Blood results

Blood results

Hi all,

I went to my GP last month for bloods after suffering extremely low energy and mood and feeling cold all of the time. I am 32 years old, eat healthily and don't smoke but feel for the past 5 months I've been a shadow of myself, with no energy or interest in socialising or exercise. The GP suggested checking my thyroid and after some googling I now recognise that I have had mild versions of other common hypo symptoms (renauds, brain fog, brittle hair, nails, thinning outer eyebrows) for the past decade.

The NHS bloods revealed low vitamin D and a slightly below normal Free T4 of 11.5 (12-22pmol/L). Iron, B12, ferritin were normal. I have been supplementing with 5,000 units per day of Vit D for the past month but my symptoms have not improved.

I decided to get some private thyroid bloods done by Medicheck to check T3 and the results (attached) came back today with "thyroglobulin antibodies are positive". What does this mean and is it serious enough to go back to my GP? I would really appreciate it if someone could take a look at the results and help me interpret.

Many thanks!

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20 Replies

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  • Your TSH alone which is 3.17 is just below the top of the range but in the UK, for some unbelievable reason, the guidelines are that the TSH has to reach 10 before being diagnosed.

    Both FT4 is below range and FT3 is low should be towards the top part of the range, which means your body doesn't have sufficient T3 in your receptor cells for your metabolism to work normally.

    You have high antibodies which means you have an Autoimmune Thyroid Disease called Hashimoto's and it is the commonest cause of hypothyroidism. The antibodies wax and wane, sometime too much and at other times less.

    By going gluten-free can help reduce the antibodies. Due to having antibodies your GP should prescribe levothyroxine which is a synthetic thyroid hormone called T4. T4 has to be gradually increased every six weeks until you feel an improvement and TSH is 1 or lower with FT4 and FT3 towards the top of the range.

    You should be prescribed levothyroxine due to having antibodies and if he doesn't agree, email louise.roberts@thyroiduk.org.uk and ask for a copy of the Pulse Online article by Dr Top and within it it states if we have antibodies, we should be prescribed.

    When you have blood tests for thyroid hormones in the future, it should be the very earliest possible, fasting (you can drink water) and allow 24 hours gap between your last dose of hormones and the test and take afterwards.

    Always get a print-out of your results with the ranges. Ranges are important as labs differ.

  • SM85,

    You are hypothyroid because FT4 is below range and your GP should prescribe Levothyroxine to raise FT4 even though TSH is not yet over range. Your GP might want to consider secondary hypothyroidism as your TSH hasn't risen much despite deficient FT4.

    cks.nice.org.uk/hypothyroid...

    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_...

    Depending on how low your vitD was it will probably take 6-8 weeks before you feel improvement after supplementing vitD.

    Iron, B12, ferritin were normal. Normal is a very broad range. What were the results and ranges?

  • Many thanks for your reply, I could only attach one picture so chose the Medicheck thyroid blood results over my NHS bloods. The other test results were as follows:

    Serum ferritin 22 (14-148)ug/L

    Serum B12 480 ng/L

    Serum folate 8.6 ug/L

  • SM85,

    Ferritin is optimal halfway through range so I would supplement iron and take each tablet with 1,000mcg vitamin C to aid absorption and minimise constipation.

    B12 480 is probably fine but many people prefer it high in range. If so you can supplement 1,000mcg methylcobalain daily or alternate days to raise B12 and take a B Complex vitamin too to raise folate.

  • SM85 In a normal healthy person one would expect to see TSH around 2 or below. Your TSH shows your thyroid is struggling. You have an under range FT4 and one would expect to see FT4 and FT3 over half way through the range in a healthy person. Also your total T4 is very low showing that you are producing very little T4 naturally.

    On top of that, you have high TG antibodies which means you are positive for autoimmune thyroid disease aka Hashimoto's. This is where antibodies attack the thyroid and gradually destroy it. Hashi's isn't treated, it's the resulting Hypothyroidism that is.

    Also this, along with your symptoms should tell your GP that you are Hypothyroid, but the fact that your TSH is within range !Ay mean that he won't be convinced and won't diagnose and treat you. Many doctors wait until TSH reaches 10.

    Dr Antony Toft, past president of the British Thyroid Association and leading endocrinologist, says in Pulse magazine that where antibodies are present then Levothyroxine should be started to 'nip things in the bud'. You can obtain a copy of the article by emailing louise.roberts@thyroiduk.org.uk

    To help reduce the antibodies you should adopt a strict gluten free diet which has helped many members enormously. Gluten contains gliadin which is a protein thought to trigger antibody attacks.

