Need help with test results

[Linzd]

Vitamin B12: 1189pg/ml (range 211-946) HIGH

Free T4: .98 (range .82-1.77ng/dL) NORMAL

DHEA-Sulfate: 182.9 (range 84.8-378.0 ug/dL) NORMAL

TSH 1.57 (Range .45-4.5 ulU/mL) NORMAL

Ferritin, Serum 108 (range 15-150 ng/mL) NORMAL

Free T3 Serum: 2.7 (range 2.0-4.4pg/mL) NORMAL

Reverse T3: 16 (range 9.2-24.1 ng/dL) NORMAL

C-reactive protein, Cardiac: 1.79 (range .00-3.00 mg/L) NORMAL

Estim. Avg Glu (eAG) 100 NORMAL

Hemoglobin A1c: 5.1 (range 4.8-5.6 %) NORMAL

My last results in July: (increased Cytomel to 5mcg along with 25mcg Synthroid)

TSH 1.170 uIU/mL (range .45-4.500)

Free T4: 1.14 ng/dL (range .82-1.77)

Results in May: (Given 2.5mcg Cytomel generic along with 25mcg Synthroid generic)

Free T4: 1.3 ng/dL (range .82-1.77)

TSH .895 uIU/mL (range .45-4.500)

T3: 100 ng/dL (range 71-180)

Results in March (When I received my Hashimoto's Diagnosis due to positive TPA. all other tests in NORMAL range): Given 25mcg Synthroid (generic)

T3 Total: 80 ng/dL (range 59-159)

TSH: 2.024 uIU/mL (range .35-4.940)

Vitamin D: 21 ng/mL (range 30-100) LOW

My TSH is creeping back up again and I am at my wits end. I have had weeks where I can barely get out of bed to eat I am so weak all after feeling better than I had for 3 years! I don't know why. My diet has NEVER been better than the last few months. NO gluten NO dairy NO eggs FEW grains LOW carbs LOTS of veggies SOME fruit NO alcohol

Its like nothing I do makes any difference on my labs. My weight keeps going up (although it seems more like myxedema or swelling than actual fat as you can't pinch it and it hurts) , I have worse brain fog again, I am depressed, still have digestive issues and the list goes on and on. Are these setbacks normal even with this kind of treatment?

[hellybaybee]

Not surprising really tsh is high and T3 is low. Nothing will make a difference to your weight until you're optimally medicated - I was an 8-10 and then went up to a 14... slowly losing it now but you can't let the weight gain bother you, it will happen every so often when your medication needs adjusting. Seems like you were better with the T3 and T4 combo... I'm not sure if this is because you can't convert or because they haven't replaced the T3 removed with additional T4. Why are you not getting T3 any more? Also are eggs a bad thing? They're full of protein. Avoiding gluten and dairy is probably a good thing with thyroid trouble, I've started cutting gluten out again and cutting down of dairy and after having a day wheat free I feel loads better. Best diets are clean or paleo to help you feel a little better but you need your medication adjusted

[Linzd in reply to hellybaybee]

I am still on T3 and T4, 5mcg and 24mcg respectively. Which is why it seems weird my TSH would keep going up and my T3 and T4 are both going down. I cut eggs because I was trying the Auto Immune Paleo diet which excludes eggs, I have reintroduced them since but I like most things in my diet, I didn't notice a big difference either way.

[hellybaybee in reply to Linzd]

Oh I see! thennu need d3 supplements from the dr... that will really help

[Linzd in reply to hellybaybee]

I am supplementing D3 with Optimal Vitamin D3 Liquid | 2,000 IU Per Drop as my Vitamin D was low in March.

[hellybaybee in reply to Linzd]

I think that's a bit low... I'm on 20,000 per week

[Linzd in reply to hellybaybee]

I do 2-3 drops per day usually

[Gambit62]

are you supplementing B12? - if not suggest you ask your GP to look into why your B12 level is so high.

[Marz in reply to Gambit62]

Previous post mentions supplementing but not how much !

[hellybaybee in reply to Gambit62]

Is b12 high? I was told u could be symptomatic if it was too low i.e. Below 500... I thought between 1000 and 1500 was ideal

[hellybaybee in reply to hellybaybee]

I do see that it is over range just want to understand

[Linzd in reply to hellybaybee]

I don't know. It was out of range but being in range isn't necessarily adequate so I wanted to check.

[HLAB35]

My B12 levels never get this high - I take methylcobalamin which tends to get excreted more readily than cyanocobalamin. If you're already taking methylcobalamin then don't worry!

