Latest results. High cholesterol at 25 and possible PCOS? Help please :)

[Salphy]

Hi I've had some results recently and was just hoping for some advice on a few things that are concerning me.

After the first 2 test results my gp said once my b12, folate and vit d had been treated we could trial levo if still symptomatic. In all honesty I don't really feel much different. However I'm concerned that because my TSH seems to be dropping she might say no. Even though my T3 has also dropped slightly but still looks ok I think?

Anyway I'm 25 and have been struggling with weight gain for a good few years. I've tried dieting and increasing exercise but it just makes me so exhausted I can't function. I do have an active job as a physio. My diet isn't perfect (who's is?) but it's not bad either so I can't understand why my cholesterol is high and it's really worrying me. I'm only 25! I've had a look through here and some say their cholesterol has come down naturally with levo. Could it be caused by my thyroid? Even when my results aren't that bad?

Finally the results flagged that one of my hormones were high and possibly indicative of PCOS. However, it's assumed I have a 28 day cycle which I never have done and was in the luteal phase. My cycle is normally around 34 days but the last 8 months or so I've been really irregular. I had 6 months of having one period every 2 months (with light spotting when I should have had the missed one) then once started vit d supplements they returned to monthly (may be coincidence) but are still irregular (+/-3-4 days), lasting a week with a week of heavy spotting prior.

How do I know what phase I was in or is this just a sign and difficulty with PCOS? I've had a look at the PCOS forum but there isn't much mention of actual results. I know it can be linked to thyroid in some way so hoping someone here may know.

My results are below

DEC 16:

TSH H 5.03 (0.27 - 4.20) mIU/L

Free T4 14.52 (12 - 22) pmol/L

Free T3 5.43 (3.1 - 6.8) pmol/L

JAN 17:

CRP H 11.30 (<5.0 mg/L)

Ferritin H 188.9 (20 - 150 ug/L)

TSH H 4.77 (0.27 - 4.20) mIU/L

T4 Total 77.2 (64.5 - 142.0) nmol/L

Free T4 12.57 (12 - 22) pmol/L

Free T3 4.96 (3.1 - 6.8) pmol/L

Anti-Thyroidperoxidase abs H 80.6 (<34)kU/L

Anti-Thyroglobulin Abs H 565.1 (<115) kU/L

Vitamin D (25 OH) L 20

(Deficient <25 nmol/L Insufficient 25 - 50

Consider reducing dose >175)

Vitamin B12 L 238 (Deficient <140 pmol/L Insufficient 140 - 250 Consider reducing dose >725)

Serum Folate L 8.31 8.83 - 60.8

March 17 (Latest):

HAEMOGLOBIN (G/L) 148 g/L (115.00 - 155.00

)

HCT 0.439 (0.33 - 0.45

)

RED CELL COUNT 4.63 x10^12/L (3.95 - 5.15

)

MCV 95 fl (80.00 - 99.00

)

MCH 31.9 pg (26.00 - 33.50

)

MCHC (G/L) 337 g/L (300.00 - 350.00

)

RDW 13.0 (11.50 - 15.00

)

WHITE CELL COUNT 7.9 x10^9/L (3.00 - 10.00

)

NEUTROPHILS 3.91 x10^9/L (2.00 - 7.50

)

LYMPHOCYTES 3.29 x10^9/L (1.20 - 3.65

)

MONOCYTES 0.47 x10^9/L (0.20 - 1.00

)

EOSINOPHILS 0.16 x10^9/L (0.00 - 0.40

)

BASOPHILS 0.06 x10^9/L (0.00 - 0.10

)

PLATELET COUNT 222 x10^9/L (150.00 - 400.00

)

MPV 9.1 fl (7.00 - 13.00

)

CRP - HIGH SENSITIVITY 0.7 mg/L (0.00 - 5.00

)

SODIUM 138 mmol/L (135.00 - 145.00

)

UREA 4.6 mmol/L (1.70 - 8.30

)

CREATININE 84 umol/L (49.00 - 92.00

)

ALKALINE PHOSPHATASE 50 IU/L (35.00 - 104.00

)

ASPARTATE TRANSFERASE 23.2 IU/L (0.00 - 31.00

)

ALANINE TRANSFERASE 20.5 IU/L (10.00 - 35.00

)

CK 71 IU/L (26.00 - 140.00

)

GAMMA GT 19 IU/L (6.00 - 42.00

)

BILIRUBIN 18.4 umol/L (0.00 - 20.00

)

