NHS blood results from gastro appointment

[ajs100uk]

I yesterday saw my rhuematologist and he printed off my blood test results that were ordered at my gastroenterology appointment. Unfortunatley, no T3/FT3 result.

For reference my previous medicheck test from March was:

THS 2.53 (0.27-4.20)

Free thyroxine 16.25 (12-22)

Total thyroxine (T4) 90 (59-154)

Free T3 3.15 (3.10-6.80)

TGA 13.880 (0-115)

TPA 5.18 (0-34)

Vit B12 402 (140-724)

Folate (serum) 9.94 (3.89-26.80)

25 OH vit D 88.45 (50.0-200)

Ferritin 88.73 (13-150)

Latest from NHS, 2/06/2017

Serum TSH 0.02 (0.27 - 4.20)

Serum T4 21 (12 - 22)

Serum cortisol 102 (137 - 429)

Serum B12. 1799 (137 - 429)

Serum ferritin 115 (13 -150)

Serum folate 18.5 (3.9 - 26.8)

Serum calcium 2.35 (2.20 - 2.60)

My liver function tests, which had been increasingly abnormal are now normal

I have only been self-treating since the end of March.

I currently take:

Metavive NDT 120mg divided by two doses. My private doctor (PD) started me on 30mg a day (divided in two doses) and I was to increase by 15mg every two weeks. A couple of weeks ago I was going to hold the dose and get tested but my PD told me to keep on the increasing regime until symptoms improve, and increase by 30mg every two weeks. Therefore, I am due to increase again on 22 June.

I take 3500mg vit C a day, 25mg gentle iron, 350mg magnesium, a digestive enzyme at dinner, DHEA 15mg, Q10 150mg, 155mcg selenium, 1000g omega 3, 1000mcg sublingual B12, a VERY GOOD multivitmin that includes 500mcg vit B12, 2000iu vit D, vit K2 100mcg.

I have just satrted taking Adrenavive II, 125mg once a day.

He also stopped my HRT and prescribed bioidentical progesterone lozenges instead.

I have to take a multivitamin/calcium/iron/zinc for life following gastric bypass. The current multivit I take has just gone up from £20 to £30 so I cannot afford that anymore, so will need alternatives (I am financially strapped and bought this multivit so I did not have to buy all seperate items).

I still get freezing cold, have lost none of my 3st unintentional weight gain (as I have said before this is despite having a gastric bypass), my legs (and I am sure my body) is still swollen, I sill get got flushes and occassional palpitations, I am still constipated, my hair is still falling out, and I still 'fly off the handle' at the slightest thing.

I have noticed that my skin is not so dry.

I think that's it lol Any thoughts much appreciated. Thank you.

[Saggyuk]

I'm a little confused as you state first tests were done in march and then date the second as being in march also? Will assume the Nhs ones came more recently as many of your levels have increased?

Can't suggest much but I would maybe say your thyroid levels seem improved and tsh and T4 levels seem optimal so can only assume your T3 levels have as well. I'm not sure you'd want to keep increasing dose as could make you hyper and symptoms might be being caused by something else? You're not indicating you have any thyroid antibodies so maybe thyroid issues being caused by other things. Did you have thyroid issues before the bypass or did they start after?

Your ferritin level is creeping up to being too high so you might want to ditch the gentle iron rather than the multi vit with more in or keep a closer eye on it. Mind you, ferritin can go higher for other reasons such as inflammation and infection and still be anaemic so you might want a blood count or iron panel to confirm. B12 is also getting higher than it needs to be too so may want to lower that a little.

The problem is with a gastric bypass, you could have problems absorbing everything including vits/minerals/micronutrients not tested for or supplemented so hard to say. You might want to do a more in depth vitamin panel at some point? You could also easily be overdosing on some things unknowingly. Maybe you can use a site like cronometer to input what you're eating and the supplements you take too see if anything is flashed up as a warning? But then again, the bypass might mean absorption issues and therefore not a problem?

If it were me, I would be tempted to look more in depth at the low cortisol too especially if tests remain low. I had levels a little lower and had brown patches on my skin and had become increasingly irritable and shouty even though I was not the type to lose my temper and would crash badly and fall asleep the minute I got too angry or even scared on a fairground ride etc. They put me through for further tests to rule out addisons but I immediately after went GF and the problem started to reverse and paid no attention at the next appointment as was just going on about how everything is better and no need as had almost complete reversal in everything lol. So I don't know what they were to be honest - all I know is that the brown patches started to fade and I am no longer irritable or crash. This can cause problems with your sodium/potassium and water balance also so could cause oedema (water retention) which could explain any swelling. I did have very low blood pressure and had lost weight also but it depends on what else is going on. Also unstable blood glucose levels can cause water retention and also issues with your adrenals so I would check these out in more depth with a cheap testing kit from pharmacy maybe if not yet done. My sugar levels were also previously all over the place from very low to very high. Hypoglycemia can cause low adrenals so worth a check. If you did want to try gluten free, be extra careful as you have more problems than most with a more restricted diet although you will feel better if this is a problem for you.

