Help please

[Michaeladell]

Blood test results from blue horizon. Can anybody help

me interpret them?

[ITYFIALMCTT]

You're taking carbimazole?

Your TSH is high above the reference range and your FT4 and FT3 are below their respective reference ranges.

Your thyroid antibodies are both outside the reference ranges.

Your B12 is just below the reference range and you will be familiar with SeasideSusie 's suggestions around levels like yours.

Your vitamin D level could likewise benefit from SeasideSusie's general advice as it's in the 'insufficient' range.

[Michaeladell in reply to ITYFIALMCTT]

Thank you. Yes 10mg carbimazole a day. What does both thyroid antibodies being outside the range mean?

[ITYFIALMCTT in reply to Michaeladell]

tbh, I'm more accustomed to seeing them both raised when people have Hashimoto's so I assume that your other thyroid results reflect the carbimazole influence but I don't know enough about antibodies to comment.

[Michaeladell in reply to ITYFIALMCTT]

I was diagnosed with an under active thyroid. Two weeks ago my TSH WAS 0.16 and the range was 0.5 to 5.0 I think.

[ITYFIALMCTT in reply to Michaeladell]

I thought carbimazole is prescribed to people with hyperthyroidism/overactive thyroid so have to confess that I'm baffled.

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

[Michaeladell in reply to ITYFIALMCTT]

Sorry I meant overactive!!! 🤣 My brain is mush

[SeasideSusie Remembering]

Michaeladell I'm having difficulty reading your results, even on my PC monitor (which is a good size) they'rea bit too small for me to know exactly what they say. Can you type in your Vit D, B12, and ferritin results, I can make out that folate is 4.7

[Michaeladell in reply to SeasideSusie]

Vitamin D 43 range 50 to 200

B12 196 range 197 to 772

Ferritin78 range 13 to 150

[SeasideSusie Remembering in reply to Michaeladell]

Thank you

Vitamin D 43 range 50 to 200

The recommended level, according to the Vit D Council, is 100-150nmol/L. You could supplement with 5000iu D3 daily for 3 months and retest. As you have high antibodies (if it's Hashi's it often causes absorption problems) then for better absorption you would be best getting an oral spray. BetterYou do a 3000iu dose, so you could take 2 doses giving you 6000iu daily for 3 months.

When you've reached the recommended level then 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

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 helps D3 to work and 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.

BetterYou do a combined D3/K2-MK7 if you prefer that, then it just leaves magnesium as a separate supplement.

**

Ferritin78 range 13 to 150

This is good, it needs to be 70 for thyroid hormone to work and recommended is half way through range. If you're not taking supplements then just to maintain this level I'd be inclined to eat liver every 2 or 3 weeks, also include iron rich foods in your diet apjcn.nhri.org.tw/server/in...

**

B12 196 range 197 to 772

Folate 4.7 >2.9

I do think that's a stupid way of giving folate results. You are over the limit but it's not particularly high. Someone with a level of 20 would also be over the limit, but who has the optimal result?

Do you have any signs of B12 deficiency b12deficiency.info/signs-an... You should now go and post on the Pernicious Anaemia Society for further advice because a below range B12 isn't something that should just be self-supplemented healthunlocked.com/pasoc Post your B12 result, folate result and any signs of B12 deficiency you may be experiencing from the list. Also mention your ferritin result so that they know there is no problem there.

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."

[Michaeladell in reply to SeasideSusie]

Thank you. I’m very confused about the whole thing. Until recently I was firmly overactive. The endo said graves but only based on the fact I’m 50. Asked for bloods in 7 weeks but I didn’t want to wait that long to know. But now both sets of antibodies are raised which has confused me but could explain why I’m over a stone heavier than I was in July??

[SeasideSusie Remembering in reply to Michaeladell]

I haven't read all of your other threads so I don't know the background, but your TSH is way over range and both free Ts well under range, so at the moment you are well and truly hypo and most likely the answer to your weight gain.

[Michaeladell in reply to SeasideSusie]

Thanks. Guess I need another appointment then. The doctors will be sick of me lol

[SlowDragon Administrator]

I would absolutely INSIST on antibodies testing for Graves - TSI or Trab to double check

This looks like Hashimoto's NOT Graves

You can have High TPO and high TG antibodies with both Hashimotos and Graves

But only high TSI or Trab antibodies with Graves

As humanbean said in previous post

If this is Hashimoto's than you should not have ever been on carbimazole

If it is actually Graves, perhaps it is in remission and you need to stop carbimazole

These results now scream hypothyroid

You can also (just to complicate matters) very rarely sometimes have both Hashimoto's and Graves at same time

Link about antibodies

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

[Michaeladell in reply to SlowDragon]

Thank you

[ITYFIALMCTT in reply to Michaeladell]

You might have seen the discussion in this thread about someone taking carbimazole who also has antibodies more in line with Hashimoto's Disease: healthunlocked.com/thyroidu...

As SlowDragon suggests, you need confirmation that this is solely Graves/hyperactive thyroid rather than Hashimoto's cycling or the rare combination of the two.

[Michaeladell in reply to ITYFIALMCTT]

I will go to the doctors as soon as I get home from my holiday. Thanks for your help. I have an appointment with my endo on 22/12 and he has asked for bloods to test for graves before I go. I’ll see if I can get that done earlier though x