I can't understand why no eggs??? They're very nutritious in that they have pretty much all of your daily required amino acids. A lot of people on the forum supplement amino acids to help them get better. At least 35% of calories should come from protein, in my case more like 50%!

[Linzd in reply to HLAB35]

I cut eggs because they are not included in the Auto Immune Paleo diet and can be a problem. I have since reintroduced eggs and didn't notice any difference. Here is more info:

Organic, grass-fed eggs are a fantastic food for quick and filling protein that is high in amino acids and nutrients. Unfortunately, if you are dealing with gut inflammation, leaky gut and autoimmune disease, eggs could be making your symptoms worse. Egg whites tend to be particularly troublesome in autoimmune inflammation because they can permeate the gut lining and cause the immune system to react even more. Luckily, this does not mean that eggs are off of the table forever. Often times patients find that once they heal their gut and cool off the inflammation in their bodies, they can return to having eggs in their diet. Removing all eggs for two to four weeks can help you identify if they are troublesome for you.

[HLAB35 in reply to Linzd]

Uncooked egg white is a problem in that it'll bind to certain things we're trying to absorb. I tend to scramble, or poach, or occasionally have a pancake and so usually have no runny white. If I don't have eggs for breakfast, I really notice it. I sometimes 'accessorise' my eggs, but they're always there.

[Gambit62]

Linzd

B12 isn't toxic but that doesn't mean that taking high doses can't cause problems.

- some people respond to high levels of B12 in serum by shutting down the mechanism that allows B12 to pass from blood to cells - leaving them deficient at the cell level - all the symptoms of a B12 deficiency but high levels in blood (functional B12 deficiency)

You only need to take high dose oral supplements if you have an absorption problem and if the levels above are the result of supplementing then you obviously don't have a significant absorption problems in relation to B12.

High B12 levels in the absence of supplementation can be a sign of kidney and liver problems.

hellybaybee the serum B12 is a guide at best to B12 status - it isn't a direct measure of how you are managing to metabolise B12 and there are significant variations from one individual to another in what B12 levels are right for them.

If used as a single measure serum B12 will result in missing 25% of people who are B12 deficient but will also result in picking up 5% who aren't. Evaluation of symptoms is an important part of evaluating a potential B12 deficiency though that can be quite complex when there are other conditions present, such as thyroid.

HLAB35 the rate at which different forms of B12 are removed from the blood varies significantly from individual. Whilst on average, for instance, hydroxocobalamin is retained twice as long as cyanocobalamin there are considerable numbers of individuals for whom exactly the opposite is true. I haven't consciously come across any studies comparing retention of methyl with that of cyano and hydroxo but have to underline that what may be true for one individual is not necessarily true for all individuals.

[HLAB35 in reply to Gambit62]

You're right. I think this may be something to do with genetic factors such as MTHFR mutations. I can't believe I neglected to mention checking high B12 out with a GP. I think my priorities went wrong ... I got sidetracked.

[Gambit62 in reply to HLAB35]

yes, likely to be genetic but not going to be related to MTHFR which is to do with processes that actually happen in cells.

[Linzd in reply to Gambit62]

I do have +/+ for MTHFR A1298C and +/- for MTHFR 03 P39P, based of genetic tests, I will mention this to my dr.

[Gambit62 in reply to Linzd]

to repeat - MTHFR isn't a genetic mutation that is likely to result in high levels of B12 in your blood.

[HLAB35 in reply to Gambit62]

Extract from drlam.com/blog/mthfr-and-ad...

"A blood test can include common laboratory serum tests such as liver enzymes, ferritin and homocysteine levels. The genetic testing can include the MTHFR profile. Glutathione is usually found low. The B12 level may be high, because the body is unable to utilize the unmethylated form." So unless this guy's completely missed the point?

I've read up on methylation cycle and it has plenty to do with take up of B12 and it is a very complex area that still requires study. However I agree that there are other (quite serious) conditions that can also cause a high serum level of B12 which is why it's always a good idea to rule out anything else with a GP.

[HLAB35]

Please check out that this high b12 level isn't signs of anything else 'going on' - I've seen on your previous post that you're only having b12 as part of a good quality B-complex, so it'd be worth finding out what's going on. Is your functional doc giving you b12 injections??

[Linzd in reply to HLAB35]

No just the B complex

[HLAB35 in reply to Linzd]

In that case I'd really get this checked out... especially as you're feeling so unwell. There are possible causes of high serum B12 that a general practitioner would want to rule out.