Help with blood test results

[Irishjen]

Hi folks, i am new to this site and was hoping somene could help with my blood result.

I have been having problems getting to sleep for months even when i am tired. I also have recently been taking part in the park runs couch to 5k and all was going ok until 2 weeks ago i went out fr 3 mile run and literally had no energy, legs felt like theu had nothingto give, breathing was awful and i just felt like i was about to hit be wall. From then i have been totally exhausted, cant function/ zero concentration ,feel overly stressed, tired and snappy feel like im off balance and head keeps gettig dizzy, muscles are tense, headaches everyday and feel quite breathless along with a heart rate i am aware off. Just not feeling good at all. I got my blood results back and the receptionist said all was ok, so i went and got a copy of the results from her. I had specifically asked for iron to be checked meaning ferritin but they just did a full blood count which didnt include ferritin.

The results are as follows amd ive only listed the results that are quite close to being out of range

Haemoglobin 141 g/l

B12 501 ng/l

Serum folate 7.5 ug/l

Serum free t4 18.1 pmol/l

Serum tsh 0.28

Mch 31 pg

Serum Gamma gt 40 u/l

Do these results look ok as my doc says all normal but i still feel off

Thanks.

Jen

[greygoose]

Well, no mystery there. You've used up all your T3 with all that running, and you're obviously having trouble converting more. But, of course, as they will not test the FT3, there's no proof of that. And, even if there were, doctors would not understand it!

Yes, your FT4 and TSH look good - although you don't give the range for the FT4 - you really should. But the most important number is the FT3, and that is probably very low. T3 is the active hormone - T4 the storage hormone, that has to be converted to T3. It is low T3 that causes symptoms, not TSH or T4. So, it doesn't matter how good they are, if your FT3 is low, you are still hypo. I would suggest you get some private tests done, so that you can get them all.

[Irishjen in reply to greygoose]

Hi grey goose thanks for the reply. The serum free t4 level is 18.1. The range is between (12-22)

The tsh is 0.28. The range is (0.27 -4.2)

Is ft3 amd t3 the same thing ?

I will ask my doc on Monday to do the other text and if he doesnt then i will go private, even if he does do it i think i will get the results and then go private to an endo to interpret the results.

So does that explain why when i always start a new exercise regime i always have insomnia and then crash in a few weeks. Its been that pattern for years. I am motivated and enjoy working out then i realise i actually get burnt out.

If the ft3 goes low does it gradually get better over time itself when i stop exercise and rest up ?

[greygoose in reply to Irishjen]

It will get better to a certain extent. But, it depends how well you convert. And you can only know that by testing the FT4 and FT3 at the same time.

FT3 is the name of the test, like FT4. T3 is the name of the hormone. But, if you see T3 on blood test reports, it will be TT3 (Total T3) which is of no use whatsoever.

Yes, it does explain why you crash after starting a new exercise routine. You are using up your T3 faster than you can produce it. You should restrict your exercise to gentle walking, swimming or yoga, until your FT3 is optimised, and you are on an optimal dose of either T4 or T4+T3, depending on how well you convert. I'm afraid doctors just do not understand this, though, so don't expect to get much help. If you feel you need T3, you might have to buy your own.

[Irishjen]

Yeah it seems from reading these forums its an uphill struggle with docs. So i can actually purchase t3 myself if i have to ?

Will an endocytosis understand?

[Irishjen in reply to Irishjen]

Ugh typo.meant endocrinologist

[silverfox7]

Folate could be higher and B12 and as you say it would have been good to get ferritin tested. Vit D is another thing that helps conversion and we are often low in that and like the others we need it to be optimal, not just in range but higher. Post any results your GP says is normal for advice as normal often means in range but where in range is very important. You. Refs to be kinder to yourself and go easy on the exercise to you get things improved. If you can though I would advise private tests as really you need to know where your F(free in the bloodstream)T3 is as we can't be certain without it to know what is actually happening.

[Irishjen in reply to silverfox7]

These are all the test results with the ranges.

Hb 141 g/l (115-165)

Haematocrit 0.42 (0.37-0.47)

Wbc 8.3 (4.0-10.0)

Platelet count 353 (150-450)

Rbcs 4.6 (3.8-5.8)

Mcv 90 (76-100)

Mchc 31 (27-32)

Neutrophil 5.0 (2.0-7.5)

Lymphocyte 2.5 (1.0-3.5)

Monocyte 0.7 (0.2-0.8)

Eos 0.08 (0.04-0.4)

Baso 0.04 (0.01-0.1)

Serum sodium 141 (136-145)

Serum potassium 4.6 (3.5-5.3)

Serum chloride 100 (95-108)

Serum bicarbonate 25 (22-29)

Serum urea level 3.7 (2.5 -7.8)

Serum creatine 65 (45-84)

Lserum total bilirubin 5 umol/L (<21>)

Alk phos 77 (40-130)

Ast serum 19 u/l (<32>)

Serum gamma gt level 40 (6-42)

Serum alt 22 (<33)

Serum albumin 46 (35-50)

B12 501 (197-771)

Serum folate 7.5 (3.9)

Serum free t4 18.1 ( 12-22)

Serum tsh 0.28 (0.27-4.2)

[startagaingirl]

Hi - can I ask a question that seems to have been missed in the answers above - have you been diagnosed as hypothyroid? I agree your symptoms sound like hypo, but your test results do not show that. In fact they would suggest that you are actually euthyroid (or normal). You have normal, low Tsh and normal, top half of range ft4. If the other important missing result - ft3 - was low, you would expect to see a raised Tsh. The main way your combo would happen with a low ft3 is by secondary hypo - a failure in the pituitary gland and that is actually quite rare. So do consider private tests as your GP is very unlikely to do that, but before getting those results you really can't yet assume that hypo is the cause of your symptoms.