Hope you feel better soon

[ajs100uk in reply to Saggyuk]

hI Saggyuk (great name, lol). Thank you for your reply.

Yes, sorry date was wrong, I have amended that.

I received further results in the post tiday from 2/06/17 test:

Haemaglobin 113. (125 - 165)

Haematocrit 0.342 (0.37 - 0.47)

Red cell count 3.64 (3.8 - 5.8)

I am think this reflects some kind of anemia but not sure which.

The bypass means I do not absorb much from food (hence, lifelong supplementation) and aslo I do not eat too much of anything.

I am due to have a CT colonoscopy at the beginning of July to see if there as a structural cause for being 'bunged up.'

The multivit I take has no iron in it. The only iron I take is the gentle iron, once a day.

I was supplementing with ferrous fumate immediately after the bypass but my iron level went way too high, so that was reduced. I have often had blood tests that indicate anaemia (such as these latest ones) but my GPs never take it any further, so I presume I do not need to worry about it.

I have been diagnosed with hypoglycaemia before but rarely get any symptoms of that anymore.

I have never received a firm thyroid diagnosis from the NHS and certainly no treatment. I got a private diagnosis in March and it is the first time I have taken anything for my thyroid, since having symptoms for 30 years.

I just do not really know what to do. i cannot really afford much more private treatment, so I guess I will wait to see if I hear from my GP when he sees the results. Mind you, the last time I had results from the hospital instigated blood tests that were abnormal, my GP would not discuss them with me as he said he did not order them!

I have never had low cortisol before. At the beginning of last year (2016) i was hyper and then hypo within a month and my cortisol was normal. The endo at the time 'did not know what to do with me' and I had no treatment, although she did say I could have a thyroidectomy as I also have a multinodular goitre.

Perhaps I will stay at my current NDT level and save up for a private test to get the FT3. My private doctor says I cannot convert so will be interesting to see what it is. I have T3 to take if necessary. I ordered that back in March but have not used it and my private doctor (in March) told me to hold off adding it in for the timebeing.

[Saggyuk in reply to ajs100uk]

Yes, blood count still show anaemia so ferritin must be storing for other reasons. Maybe need an iron panel for further investigation. Did they base their determination that iron levels were going too high initially on ferritin only or did they do other test?

Unfortunately most doc are unhelpful and people go to extreme measures that cause problems when many of these issues might have been resolved in the first place. As much as you might be supplementing, none of these will replace the calories needed to convert to energy or even other things like protein and amino acids and so on. Are you eating as much as you can in little amounts and often? Have you tried liquid shakes and things? Have you tried a food diary to work out which foods you might be able to digest easier and therefore can eat more of. Sorry I don't know much about bypasses as don't agree with them tbh so only a couple of guesses of things that might help. Hopefully they will be able to help after the colonoscopy.

If you had issues with your blood sugar levels, it is definitely worth checking these out in more depth especially where can effect adrenals. The test packs are about £15-20 and you can monitor yourself at different times of the day over a few days and see if what's really going on there.

It's hard to say whether you seem have conversion issues as your T4 levels are low in the first test which would obviously mean low T3 and no T3 test in the second.

I would read as much as you can about everything so you are in a better position to help yourself and not have to rely on doctors. You can just take things one by one and hopefully you'll see some improvements

Ps, Saggy was my nickname as a kid as my initials are SAG lol

[Saggyuk]

Because I don't know much in detail about the consequences of bypass, I just had a quick read of wikipedia (has it's uses and is easy to read lol). It gives quite a few good pointers in regards to possible side effects on the body and which things you need to supplement such as the protein/amino acids I mentioned earlier which you don't appear to be supplementing. It also talks in depth about which types you need because you have bypassed certain parts of your stomach - such as you need calcium citrate rather than other types as this is the only one that can be absorbed in the remaining part of the stomach. It might help work out if you are taking the right things.

I wouldn't get your info from here but it's a good place to start and then you can read from there maybe. Good Luck

[ajs100uk]

I take protein shakes. I had my bypass in 2009, without it I would probably not be here now, so for me it was essential. I can now eat a pretty much normal diet just not huge amounts. After the initial massive weight loss in the first two years, and once I was eating a bit more normally, my weight either stayed the same or I would lose 1 to 2lb a week. I NEVER gained and could easily lose 7lbs by restricting myself. This continued until december 2015 and since then I have gained 3 stone with no change to my eating, and even if I restrict myself I lose nothing.

I will look into amino acids and maybe get a supplement.