    Gluten/Thyroid connection - chriskresser.com/the-gluten...

    Supplementing with Selenium L-selenomethionine 200mcg daily and keeping TSH suppressed also help reduce antibodies.

    Hashi's Information:

    stopthethyroidmadness.com/h...

    stopthethyroidmadness.com/h...

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

    **

    Are you taking Vit D's important co-factors K2-MK7 and magnesium along with your D3?

    **

    Iron, B12, ferritin - what is normal? Can you post the results as normal doesn't mean optimal. Also what was your folate result?

  • Thanks Susie. I am taking liquid magnesium drops at night separate from the D3, plus a multivitamin (containing some K2) but think I will ditch the multi in favour of an individual higher strength k2 supplement. My other test results were as follows:

    Serum ferritin 22 (14-148)ug/L

    Serum B12 480 ng/L

    Serum folate 8.6 ug/L

  • SM85 Good idea to ditch the multivitamin, they generally are a waste of money as they don't contain enough of anything to do any good and usually contain the wrong/cheapest/least absorbable form of ingredients. Most separate K2-MK7 supplements contain around 90-100mcg.

    D3 and K2 are fat soluble so should be taken with the fattiest meal of the day. If you buy softgels they generally contain some oil to aid absorption. This is a decent K2-MK7 amazon.co.uk/Jarrow-MK-7-90...

    **

    B12 below 500 can cause neurological problems. Recommended level is very top of range, even 900-1000. Solgar sublingual methylcobalamin lozenges 1000mcg daily will help raise your level.

    **

    Folate - is there a range? It needs to be at least half way through. When taking B12 we need a B Complex to balance the B vits. Best to get one with methylfolate rather than folic acid.

    **

    Ferritin needs to be at least 70 for thyroid hormone to work properly (our own or replacement). For females it is recommended to be 100-130. With your level so low you could buy some Ferrous Fumarate from Amazon and take one tablet twice daily and take each tablet with 1000mg Vit C to aid absorption and help prevent constipation. Finish the packet, wait a week and retest. Once you reach the recommended level you need to keep it there by either taking a maintenance dose or eating liver regularly.

    Keep iron supplements away from other supplements by two hours as it can affect their absorption.

    **

    If you do manage to be prescribed Levo, keep iron, Vit D and magnesium away by four hours, other supplements by two hours.

    **

    Don't take any supplements containing calcium or iodine unless tested and found to be deficient.

  • SeasideSusie

    I bought Solgar Methylcobalamin B12.

    This time I put tablet under tongue and not much happened.

    I then read the label. "As a dietary supplement take one (1) nugget daily preferably with meal or as directed by practitioner. Place nugget under tongue for 30 seconds before swallowing. The tablet barely changed after 30 seconds and as far as I'm concerned it isn't sublingual as I had to swallow it with water.

    I've emailed Solgar to say that sublingual means absorbed through tongue not that it should be swallowed. If you've P.A. you cannot absorb through stomach.

  • shaws It's the only brand I've used, and I've had quite a few bottles now (1000mcg strength)

    This is the one I buy amazon.co.uk/Solgar-Subling... and it is the one that dissolves in about 45 seconds.

    Is yours either of these as they don't say sublingual on the label hollandandbarrett.com/shop/...

    hollandandbarrett.com/shop/...

    ETA: Just had a look to see if the links work and the first one does actually say sublingual.

  • I purchased same sublingual 1000mcg one via the amazon link, so fingers crossed.

  • Mine definitely says Solgar Sublingual from Amazon and I've used it many times. These don't dissolve and why does it say put under tongue for 30 seconds and then swallow just doesn't ring correct. The others used to dissolve more or less immediately.

    Delivered 16 Feb 2017

    Parcel was handed to resident

    Track package

    Solgar, Sublingual Methylcobalamin, 5000 mcg, 60 Nuggets

    Sold by: Nature's Remedies

    Return window closed on 19 Mar 2017

    £11.95

  • That's very strange shaws It sounds as if something has gone wrong, wrong tablets in the bottle maybe, but to say on the label 'before swallowing' is very strange too. It will be interesting to know what they say in answer to your email. I wonder if they will send you a replacement.

