I would appreciate your comments on the following blue horizon results. I am particularly concerned about result 978 for anti-thyroglobulin abs - don't understand what it is so would be greatful for your explanation and guidance please. Do I need to do anything and should I ask my doctor to refer me to consultant. I am not on medication as doctor has been routinely testing my bloods and doesn't think I need to take any medication. I also have been diagnosed 33 years ago with pcos.
Scout1 - if you edit your post and include the reference ranges then members can comment. Ranges vary from lab to lab, they're not standard, so we need to see where in the range you lie.
CRP is an inflammation marker, yours is nice and low so that's all good.
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TSH H 9.97 (0.27 - 4.20). mIU/L.
T4 Total 78.4 (64.5 - 142.0) nmol/L
Free T4 13.0 (12-22). nmol/L
Free T3 4.24 (3.1-6.8) .pmol/L
Most doctors wait until TSH reaches 10 before they will diagnose Hypothyroidism. With such a low FT4 and being just 0.03 from the magic 10, I would hope that you get a diagnosis of primary hypothyroidism now.
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Anti thyroid peroxidase abs 22.5 (<34) kIU/L
Anti thyroglobulin abs H 978 (<115) kU//L
Your TG antibodies are extremely high, this confirms autoimmune thyroid disease aka Hashimoto's. This, along with your high TSH and low FT4, means you really should be diagnosed and treated now.
Hashimoto's is where antibodies attack the thyroid and gradually destroy it. Read about Hashi's here:
You can help reduce the antibodies by adopting a strict gluten free diet. Gluten contains gliadin which is a protein thought to trigger antibody attacks. Read about the gluten/thyroid connection here
Supplementing with selenium L-selenomethionine 200mcg daily and keeping TSH suppressed also help reduce antibodies.
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Ferritin 23.7 (20 -150). Aug/L.
This is dreadfully low, see your GP about this. No thyroid hormone can work with ferritin at this level, neither our own nor replacement. It needs to be at least 70, with half way through range recommended, and for females 100-130 is apparently best.
You might want to ask your GP to do an iron panel, full blood count and haemoglobin test to see if you have iron deficiency anaemia.
If you are given iron tablets then take each tablet with 1000mg Vit C to aid absorption and help prevent constipation. If you are prescribed Levo then take it four hours away, and for any other medication and supplements leave two hours as it affects absorption.
Eating liver regularly, no more than 200g a week, will help raise ferritin.
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Vitamin D (25OH). L 22 (deficient <25) (insuffient 25 -50) (consider reducing dose >175) nmol/L
Recommended level is 100-150nmol/L.
Ask your GP to check the Vit D Deficiency guidelines for your area. They will be very similar to the NICE Clinical Knowledge Summary which states
"For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.
Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
So you need loading doses followed by a maintenance dose for life.
Please come back and tell us what your GP prescribes.
There are important cofactors needed when taking D3 which your GP won't know about because they're not taught nutrition, read about them here
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, four hours away from Levo if prescribed.
Magnesium comes in different forms, check here to see which would suit you best and as it's calming it's best taken in the evening, four hours away from Levo if prescribed
These work together. B12 under 500 can cause neurological problems. Recommended level is very top of the range, even 900-1000. You can buy some sublingual methylcobalamin lozenges 5000mcg and take one daily. Finish the bottle then buy the 1000mcg dose and take one daily. Solgar and Jarrow's are popular.
Folate should be at least half way through it's range. Whilst taking B12 we also need a B Complex to balance all the B vitamins. If you buy one with 400mcg methylfolate that will help raise your folate level. Look at Thorne Basic B (one capsule daily) and Metabolics B Complex (two capsules daily and contains no fillers).
Another really good post SeasideSusie . I always enjoy and appreciate them even if they are a tad long 😉. I thought I'd also add my two pence's worth. Thanks.
