Test result interpretation please

[t3rcam]

I wonder if anyone can throw some light on the following results for my daughter. She is struggling with sheer exhaustion and other hypothyroid symptoms. (I have Hashimoto's)

November 2016 NHS test results -

free T4 - 14pm/L (20 - 25)

TSH - 3.09mU/L (0.55 - 4.78)

Vitamin B13 288ng/l (200 - 700)

Ferritin 69.6ug/l (7.0 - 150.0)

Private blood test results July 2017-

Free thyroxine - 15.08 pmol/L (12.00 - 22.00)

TSH - 4.62 mIU/L (0.27 - 4.20)

Total thyroxine (T4) - 89.9 nmol/L (59.00 - 154.00)

Free T3 - 4.09 pmol/L (3.10 - 6.80)

Reverse T3 - 23

Reverse T3 ratio - 11.58 (15.01 - 75.00)

Thyroglobulin antibodies - 11.950 IU/ml (0.00 - 115.00)

Thyroid Peroxidase Antibidies - 13.47 IU/ml (0.00 - 34.00)

Vitamin B12 - 809 pmol/L (140.00 - 724.00)

Folate (serum) - 8.71 ug/L (2.91 - 50.00)

25 OH vitamin D - 197 nmol/L (60.00 - 200.00)

Ferritin - 98.61 ug/L (13 - 150)

Iron - 31.96 umol/L (6.60 - 26.00)

T.I.B.C - 60.6 umol/L (41.00 - 77.00)

Transferrin saturation - 53.21 (20.00 - 55.00)

The numbers just confuse me, not to mention the units of measurement 😬

Thank you in anticipation.

[t3rcam]

Oops, NHS test result should be B12 not B13!

[helvella in reply to t3rcam]

You can edit your own post and replies - and this is how:

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[Eddie83]

In the short term, she would probably be helped by use of T3 (synthetic T3 or from NDT) since her FT3 is only 26% up in range. I don't know how rT3 ratio is calculated in the UK, but I am assuming that it is FT3/rT3 with a units conversion, with an underrange value indicating that she has too little T3 in comparison to rT3. This indicates to me her body is in a stress state where it is deciding to turn T4 into too much rT3. Is she using levo?

In the long term, those TGB and TPO antibodies mean her body is struggling with something like a food sensitivity, or environmental chemical exposure. Do not assume that, since her values are below the cutoff range, they are OK; I had low-level values for a long time and it wrecked me. I gather she has been using iron, vit D, B12. I think you need to do:

o Radical diet shift. Get rid of grains (esp. wheat), refined sugar, anything that could be classed as 'junk' food. Fruits, vegetables, complex carbs, clean proteins are OK. Dairy might be (or not) OK, I would exclude it if you can. If you can keep her on a clean diet, test in 6 months to see if antibodies are going down. If they won't, see if you can get her tested for common pollutants such as heavy metals.

o Perhaps a more comprehensive supplement program. Obviously folate needs to come up. I would investigate which supplements would best help her body clear out undesirable pollutants. There are various amino acid derivatives and antioxidants which would help with this; seeing a naturopathic doctor would help identify the best ones. If she is harboring heavy metals, you might have to do chelation.

[t3rcam]

Thanks for getting back to me Eddie33. She doesn't take anybthyroud meds. She has been taking vitamin D, vitamin K2, vitamin B12 and a Vitamin B12 complex. To be perfectly honest she has been so exhausted for so long & has a 4 year old and a 20 month old to deal with I think 6 months for retesting would be like a lifetime away for her. She sleeps 12-14 hours a day. She is taking an anti-depressant, Citalopram, for Post Natal depression but says she is feeling much better mentally & I definitely see a huge improvement in that side of things. She has a really good diet but occasional tummy upsets direct her to thinking gluten/wheat is an issue. I forgot to say that her private blood tests also suggested that she may have Gilbert's syndrome. She has an appointment at the Rapha clinic in September which will hopefully give her some direction re food sensitivities and heavy metals.

[SlowDragon Administrator]

Gilbert's syndrome can make some people feel down and moody. It's is also suggested on a few websites that people with Gilbert's may be more likely to have susceptibility to gluten intolerance.

Why not try gluten free diet to see if it helps?

Obviously gluten free helps very many of us with Hashimoto's too.

If taking B12 then also taking vitamin B complex is recommended to keep B's in balance. But we have to remember to stop taking any supplements with biotin in 3-4 days prior to any future blood tests. Biotin can falsely affect test results.

endocrinenews.endocrine.org...

endo.confex.com/endo/2016en...

[t3rcam in reply to SlowDragon]

Thanks slow dragon. My daughter does in the main cook from scratch & gluten free but not totally. She takes a B complex and a B12. I will check to see if there is Biotin in either. She took no supplements for 5 days before the blood test. Interesting articles. Thank you.

[SlowDragon Administrator in reply to t3rcam]

Interesting article

chriskresser.com/3-reasons-...

[Treepie]

Your daughter's antibodies are below the line for Hashimotos. THS is high and FT3 and FT4 are low ,so the thyroid is struggling but GPs unlikely to do anything until 10.

Try to persuade the GP for a trial.

[t3rcam]

That was my thinking. I am not confident that any of our GP's will allow a trial but we will ask. Just in case we have to self medicate do you think Levo or T3 would be her best option?