  • This is my email to them: their return comment: and my reply to them:-

    I bought these tablets but even though they state sublingual - they are not as the directions state place under tongue for 30 seconds and swallow with water. So, they are not sublingual and I have had many sublingual tablets. Definition of Sublingual:- Sublingual and buccal medication administration are two different ways of giving medication by mouth. Sublingual administration involves placing a drug under your tongue to dissolve and absorb into your blood through the tissue there. http:www.healthline.comhealthsublingual-and-buccal-medication-

    Thank you for your e-mail and kind interest in our products

    This is not the instruction on the UK label, so it sounds as though you may have bought a US market version, perhaps through Amazon UK, where some US stockists do sell. Technically, they should not, as US market products do not comply with legislation here.

    In this case, I believe US legislation has dictated their different instructions, but for optimal absorption, you would need to hold the tablet in the mouth as long as possible.

    +++++

    My reply to them:

    Thank you for your quick response. I have used Solgar sublingual very often but realise, as you say, it may be the USA type. I did not look at the Reviews as I didn't need to as I've often used them. On the Amazonuk site where I ordered a couple of people commented about the 'hardness' I find it surprising that sublingual doesn't dissolve as it should. I have had it under my tongue now and it is coming up to 15 minutes . Not sure if it absorbed by tongue or being swallowed. Very unusual.

  • I wonder if you'd get any joy by contacting the seller? Explaining that they're not the same as the ones you usually have. It certainly isn't my experience with sublingual. I have the 1000mcg but they've always dissolved in no more than 45 seconds.

  • These are 5,000 but why would they not dissolve as we'd believe. I will think about contacting seller.

  • shaws I've just been checking my Amazon orders, I didn't buy from the same seller as you but checked yours and mine, they both have this

    "Legal warranty:

    If a product turns out to be faulty or not as advertised, you may be entitled to free of charge repair, replacement or refund. Read more on legal warranty."

    I think that might be worth pursuing. It's definitely not the same product as you've had before.

  • Just to update you both, the Solgar ones I bought using the link from SeasideSusie dissolve nicely under the tongue in less than 10 seconds.

  • shaws Clutter SeasideSusie Thank you all so much for your help. I made a last minute appointment today and saw a locum doctor who didn't appear to have much knowledge of thyroid. When I showed him my positive antibodies blood results he suggested just "waiting another few months" to see if things changed. The information gained here really helped and I was able to explain that it points to Hashi's, and therefore waiting wouldn't benefit me. He did a quick read-up on his computer about secondary hypothyroidism while I was sitting there, and meekly suggested maybe I could try Levothyroxine for a few months.

    So I left with a prescription for 50mcg of Levo but now I am unsure what to do. I have read here that the dose needs to be built up and monitored, but feel this will be totally down to me as that locum doctor seemed clueless.

    Do I start on the full 50mg and book another appointment with my regular GP to ask them to check how it's going? Or do I cut the tablet and start lower? Should I split the dose throughout the day or take in the morning as suggested on the prescription? How long should I wait before going back to the GP? Is NDT better than Levo and something I should push for? Should I change doctor to someone with better knowledge?

    On your earlier recommendations I have just ordered the below supplements and will begin those this week too. Is there a particular order I should take them in?

    Sorry for all the questions, I appreciate your advice more than you will ever know!

    Xx

    *********************

    Solgar Sublingual B12 - 1000mcg (Methylcobalamin)

    Thorne B Complex Vitamin (Methyltetrahydrofolate)

    Source Naturals Selenium - 200mcg (Selenomethionine)

    Ferrous fumarate - 210mg X 2

    Solgar Vitamin C- 1,000mcg X 2 (L-ascorbic acid)

    Nutravita D3 softgels - 5000iu

    Jarrow K2 - 90mcg (MK7)

    Mega-Mag Magnesium drops - 375mg

    Solgar Zinc - 22mg (Picolinic)

    **********************

  • SM85 Read what I've said about Solgar methylcobalamin above. I've used them before, but these aren't sublingual even though it says on the bottle.

  • SM85,

    50mcg is a low dose so you can take the entire 50mcg without building up. Levothyroxine can be taken any time of day as long as it is taken away from food, medication and supplements.

    For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements and oestrogen.

    It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

    You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

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

    It is good practice to introduce one supplement every 2 weeks. Otherwise you won't be able to identify which is causing problems if you have an adverse reaction.

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