Dear Seaside Susie thank you once again for your knowledge. I hope you don't mind if I as you for some further help? I live in West Somerset and there is at present 2 week wait to see GP. I've seen several doctors. One was hesitant to treat me but after a chat put me on thyroxine but I became moady(husband says) and bloated so I decided to come off the thyroxine. The next doctor said if I wasn't treated I would eventually DIE ( My levels were higher), however I moved from Exmoor practice to nearest seaside town and now my present doctor who I seem to have each time at my new surgery doesn't appear concerned with the tests she has taken. Money is very tight in this area. As a GP her knowledge is of course general. Please can you tell me where I should go from here? I will have to see her. Do I ask to see consultant and would a consultant address the areas you have highlighted. I was in need of 2 units of blood 15 years ago because I was anaemic immediately after the birth of my son having had episiotomy. If I was to say anything about the way I feel in general about my health- I am overweight ( not in a huge way) because I am always wanting classic chocolate, bread, cake and sugar in tea and however hard I try I can't get off this road. I have always suffered from constipation from a child. i look at my husband and he can just lose weight and has so much energy . I generally do not have the energy and to do anything is an effect .I think if I was to look back I think I have always been like this. Because of this my moods are up and down ( suffered depression) and am emotional .I would really appreciate your opinion- thank you.
Scout1 I didn't receive notification of your replies because you replied to your own (original) post, not mine
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When you were prescribed Levo, what was the dose? How long were you on it? Were you retested for thyroid levels? Did you have any increase in dose? What did the doctor say about your reaction to it?
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The doctor who told you that you would eventually die should really have explained further. What would happen is that the longer you remained untreated the more your organs would struggle and eventually you could develop myxodeama coma. Explanation of myxodeama coma:
"Myxedema coma is defined as severe hypothyroidism leading to decreased mental status, hypothermia, and other symptoms related to slowing of function in multiple organs. It is a medical emergency with a high mortality rate."
and
"Myxedema coma is a loss of brain function as a result of severe, longstanding low level of thyroid hormone in the blood (hypothyroidism). Myxedema coma is considered a life-threatening complication of hypothyroidism and represents the far more serious side of the spectrum of thyroid disease."
So you can see that Hypothyroidism needs to be treated.
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I have made suggestions about your vitamins and minerals so you need to decide what to do about them. I would certainly see your GP about your low ferritin and ask about the iron panel and full blood count.
Vit D you can sort yourself, I had severe deficiency with a level of 15 and I didn't bother with my GP. If you want to do it yourself then suggestions can be made for doses, just ask.
B12 and folate are also easy enough to do yourself.
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You have all the information you need about addressing Hashimoto's. Doctors won't do anything about that anyway.
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So what you need to do now is get your GP to treat your obvious Hypothyroidism. I've explained that you are just 0.03 away from the magic 10 that the NHS requires to give you that diagnosis, so now you fight for it. If necessary you ask for a referral to an endocrinologist if your GP won't diagnose. You point out your TSH result and your high antibodies and tell him that if he won't do anything then you are no longer prepared to continue living as you are because it affects every aspect of your life and you wish to see an endo (take hubby for support, get him to speak up for you if necessary).
Before making any appointment with an endo, email louise.roberts@thyroiduk.org.uk for the list of thyroid friendly endos and see who is in your area. Ask for feedback about any of them from members here, they will have to reply by private message.
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Some information to use when seeing your GP from ThyroidUK's main website
Signs and symptoms of Hypothyroidism, print off and mark everything appropriate -
thyroiduk.org.uk/tuk/about_... - Scroll down to treatment options for alternatives to Levo. A GP can't prescribe them, an endo would have to initially if a trial of Levo doesn't help. You may have to fight for any alternative to Levo. T3 is being restricted or refused due to cost, and NDT is unlicensed so a doctor needs to take responsibility for prescribing it and not many will.
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Read and learn as much as you can so you can fight your corner. The ball's now in your court.
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By the way, do you have any diagnosis of any other medical condition?
Thank you. I realise now I am going to have to do a lot myself and you have made it clear. I take no medication at all. I am 49 and am peri menopausal. Was diagnosed with psoc but periods have been regular since child born. 15 years ago. Same time last year my serum t4 was 7.5( ref range 7.9-20) abnormal
TSH was 21.05(0.34-5.6 mu/l)
The same doctor I have now ,telephoned me and she asked me how I felt. In general I feel healthy so the doctor felt no need for medication and in view that I had not been happy with the levo i agreed . i am lucky as I don't get ill very often. I have always been emotional / lethargic and constipated all my life. The emotional thing could also be to do with an early unstable family life.The only reason this thyroid has been noticed is because I reached the Mid forties and had been asked by surgery to have full health check. I wonder if my thyroid has always been like this.