Gillian xx

[Irishjen in reply to startagaingirl]

Hi gillian, no i haven't been diagnosed with anything. My doc says all test results are normal amd they havent mentioned anything about thyroid, i initially asked the nurse about iron levels but she just took full blood count. How i came about finding this group was by googling my tsh result 0.28 (0.27-4.2), to me the 0.28 was just in range at the lower scale so my little brain was trying to find out what that meant.

Maybe i am on the wrong path here with thyroid and its nothing to do wih that. So basically if he ft3 comes back low then that wouldnt explain my tsh result as it should be high, is that correct ?

I will see if my doc will do ft3 and if thats ok then i will disregard the thyroid, in the meantime i will also get a more in depth iron test that also shows ferratin. The past week i have been taking floradix and i must say from thursday i have been feeling perkier and ive been sleeping and waking up at a normal time. Still slightly light headed and that weird heart rate feeling and still feel off but not compared to how i felt this time last week so maybe iron might show something up.

I really appreciate all of you input and looking st your answers im feeling slightly positive to the fact it's maybe not thyroid at all. My mum had thyroid issues along with my aunts so that's why i seem to be homing in on thyroid.

[startagaingirl in reply to Irishjen]

Hi - if you are feeling better with iron supplementation then that may be your issue. Even if your haemoglobin levels are ok (iron in blood), a low ferritin can definitely give issues as this is the protein that carries that iron through the bloodstream. Vit C helps iron absorption and minimises associated digestive issues so you shoul take 1000 with ease dose.

For the thyroid, TSH generally works inversely with ft3, so if Tsh is high it normally means ft3 (the active hormone) is low, hence your pituitary shouts at your thyroid - raised Tsh- to produce more. In the vast majority of cases a low Tsh means an ok ft3. On another point, thyroid problems are indeed hereditary so you may well have a tendency to issues. It is possible that you have an auto-immune condition called hashimotos when your own immune system mistakenly attacks your thyroid, gradually reducing its potential output. It can take a long time before this process goes far enough to show as hypothyroid, but can be seen in blood tests as positive anti-bodies ( TPoAb and/or TgAb) before this. Again these can be included easily in a finger prick private test but GP is unlikely to do. If these are positive, there are measures that can be taken to try to slow the process down and reduce its impact. These can produce symptoms even if you are not showing hypo yet.

Good luck and I hope you get to the bottom of your issues soon.

Gillian xx

[Jann207 in reply to startagaingirl]

Hi Gillian startagaingirl , after reading your comments on this thread I was just wondering if you might happen to have any ideas what it might mean if TSH is above range (FT4 almost mid range) but FT3 is close to top of range - so an elevated TSH and ok FT3. I have searched a lot and cannot find any info or suggestions as to what these type of results could mean. I have quite a few hypothyroid symptoms and rising TSH but my FT3 result is not low.

[startagaingirl in reply to Jann207]

Hi - what that would indicate to me is that your body is working hard to produce the t3 that your body needs and is pushing conversion of t4, hence the lower level of it to t3. Your high the indicates pituitary is shouting at thyroid "work harder!". But high is subjective for TSH, anything above about 1.5 indicates a struggling thyroid, but not classes by mgs as subclinical till over lab range and they are reluctant to treat till 10ish. Does that help?

Gillian xx

[Jann207 in reply to startagaingirl]

Yes for sure! thank you so much for replying to my comment Gillian

[Vallillyann1]

I'd support what other says and you really need to see your T3 level although relying on GPs and Endo's is likely to leave you sick for longer. The other thing i would explore would be what is happening with your adrenals- your GP can do a 9am blood cortisol test as a starter & then it's worth doing a saliva test about £80. Good luck x

[silverfox7]

Thanks for clarification. And sensible of you to think of your thyroid with having family history. Bit confused with the folate and the range though? Sounds as though the addition has shown you may be low in ferritin so I would keep that going but have a word with your GP about it.

[Irishjen in reply to silverfox7]

The serum folate shows 7.5 ug/l and then in brackets it shows (3.9>)

[Irishjen]

Folks i have to say you are a wealth of knowledge, seriously would think you are all endos, would do a better job than most by the sounds of it. 😉 isnt it a sorry state of affairs when you have to resort to on line sites to help wih health issues.

[helvella in reply to Irishjen]

Would be so much better if the treatment side was adequately handled by endocrinologists and GPs working together. Leaving the forums for mutual support, discussion, etc.

