I finally bit the bullet and paid for some private testing after the Lab kept refusing to do anything requested by my GP aside from TSH.
I've just had my results back and was hoping someone knowledgeable on here might be able to confirm/contradict the comments made by the private GP?
Results received today are as follows:
TSH: 2.14 (0.27-4.20)
Free Thyroxine: 14.3 (12.00-22.00)
Total T4: 99.3 (59-154)
Free T3: 4.54 (3.10-6.80)
Thyroglobulin Antibody: 13.600 (0.00-115.0)
TPA: 11.8 (0.00-34.00)
Active B12: 60.3 (25.10-165.00)
Folate Serum: 3.36 (2.91-50.00)
25 OH Vit D: *33.4 (50.00-200.00) (Insufficient)
CRP: *15.7 (0.00-5.00)
Ferritin: 33.3 (13.00-150.00)
The GP comments, paraphrased in places, are as follows:
"TSH, T4 and T3, are all normal, which suggest healthy thyroid function. Antibodies, vitamin B12 and folate are normal.
Vit D levels are insufficient, suggest supplementing 20-25mcg per day for 12 weeks, then 10mcg per day.
CRP level is elevated, take a more aggressive approach to managing cardiovascular risk factors.
Ferritin is toward lower end of normal, which could cause fatigue, increase intake of green leafy veg and oranges. "
The tests were prompted by me reaching the end of my tether with feeling awful all the time. I feel absolutely exhausted at all times, to the point where I could cry most days. I am achy all the time, I can't lost weight (and can put it on just walking past a potato in asda), have a family history of thyroid problems, have intense brain fog/struggle to concentrate/remember things.....and the list goes on.
Is it wrong that I was hoping that this would come back with something obviously wrong? I am so desperate to feel better and no one seems to be able to help.
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theParners
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In a normal, healthy person you might expect to see TSH 2 or below. Your FT4 is rather low in range, you'd expect that to be about half way (or more), FT3 again a bit low, you'd expect that to be in balance with FT4 so a bit higher.
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Thyroglobulin Antibody: 13.600 (0.00-115.0)
TPA: 11.8 (0.00-34.00)
No indication of autoimmune thyroid disease with these results. However, one negative doesn't rule it out, you'd need a few over time to do that.
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Active B12: 60.3 (25.10-165.00)
Sorry, I can't interpret Active B12, only normal B12
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Folate Serum: 3.36 (2.91-50.00) folate normal
I don't agree with that. Folate should be at least half way through it's range. A decent B complex containing methylfolate (preferably 400mcg) will help raise your level, and it's a good general supplement for thyroid.
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25 OH Vit D: *33.4 (50.00-200.00) (Insufficient)
This is very low, not much above the Deficiency category (less than 30nmol/L) used in the NICE Clinical Knowledge Summary cks.nice.org.uk/vitamin-d-d...
The recommended level, according to the Vit D Council, is 100-150nmol/L.
You can buy some D3 softgels like these bodykind.com/product/2463-b... and my suggestion would be to take 10,000iu daily for 6 weeks, then reduce to 5000iu daily. Retest 3 months after starting. When you've reached the recommended level you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
There are important cofactors needed when taking D3
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, D3 four hours away from thyroid meds.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
High CRP can be a sign of inflammation or infection labtestsonline.org.uk/under... Were you unwell or did you have a virus at the time of testing?
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Ferritin: 33.3 (13.00-150.00)
This is very low. Ferritin should be at least 70 for thyroid hormone to work - that is our own or replacement hormone.
You could speak to your GP about an iron supplement or buy your own ferrous fumarate from Amazon. If you buy your own you would need to retest after 3 months. Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron two hours away from medication and supplements as it will affect absorption (some need four hours).
You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
I raised my ferritin from 35 to 91 by eating liver as I can't tolerate iron tablets. I still eat it regularly now.
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So you can see that your Vit D, Folate and Ferritin need addressing.
Other general supplements would be Vit C (helps support adrenals), maybe 2000mg daily in divided doses and selenium which helps with T4 to T3 conversion.
I've previously had my high CRP blamed on hypermobility, which surprisingly is un-treatable and therefore a perfect diagnosis to allow people to fob you off for the rest of your life. I have had two ear infections since May that couldn't be treated with 5 different antibiotics, so I've just been left for two months waiting for an ENT appointment. If I hadn't had previously high CRP results, it therefore wouldn't surprise me to have them now.