I asked to have t3 too as I may be wrong but I seem to remember reading somewhere t4 converts to t3 and then then the t3 helps the thyroid and that some people are unable to convert their t4. The doctor said she had been asked this before but did not know. Now I realise I was probably jumping the gun anyway because my thyroid is not that bad at moment compared to most others. Although I had thought that I may not have been converting and this was why I had been bloated i.e. The thyroid was not getting the medication.
I was on the thyroxin for 6 months. I don't have any readings for this period but I believe they were in range because my medication was not adjusted. I started off on 50 and went up to 100. I looked bloated with Neck , tummy ,face almost like water retention I suppose. I didn't feel myself - thick headed. My husband said I was moody. With being border line with hypothyroidism I decided to come off the thyroxine.
i decided to get a private test to get the full readings myself. For the last blood test I didn't receive a letter to say anything. The surgery usually only contact if something is wrong. I think I am going to have to be more proactive in asking for my results. It always is difficult to get readings from the surgery for my thyroid but I shall push further to get these. I have always been trusting with the decision the doctor has made.
Thank you for helping me. It is very daunting when you have no medical knowledge and i feel like I am alone with this. My husband is anti drugs and thinks I am better off without any medication.; he's one of those who doesn't like taking paracetamol.
I'm sorry I didn't put it on your reply. I didn't realise this, I thought it would come up automatically.
I can't thank you enough for your help and thoughtfulness.
Scout1 - you are correct about T4 converting to T3. T4 is a pro-hormone and some of it is converted into T3 which is the active hormone which every cell in our bodies need. This is why it is important to have FT3 tested, to see if we have enough, and to see if T4 is converting properly. Unfortunately, most doctors don't seem to know this so attach no importance to it and that plays a big part in why so many Hypo patients remain unwell.
If you have any questions or want anything clarified, come and ask, there's always plenty of members happy to help.
One thing that needs clearing up - your husband has the wrong idea. Levothyroxine, or any thyroid medication, is not 'drugs'. When we are Hypothyroid our bodies cannot produce enough natural thyroid hormone for whatever reason. Treatment for Hypothyroidism is purely giving us that hormone synthetically. Without replacing it our organs will struggle, we will become very ill and eventually this can lead to 'myxodema coma' which can be fatal. Have a quick Google to show hubby.
Liken a Hypothyroid patient to a diabetic patient. We need replacement thyroid hormone as much as they need insulin.
Hi seaside sue, I don't know if you remember me but you gave me some very good advice and I wanted to update you. I went to my doctor armed with my private test results and the advice you had given me. I questioned and asked for his advice about hypothyroidism.The end result was a referral to an endocrinologist. I looked on the list of recommended endos and knew that one practiced near me privately but not at The hospital I wS referred to, dr singhal. When I booked the appointment I asked if I could see the endo at another NHS hospital in the county and was told yes. When I went for the appointment Dr Singhal consultant was unavailable and I had to see another member of his team but put me on 25 mg of levothyroxine , large doses of vitamin d and iron tablets. Went back today and was lucky enough to see dr singhal and he says I have hashimotos and increased my dose to 75. I have to go back in another 6 weeks as he's testing t3 and wants to see how I'm adjusting . He says I'm not just a little under active but a lot. How about that . Sounds ridiculous-I'm so pleased. I am also taking magnesium, selenium and continuing vit d, ashwaganda. I can't thank you enough for the advice, I feel like I'm very lucky .x
Good news Scout It sounds like your endo is clued up, if ever you have to see someone in his team rather than himself at another appointment, and they want to reduce your dose or, if you've been given T3 and someone else wants to take it away, insist it's run by Dr S, don't let someone else override what he's put into action. And if your GP wants to reduce your dose, again ask for it to be run by Dr S.
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Blood Results help
Blood Test Results Showing High Reverse T3
