (that was done in the afternoon). Are the TPO and Tg antibodies tests conclusive? My RA is in remission as I am on biologics, so I can't help but feel that this pins and needles is autoimmune (I've recently had an MRi scan on my neck and I'm being sent for EMG tests to double check). Thyroid seems the most obvious villain!

[greygoose in reply to rebs48]

Your TSH will be highest early in the morning, after fasting over-night. So, your TSH, there, is not as high as it could be.

Antibodies are conclusive if they are high. But, as antibodies fluctuate, a negative result does not completely rule out Hashi's.

Pins and needles are more likely to be connected to low B12, and yours was very low before you started the injections. Perhaps you haven't been having them long enough to have had the full effect. Are you also taking a daily B complex? If not, you really should be. All the Bs work together, so need to be kept balanced.

[Treepie]

Your TSH result suggests your thyroid is beginning to struggle but you also need FT4 and FT3 results. As Grey Goose adds you need the antibody tests to tell if you have Hashimotos. However ,the treatment for that is just the same as for hypothyroidism. If antibodies are high you may be treated.If not you probably will not until TSH rises to around 10.

[rebs48 in reply to Treepie]

Thanks for your helpful reply, Treepie