My private doctor said I had a conversion problem because for years my thyroid function tests have been 'normal' (although I now know not optimal). He said that even though my thyroid was producing what it should I was not converting into the T3 at cellular level. As I never had any treatment, due to the normal tests, I have ended up developing profound symtpoms of hypothyroidism spanning 30 years. He said he could have diagnosed me just from looking at me.

Anyway, it is going to be a long hard battle for me I am sure, especially having a non supportive GP and limited finances. I cannot change my GP, as it seems where I live if you want to change doctors you have to write to the new surgery stating why you want to change from your current GP. I am not sure my reasons would go down very well

I appreciate you taking the time to comment on my post, thank you

[Saggyuk in reply to ajs100uk]

Ah. sorry, your initial post suggested you had it because you couldn't shift just the three stone since. Well hopefully the colonoscopy will help determine the problem and you can eat a little more

Nutritional deficiencies and inflammation can stop optimal conversion as can too low calories. Hope you feel better soon though

[Heloise]

Hi AJS, I just read your post of today and came back to this one. The bypass has probably got people stumped since the first thing I would ask is whether your stomach can produce enough acid to get the nutrients out although I'm sure you are taking in many that don't need a lot of metabolization. If they get to the small bowel it may be fine. Are you taking any sublingual supplements which seems like a good way to go.

Your levels are all too low and your FT3 at 3.15, the important one, is barely in range. This has awful implications. Your FT4 is 16.25 in the range of 12-22 that is the lower half and you should be in the upper third. I don't know when you had these taken since you say at the same time as your gastro appointment. When was that?

I'm not worried about ferritin, mine was at the top of range at 150 and I'm sure it had more to do with inflammation than high iron.

If the above are your most recent test results, I would say you need to increase your thyroid hormone. It seems that is what you are being advised from your last paragraph. Your symptoms show that you are either not taking enough supplemental hormone or what you are taking is not working as well as it should. Ferritin and cortisol are the largest culprits in deactivating your thyroid hormone. If you are taking two grains now or still getting there, I think you will see improvements once you are on it for a while. Best Wishes!

[ajs100uk in reply to Heloise]

Heloise, thank you for taking the time to comment.

The tests your post refers to are my initial results from back in March, before treatment. The latest results from June are there too, towards the bottom of the list :-).

I also have a separate post for my latest private results.

[Heloise]

ajs, did I post this to you before? I find them helpful. European ranges may be slightly different. I'd be very tempted to take a bit of the T3 unless there is a very good reason not to. One doctor said that everyone should be taking some T3 and I tend to agree. Modern day stresses, toxins in abundance and less than nutritious food make all our organs work harder.

Do you take digestive enzymes? Were you recommended to take them? I would take all the enzymes I could afford or at the least add some unfiltered apple cider vinegar before meals.

I hope I don't miss your follow up posts.

stopthethyroidmadness.com/l...

drkaslow.com/html/blood_cel...

[ajs100uk in reply to Heloise]

You have provided me some useful stuff before, thank you

I do take a digestive enzyme. I also had my gallbladder out a couple of years after my bypass surgery.

I was taking apple cider vinegar before every meal but the other day I read, cannot remember where, that those on nsaids should not take it! I take nsaids for my inflammatory arthritis/ osteoarthritis. So I am not taking ACV now. Unfortunately, I cannot move without taking nsaids so cannot give them up for the sake of ACV (I have tried unsuccessfully several times).

I do have some T3. I ordered it a few months ago before taking anything and it is still sitting unopened. I am tempted to take some but cannot afford to consult my private doctor at the moment, so I do not really know what to do for the best :-s

[Heloise in reply to ajs100uk]

Not being a doctor I can't press you into anything but then again I don't think the real doctors are also not pressing when they should. The inflammation is probably proved by your arthritis. You are in such a difficult place needing the nsaids. I've posted something about proteolytic enzymes which I am thinking may be the last hurdle to cross for some of us who have pain with our Hashimoto's. That was my main problem mostly lower back and rib cage but between the vinegar and serrapeptase I am more flexible and able to stretch and release some of the trigger points. It is considered an antiinflammary but without side effects. Izabella had recommended Wobenzyme.

So much of this is a do it yourself project as it seems to be beyond most of the professionals. I put more stock in what Dr. Bergman has to say. Have I posted any his videos for you? He has some on arthritis I'm sure.

youtube.com/watch?v=9brhLXN...(Not working as expected?)

[ajs100uk in reply to Heloise]

I have watched videos and tried all sorts of things to stop taking nsaids. I have no money left to try anything else and at least my nsaids are prescribed.

I have no disc left at L5/S1, it is bone on bone, and my other discs could go the same way. Without nsiads and painkillers I simply cannot function. I am in a good place with my back problem finally after 30 years and I am not going to do anything to myself again that would set me back. The pain is worse than childbirth and if nsaids keep it at bay, then so be it.

About 10 years ago, for instance, I tried an osteopath. That experience set me back a couple years. I cannot put myself through anything like that ever again.