Abnormal bloods

[LucyB7]

Hi I am new and have these abnormal bloods? Thank you

TPO ANTIBODY 455.1 (<34)

TSH 61.0 (0.2 - 4.2) not 6.10

FREE T4 10.2 (12 - 22)

FREE T3 3.3 (3.1 - 6.8)

[SeasideSusie Remembering]

LucyB7 Presumably your GP arranged the tests, what has he said about the results?

[LucyB7 in reply to SeasideSusie]

GP arranged the tests, she has sent me away with antidepressants.

[SeasideSusie Remembering in reply to LucyB7]

GP arranged the tests, she has sent me away with antidepressants.

Oh FGS!!! She is an idiot. Hopefully you haven't started taking the antidepressants.

Please make an appointment with a different GP and show him these results

TSH 6.10 (0.2 - 4.2)

FREE T4 10.2 (12 - 22)

FREE T3 3.3 (3.1 - 6.8)

and say that you have over range TSH, below range FT4 and barely in range FT3. Also, point out that

TPO ANTIBODY 455.1 (<34)

means that have autoimmune thyroiditis (aka Hashimoto's as we call it).

This combination means that a patient should be started on Levothyroxine without waiting for TSH to reach 10, which is the usual point where a diagnosis of hypothyroidism is made.

Dr Toft (ex president of British Thyroid Association and leading endocrinologist) wrote an article in Pulse Online magazine which says that if antibodies are present then patients should be prescribed levothyroxine to 'nip things in the bud'. Email [e-mail] and ask for a copy which you can then show to your doctor.

**

Because very few doctors don't know about or understand Hashimoto's, and dismiss antibodies as not important, it is crucial that you read and learn all you can so you can help yourself.

Hashimoto's is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

**

Hashimoto's tends to go hand in hand with gut/absorption problems and quite often results in low or deficient nutrient levels. You should ask for the following to be tested, then post results (with reference ranges) for comments and we can suggest supplements where needed.

Vit D

B12

Folate

Ferritin

Iron panel and full blood count if ferritin is low

All vitamins and minerals need to be optimal (not just in range) for thyroid hormone to work.

[LucyB7 in reply to SeasideSusie]

No unfortunately I started the antidepressants today, she believed the symptoms I was having were psychological and I have a swollen thyroid which was scanned and shown to be enlarged. I have vitamin and mineral levels and I will post them.

Ferritin 27 (30 - 400)

Only thing from complete blood count that was abnormal was MCV 77.2 (80 - 100)

Iron 6.2 (5 - 25)

Transferrin saturation % 15 (10 - 30)

Folate 4.1 (4.6 - 18.7)

Vitamin B12 203 (190 - 900)

Vitamin D 27.2 (25 - 50 deficiency)

[SeasideSusie Remembering in reply to LucyB7]

As you've only taken them for 1 day, I presume it would be safe for you to just stop them. Seriously, I would do that. Depression is a symptom of hypothyroidism and it's a cop out for doctors who know diddly squat about recognising or treating hypo.

[SeasideSusie Remembering in reply to LucyB7]

Ferritin 27 (30 - 400)

For thyroid hormone to work (our own or replacement) ferritin needs to be at least 70, preferably half way through range.You need an iron supplement. As your level is below range, ideally you an iron infusion so ask for one, but you may only be prescribed tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours.

Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.

Only thing from complete blood count that was abnormal was MCV 77.2 (80 - 100)

And that is enough to suggest iron deficiency anaemia so you need to point this out to the other GP you will hopefully see and ask for treatment. See NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines) cks.nice.org.uk/anaemia-iro...

How should I treat iron deficiency anaemia?

•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).

•Treat with oral ferrous sulphate 200 mg tablets two or three times a day.

◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.

◦Do not wait for investigations to be carried out before prescribing iron supplements.

•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.

• Monitor the person to ensure that there is an adequate response to iron treatment.

**

Folate 4.1 (4.6 - 18.7)

Vitamin B12 203 (190 - 900)

You are folate deficient with very low B12. Do you have any signs of B12 deficiency b12deficiency.info/signs-an...

You need to post on the Pernicious Anaemia Society forum for further advice. Quote your Folate, B12, ferritin and iron deficiency information, mention any signs of B12 deficiency you may be experiencing. You may need testing for Pernicious Anaemia and you may need B12 injections. Discuss what they say with your GP.

healthunlocked.com/pasoc

I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Folate should be half way through it's range.

**

Vitamin D 27.2 (25 - 50 deficiency)

You are just 2.2 away from severe deficiency. You need treatment, ask your GP for loading doses as mentioned in NICE treatment summary for Vit D deficiency:

cks.nice.org.uk/vitamin-d-d...

Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

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)."

Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the guidelines and prescribes the loading doses. Once these have been completed you will need a reduced amount (not the paltry 800iu you will be prescribed) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose which may be 2000iu daily (not 800iu), 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

vitamindcouncil.org/about-v...

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

naturalnews.com/046401_magn...

Check out the other cofactors too.

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You really need to see a different GP, get treatment for all these dire results, then wipe the floor with the stupid GP who gave you the antidepressants.

[LucyB7 in reply to SeasideSusie]

TSH should read 61.0 not 6.10 sorry

[SeasideSusie Remembering in reply to LucyB7]

TSH should read 61.0

And that makes is so very much worse. A TSH of 61 and no diagnosis of hypothyroidism, when the level for diagnosis is 10!

As I said, make the biggest fuss and make an official complaint against this person who doesn't deserve to be called a doctor.

Please come back and tell us what the different GP is going to do.

You should be started on Levo immediately and unless you are elderly or have a heart condition you can be started on 50mcg. Repeat tests and increases of 25mcg should be done every 6-8 weeks until your symptoms abate and you feel well.

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo.

Take Levo on an empty stomach, one hour before or two hours after food, with a glass of water only (no tea, coffee, milk, etc for an hour). Any other medication or supplements should be taken two hours away, four hours for some.

Don't forget to read the links about Hashi's and to adopt a gluten free diet and supplement with selenium.

[Puska in reply to SeasideSusie]

It’s scary isn’t it. Antidepressant for an under active thyroid. Heaven help us.

[SeasideSusie Remembering in reply to Puska]

It is scary Puska but unfortunately it's quite common here in the UK. I think it's probably a combination of ignorance about thyroid disease, laziness on the part of the GP and the fact that there's probably extra funding for prescribing antidepressants.

[Puska in reply to SeasideSusie]

It’s quite the opposite here in Aus. And with results like above they’d be relieved they can easily diagnose and prescribe thyroxine.

[Spongeybob]

It's funny that doctors are quite comfortable prescribing antidepressants in spite of the associated risks but refuse to treat the thyroid. But in psychiatry if you aren't absorbing your antidepressant we prescribe cytomel which is T3. Not a coincidence