TOTAL PROTEIN 74.8 g/L (63.00 - 83.00

)

ALBUMIN 44.5 g/L (34.00 - 50.00

)

GLOBULIN 30.3 g/L (19.00 - 35.00)

CALCIUM 2.50 mmol/L (2.20 - 2.60

)

CORRECTED CALCIUM 2.41 mmol/L (2.20 - 2.60

)

URIC ACID 260 umol/L (175.00 - 363.00

)

HBA1C (MMOL/MOL) 31.00 mmol/mol (20.00 - 42.00

)

IRON *29.85 umol/L (6.60 - 26.00

)

T.I.B.C 59.85 umol/L (41.00 - 77.00

)

TRANSFERRIN SATURATION 49.87 % (20.00 - 55.00

)

FERRITIN 74.47 ug/L (13.00 - 150.00

)

TRIGLYCERIDES 1.48 mmol/L )0.00 - 2.30

)

CHOLESTEROL *5.51 mmol/L (0.00 - 4.99

)

HDL CHOLESTEROL *1.16 mmol/L (1.20 - 1.70

)

LDL CHOLESTEROL *3.68 mmol/L (0.00 - 3.00

)

HDL % OF TOTAL 21.05 % (20.00 - 100.00)

THYROID STIMULATING HORMONE *4.64 mIU/L (0.27 - 4.20

)

FREE THYROXINE 14.01 pmol/L (12.00 - 22.00

)

Free T3 4.9 (3.1-6.8)

OVARIAN/GUT ANTIGEN CA125 16.57 KIU/L (0.00 - 35.00

)

FOLLICLE STIM. HORMONE 7.55 IU/L

Ref Range: Follicular 3.5 - 12.5

Ref Range: Mid-cycle 4.7 - 21.5

Ref Range: Luteal 1.7 - 7.7

Ref Range:Post-meno 25.8 - 134.8

LUTEINISING HORMONE * 46.75 IU/L

Ref Range: Follicular 2.4 - 12.6

Ref Range: Mid-cycle 14.0 - 95.6

Ref Range: Luteal 1.0 - 11.4

Ref range: Post-meno 7.7 - 58.5

17-BETA OESTRADIOL 435.6 pmol/L

Ref Range: Follicular 98 - 571

Ref Range: Mid-cycle 177 - 1153

Ref Range: Luteal 122 - 1094

Ref Range: Post-meno < 183

VITAMIN B12 *>1083 pmol/L (140.00 - 724.00

)

FOLATE (SERUM) >19.98 ug/L (3.89 - 26.80

)

25 OH VITAMIN D 81.08 nmol/L (50.00 - 200.00

)

Interpretation of results:

Deficient <25

Insufficient 25 - 49

Normal Range 50 - 200

Consider reducing dose >200

Thank you

[puncturedbicycle]

I believe your cycle may be running long because your thyroid is clearly sputtering a bit. Your metabolism will be slowed.

A trial of levo might be helpful as you know you have antibodies, but as you say w these results your gp may not be willing. Considering the ovarian route is entirely a different thing (and I'm afraid I can't comment as I don't have any relevant info) I'd think a trial of levo would be worth a go before looking at something else entirely.

[Salphy in reply to puncturedbicycle]

Hi, thank you for responding I will try to use this logic when I go back to see my gp on Fri.

Hopefully she will still be willing to try because I still feel so crap!

Thanks again

[puncturedbicycle in reply to Salphy]

Yes, considering the hypothyroidism can have on periods, and you do have raised cholesterol, antibodies and highish tsh (which indicate your thyroid is having a bit of a wobbly) it might be worth a try. Good luck!

If you have some spare time have a look at the topic 'Can't get diagnosed' on the right of the page. You may find some useful links there. Sometimes if your gp is amenable to looking at supporting evidence it can be helpful pushing the whole thing over the line.

[Treepie]

I would not worry too much about your cholesterol .You do need to get D3 and B12 higher and the high antibodies suggest that you will benefit fro levothyroxine.

[Salphy in reply to Treepie]

Thank you, how much higher would you say b12 and vit d need to be? I don't think my gp will be happy with it being over range as it is so I doubt she'll let me have more injections

[Treepie in reply to Salphy]

Sorry, there were so many results I missed the B12 and D3 lower down. B12 is now a bit high as I believe the PA society recommend at least 500 and preferably near the top 900-1000.D3 is OK but Someone else may have better idea as to what is optimum.