Could the vitamin deficiencies be the route of the problem do you think?
I've been lurking on here for a while reading people's results and comments and assumed that if T4/T3 were low, then TSH should be higher trying to compensate for it. I assume everything thyroid related is "normal" enough that I don't need anything for it? My GP has about 4 TSH results for me but said that each was "normal", they never gave an actual reading.
If you could get those previous results, we could see what's happening to your TSH - is it actually rising, is it stable, it's all part of the picture.
Do you take any medication for anything?
Your TSH is 'normal' because it's within the range, it's a fraction under half way. FT4 is low at 23% through range, and FT3 could be classed as lowish at 38% through range.
If you look at this article, you'll see that a normal TSH with low FT4 and low FT3 can have 3 causes bestpractice.bmj.com/best-p...
If you can class your FT3 as low, then going by that chart, if you can dismiss the two lower reasons (actually, you can't dismiss assay error, you have to assume it's correct) then you're left with secondary or central hypothyroidism.
Very few doctors know about this so you'd have to do some research. It's where the fault lies with the pituitary or the hypothalamus.
BUT before you go down that route, I'd optimise your vitamins and minerals because deficiencies can cause symptoms similar to hypothyroidism. So I would aim to get the following levels
Vit D - 100-150nmol/L
B12 (Normal, not active) - very top of the range
Folate - at least half way through range
Ferritin - half way through range, even 100-130 is recommended for females
Once those are all optimal, then if you still have symptoms they can't be caused by poor nutrient levels and you could look into thyroid - whether that's primary hypothyroidism (high TSH, low FT4/FT3) or secondary/central as mentioned.
Also it would be worth repeating thyroid antibodies, just in case they've been caught at a time when they're inactive this time.
Thanks for that link seaside, it's really helpful.
I don't take any medication for anything at the minute (I have painkillers for muscle and joint pain but I try not to take them as this is now my normal so I need them to work when things get really bad, and tranquilisers for vertigo that I don't take because I have a job and things I need to do).
Okay, I'll take a look at the vitamins tonight.
I just desperately need to feel better. We have a once in a lifetime trip planned in 6 weeks and I feel like it's going to be wasted on me as I can barely stay awake to go to work, let alone have a life!
Your muscle and joint pain could very well be down to your low Vit D.
I know how you feel about your once in a lifetime trip, I went to my dream destination when I wasn't anywhere near well enough, but I made the most of it and just about managed OK.
Repeated antibiotics may have lowered gut bacteria. You could try a daily probiotic too
Low vitamin D apparently changes the gut environment and low B vitamins as result
When taking any B complex it contains biotin and this can falsely affect future blood tests. Always stop all biotin supplements 3-5 days before any test
Muscle aches and extreme fatigue might easily be caused by lack of vitamin D. I don't know if it can cause the other symptoms. If you don't feel better after taking vitamin D for a couple of days, I suggest having a complete blood count and full tests for iron deficiency. It could be anemia. I know what it's like to be extremely fatigued everyday, so if you don't feel better in a few days you can try coming back here and I'll see if I can be of more help if neither of theses suggestions are the answer to your fatigue, because then less common causes must be ruled out.
I'm just trying to get my head round all of this vitamin info. SeasideSusie
So, Vit D as above, sorted, I'll get the linked gel tablets. The info i've read about having too much vit d, suggests if i start having constant nausea, i might be too much? Will take as directed and retest in December.
Bit worried about K2-MK7- the info about them says it promotes the elasticity of soft tissue. As i have a connective tissue disorder re: over-elasticity of ligaments, am i right in reading this is more about elasticity of skin than ligaments with it saying soft tissue rather than connective?
Could you recommend a b complex with methylfolate? Would this be okay? It has 160mcg of vit c, so i assume i'd still need the vit c supplement as well.
Is this going to be too much to start taking all at once? Is there anything i should be looking out for?
Is there a more efficient way to do it? I'm worried about how on earth i'm going to get all these supplements through customs on holiday as taking a massive bottle of each is going to fill my luggage up!!
I took 7 day pill dispensers, (big ones from asda to hold 8 for each day) with me and photographed a clear lineup of the bottles with each pill in front of them just in case. I put everything in a clear bag like you do for liquids and put on display through security. They didnt bat an eye!
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