[Howard39]

Hi

I'd definitely do the free t3 tests through blue horizon with the 12 vitamins even if it was just to rule it out.

Yes b12 and folate are low and vit d should be tested as most peoples are low. New research in Germany suggests b12 levels at 1000.

I totally agree with the adrenal fatigue test. Dhea not just cortisol will be tested. Low doses causes extreme tiredness. ( high cortisol causes anxiety and a panicky feeling- you'd tell if that was out of line. Strangely both high and low dhea causes poor sleep)

In the meantime if poor sleep is an issue you could try motherwort which is an excellent adaptatagen and natural. For Severe cases melatonin is helpful at low doses to start with.

Sometimes you have to rule things out to get to the end result. At this stage I'd do my own research first then return to the gp.

Please can I ask if you take any other meds? Creatine is an expensive blood test and unusual one. Usually done if you are testing kidneys issues or to check if strong meds are not affecting them- like anti vitals. Just wondered what the thought process was.

Good luck. Message if you need more help.

[Irishjen in reply to Howard39]

I dont take any other meds, general health ok but this burnt out feeling raises its head from time to time and usually its after i start a new exercise plan. I can see the pattern.

I have a melatonin prescription but its still lying in my bag as i specifically told the doctor i didnt want it due to trying it in the past and it gave me bad nightmare. To be fair my doc seems very nice, he is quite new to me and stands up to greet you and shakes your hand when you go into his surgery, he will not write prescriptions such as sleeping pills etc and seems to be into more of the natural route, he lets you talk without shooting you down which is unusual so ill see how i go with him.

I have a test at home somewhere from i think genova laboratories which is to test saliva 4 times over 24 r period, i will find that and use it.

Sorry if i should daft here but what are the 12 vitamins test and if i do the free t3 test through blue horizon who actually takes my blood to send off ?

So i have a list here of what i need to do.

Ft3 test

12 vitamin test

A more im depth iron test

9am blood cortisol test

My adrenal saliva test

Does that seem correct?

Just as a matter of interest, if i go to see a private endo does anyone know the cost ? Ive looked at the private clinics here in belfast and its around £130.00, i would think that is just for the first consultation and not including blood tests etc, any idea how much extra for the blood tests ? can an endo also while testing the thyroid test for the iron ?

[Eddie83]

Please post the lab range for your FT4. But keep in mind that docs who take only TSH and FT4 do not know what they are doing.

[Irishjen in reply to Eddie83]

Hi eddie. Lab range is Serum free t4 18.1 ( 12-22)

[Eddie83 in reply to Irishjen]

I didn't see anything in your original post that said whether or not you are taking levo. Are you? Since your FT4 is already 61% up in range, and your TSH is at the lower end of range, I doubt levo replacement (or a higher dose, if you are on levo) would do much for you. So many of your symptoms sound like things I experienced, before I went on T3-only and then finally went back to T3+T4. My FT4 is only ~15% up in range and I don't do well with increasing T4; T3 is what does the trick. I think you should go outside NHS if possible and get the full panel TSH/FT3/FT4/rT3/TPOAb/TGBAb. You do need to deal with Hashi's autoimmunity if you have it, which is revealed by the Thyroid Peroxidase and Thyroglobulin antibody tests.

BTW are you supplementing any trace minerals? Chelated selenium at a low dose (100-200 micrograms per day) does support the deiodinase enzymes that do T4->T3 conversion. Selenium lab testing is available but I have never used it and don't know how good it is.

[Irishjen in reply to Eddie83]

Hi eddie, im not taking anything and have not beem diagnosed with a thyroid problem. I did however get a blood test that came back normal but when i looked at the results i thought the tsh was very borderline and it made me question whethet there is a chance i may have a thyroid issue

[Eddie83 in reply to Irishjen]

I am confused that your TSH=0.28 is fairly low, yet you have fatigue issues. I would not expect TSH to be that low if you have poor conversion. I guess you should test FT3, just to make sure.

If it is not thyroid, then the likely culprits are adrenals or nutrition. If the problem continues, you might want to find a practitioner who can take a 5-sample saliva test to see if your cortisol level and rhythm is OK.

Have you checked your Total Blood Protein to make sure your digestion is humming along well? Low protein can certainly contribute to fatigue and weakness.

I think you should go back and demand a ferritin test. MCH of 31 is so close to the bottom.

[Irishjen in reply to Eddie83]

Got my ferritin checked and its 79 amd the iron is 16. Haven't picked up the results yet to see the ranges though. How do the ferritin and iron results sound.

[Eddie83 in reply to Irishjen]

I do suggest that you be prepared with units and ranges when you ask a question! But I will guess on that by using units and ranges from elsewhere. The female ferritin range is about 12-150 ng/ml and most restorative medicine types will say you need to be near the top of that range to feel best; 79 is only 48% up in range. The female serum iron range is about 50-170 mcg/dl so your iron of 16 is quite low if your test is in mcg/dl! You should get onto an iron supplement ASAP, probably a chelated form that is well absorbed. If you want to get iron from food, it used to be that liver was suggested to boost iron, although getting clean liver now can be an iffy proposition.