[Salphy in reply to Treepie]

That's OK I think it's expected to be a bit high after 6 loading injections and it will start to fall again now until my maintenance dose in May. Hopefully I can maintain it on my own because I hate needles!

I think somebody else said to aim for around 100 so I'm going to increase my dose now I think my gp will be happy with that level and stop prescribing it.

Just wanted to be fully prepared for my appointment tomorrow. Thank you for your help

[Treepie in reply to Salphy]

100 for the D3? Or did you miss a 0 meaning B12?

If you have not already done so it may be worthwhile also joining the Pernicious anaemia community on Health Unlocked.

[Salphy in reply to Treepie]

Yes vit d I've just checked and they said between 100-150 is optimal I have done thank-you x

[Serendipitious]

Your cholesterol is high because it is not being used by your body and insufficient thyroid hormone is a cause of that. Cholesterol is vital for the creation of pregnenalone and DHEA which are hormones that create progesterone, testosterone and oestrogen. So if your cholesterol is not being used to adequately create these hormones you will have hormonal imbalances which manifest themselves in different ways.

Since my 20s my cholesterol has always been around 5.7 - 6.1 because I still haven't managed to resolve my hypothyroidism. I only discovered this forum a few months ago. I also have heavy and painful periods and I can never predict when they will start. In theory, correcting thyroid problems with Levothyroxine T4, Liothyronine T3 or NDT should reduce the high cholesterol and enable it to be used to create the right balance of hormones.

I have read posts here where people have said that within a few months of adding T3 their cholesterol lowered and their periods settled. All the best.

[Salphy in reply to Serendipitious]

Thank you, that sounds a lot like me! I know it sounds awful but I just wish my thyroid levels reflected how bad I'm feeling so I would know 100% it was the main culprit! And my gp would be more willing to treat me.

Fingers crossed she knows about the relation to cholesterol and sees it as another reason to trial treatment. A hormonal imbalance would explain the mood swings anxiety and bad pms too! X

[Hidden]

My cholesterol was much higher than yours in December 2015, I've not had it tested since as I am 37 and GP said no real risk. I am having it tested next week though for my peace of mind just to see if it's come down.

My triglyceries were 3!!

Total cholesterol 6.9

HDL 1.6

LDL 3.4

My gp wasn't worried at all.

I would work on getting your vitamin D and B12 increased.

[Salphy in reply to Hidden]

That's reassuring to know thank you it's just been a worry because I'm only 25 and feel like I'm falling apart!

how much more do I need to increase my vit d and b12?

After loading doses by b12 has gone from 238 to 1083. I'm not due another injection now until May.

My vit d has gone from 20 to 81.08 after 7 week loading dose of 20000 twice a week. I was going to try and go onto 5000 daily now.

Thank you

[SeasideSusie Remembering in reply to Salphy]

Salphy As mentioned in my reply on your other thread yesterday, the recommended level for Vit D is 100-150nmol/L.

You can check out the Vit D Council's website here where they suggest that "Sufficient" is 40-80ng/ml. To convert ng/ml to nmol/L you multiply by 2.5 so they're saying "Sufficient" is 100-200nmol/L

vitamindcouncil.org/about-v...

Also check out this page which has information about levels. Remember to multiply ng/ml by 2.5 to get nmol/L which is the unit of measurement we use in the UK

vitamindcouncil.org/i-teste...

And have a look at Grassroots Disease Prevention Chart here and you will see the diseases that can be prevented, in all or by part, when levels are up to about 175-200nmol/L

vitamindwiki.com/Chart+of+V...

As for B12, anything under 500 can cause neurological problems. It's recommended to be at the very top of the range, even 900-1000.

[Salphy in reply to SeasideSusie]

Thank you Susie

I was just checking as twice people said both were still too low but I think it's just because I had so many results to look through and my most recent ones were near the bottom

I think if they were going to make me feel better they would have by now but I will still keep trying to get the vit d up a bit more x

[shaws Administrator]

This is a response I did yesterday with info about PCOS.

healthunlocked.com/thyroidu...

Did you have your blood tests at the earliest possible, fasting (you can drink water). This keeps our TSH at its highest. It drops throughout the day and doctors only seem to refer to the TSH alone. If you were on levothyroxine, you'd allow 24 hour gap between last dose and the test and take afterwards.

A higher cholesterol is a clinical symptom of hypothyroidism and reduces when on thyroid hormone replacements.

In other countries they prescribe when TSH is 3. In the UK - a ridiculous 10.

[Salphy in reply to shaws]

Oh thank you Shaw's. I did look at the thread yesterday but must have been before you posted.

Is it another one of them things that gp's aren't aware of being connected to thyroid though? X

[shaws Administrator in reply to Salphy]

I doubt they know any at all. Before the introduction of blood tests and levothyroxine, doctor 'knew' how to take account of our symptoms, particularly low tempt/pulse etc. We got a trial anyway and if we felt better we continued. If we didn't I assume they looked elsewhere for diagnosing.

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

[Salphy in reply to shaws]

Fingers crossed she's still willing to try! Does anyone know why serum dilate ranges are so different? My first 2 tests were with bluehorizon and third with medichecks but as far as I know they use the same lab? Pretty sure it was the same address I returned the sample to

[shaws Administrator in reply to Salphy]

I cannot answer, so maybe someone else can. Did you take the samples at exactly the same time?

[Salphy in reply to shaws]

I think maybe about 2 hours apart. That shouldn't change the ranges though should it? X

[shaws Administrator in reply to Salphy]

There may be a small difference but am not sure. I do know TSH might well change.

[Salphy in reply to shaws]

I've just realised medichecks is ug/l and blue horizon is nmol/l. Now traipsing the internet looking for a conversion tool lol.

[shaws Administrator in reply to Salphy]

We can well do without these differences in blood tests. I was unaware and I've responded to a few which may have been wrong.

[Salphy in reply to shaws]

Strange considering it's the same lab not going to be easy for my gp to compare tomorrow which is a pain but we'll see

[shaws Administrator in reply to Salphy]

It is strange if it's the same lab.

[Salphy in reply to shaws]

It was county pathology guildford surrey. If I remember correctly blue horizon was the same. I've tried an online converter but it doesnt make sense. Basically saying my level has reduced when I've been supplementing and it's in range so I don't think it's right

[shaws Administrator in reply to Salphy]

Put up a fresh post and you should get more responses. Medichecks is new to TUK so maybe someone has the answer and they may have used them.

[Salphy in reply to shaws]

Just got back from the Dr, she didn't even notice. Just saw that it was in range and moved on. Finally got a prescription for Levo! 25mcg on trial though. She said they always start low, got to have another blood test in 6-8 weeks so hopefully will get an increase. I'm just worried if 25 doesn't make a difference she'll stop it. She said if it doesn't we can start looking into PCOS didn't give me the exemption for prescription charges either so I've had to pay for the Levo x

[shaws Administrator in reply to Salphy]

50mcg is a starting dose, 25mcg incremental doses.

[Salphy in reply to shaws]

So annoying. What do I do. Go with what they say for now or double up?

[shaws Administrator in reply to Salphy]

It may be a difficult decision as initially we are a bit nervous of medication. I started on 25mcg but Endocrinologist said it should have been 50mcg.

[mistydog]

Firstly, your cholesterol isn't "high". It's at the top of a range, but that range is an arbitrary figure decided upon by the powers that be in conjunction with the makers or statins in order to flog more statins? I believe the conversation went something like "If we make the upper limit 5 instead of 6, we can put more people on statins". "Oh yes, what a good idea."

As we are now finding, statins have significant side effects, on of which is to lower cholesterol, which we actually need in the body anyway. The lowering of cholesterol has an effect on death from heart attacks (CVD), it increases that risk, contrary to popular belief! You should have a look at the great cholesterol con, by Dr Malcolm Kendrick, it's an eye opener. Anyway, that aside, if you were optimally medicated, your cholesterol would find its natural level.

It may be that when you had your second TFT, you had bloods taken later in the day. If you get another, have it first thing in the morning, fasting, and only drink water. If you are given levo, always take your meds no less than 24 hrs before and then take afterwards as normal.

[Salphy in reply to mistydog]

Thank you Mistydog. They have just started me on 25mcg as a trial so hopefully it will start to work and they'll increase me in a few weeks.

I actually took the first test at 1pm in the afternoon. The other 2 with lower TSH were done in the morning 8am and 11am. So frustrating

[mistydog in reply to Salphy]

Oh well, fingers crossed. I think because you have antibodies, they should be treating you anyway, because Hashimoto's goes in upswings and downswings, which is why you probably have got various results depending where you are. I think you have already been advised that a gluten free diet can help people manage their condition, although I have it and it didn't really work for me, but it does for most, I believe.