Test results, lots of numbers - insights please

[muddlemand]

NB: I realise it's nearly Xmas - I won't take any action (except online) until next week, more likely January. So please tell me if I should bring this question up after the season's over, instead. I wanted to do the typing asap today for fear of losing the bits of paper by tomorrow.

These results are nearly six years old - from when I was hyperthyroid. Was never told Grave's or anything specific; took carbimazole for 15 months and was fine.

Two reasons I'm asking about results that are so old. Mainly, I think these mean I couldn't possibly have Hashimoto's, then or now. But what do I know?

Also some things showed up that weren't mentioned to me. Maybe some are to be expected while I was very hyper. Others, I can't tell if they improved and I don't know if carbimazole would improve them. Most I don't know if they relate to the thyroid. And another point; if there's something that only gets worse as time passes, and it was aready at a bad level back then, I'd like to know!

I also have my recent tests but that's only TSH. It was 0.72 (two months ago) and I haven't been given the range. I cannot get T3 and T4 tested on the NHS. The GP says she can't overrule that, the lab simply won't do it while the TSH is within range. She also can't refer me back to endocrinology, nowadays the GP writes to the consultant, who tells the GP how to treat, and that's all. Our conversation didn't even get as far as asking for antibodies or B12 and all the rest, it really wasn't worth speaking to her. She doesn't even think it's worth knowing what is pushing my b/p up this year after twenty years relatively stable.

Everything else on the recent test was for the routine diabetes check-up. I was surprised to see an asterisk by one value - that's the lab flagging it up, isn't it? It is the plasma creatinine level, 52 umol/L. No range but online I *think*, if I've understood correctly, I saw this should be >74? I'm surprised not to be told if something is out of range, but probably because I didn't get to the check-up appointment (ill on that day). Online I've only learnt that this is linked to low muscle mass / muscle wastage, and I'm surprised it's low when urea isn't... but I don't know what I'm talking about with these.

(I've spent all week getting hold of these results - and now I know I'm definitely going to leave this GP practice! My new GP is the worst kind. The online system for patients to log into their own records doesn't show these results, only what were tested but with all the values blank. There's nothing to keep me with Gloucestershire any more, my former GP, the secretary I used to know well, and my lovely diabetes consultant and nurse have all retired or left. Even the pharmacy has become frighteningly unreliable after being great for years. I've lived in Wiltshire for a long time and will finally move to the more local GP practice in the new year. At least it's an easy decision, after this week's arguments!)

In 2012:

thyroid peroxidase antibody <20 iu/mL (comment: <60 negative, 60-100 doubtful, >101 positve)

serum free triiodothyronine >30 pmol/L (range 3.9-6.7) - this is FT3, isn't it?

I was put on carbimazole straight away. A week or so later, this was 18 pmol/L.

serum free T4 >95 pmol/L (range 10-24.5)

In the later test this was 42.1 pmol/L.

serum TSH <0.05 miu/L (range 0.2-5.5)

In the later test this was still <0.05 miu/L.

There is a note: Thyrotoxicosis. Surprise!

Those are the only ones which I'm sure are thyroid related. Others that interest me:

Low:

Serum albumin, serum creatinine, total white blood count, basophil count, eosinophil count (observation), neutrophil count, haemoglobin concentration, haematocrit.

Later the total white blood and eosinophil had crept just into range.

Whereas Hb concentration slipped below range by then.

Low but within range:

Serum total protein, serum creatine kinase, lymphocyte count, mean cell haemoglobin, mean cell volume, total white blood count, neutrophil count.

(Is creatine kinase the same as creatinine?)

High:

Serum alanine aminotransferase: 43 iu/L, range <33.

Some without numbers:

anti-nuclear factor level: positive

(I assume I can ignore all negatives, only positive results matter?)

autoimmunity profile - lab comment: ANA titre >1:80

In total there are nearly three A4 pages from March-April 2012. If more detail would help, can I post them as an image? too much typing!

Many thanks in advance for any insights!

[Clutter]

Muddlemand,

Thyroid peroxidase antibodies were negative but you needed TRab or TSI antibodies tested to confirm or rule out Graves Disease which is the autoimmune type of hyperthyroidism. They're usually tested in endocrinology.

TSH 0.72 is euthyroid (normal) but one would need to see FT4 and FT3 to confirm. As your practice can't order FT4 and FT3 you can order private thyroid tests via thyroiduk.org.uk/tuk/testin... Medichecks offer #ThyroidThursday discounts.

It's really not worth trying to analyse results from 6-7 years ago. They probably bear little relation to evaluations today. * indicates abnormal results ie above or below range, but ranges taken off the internet may not relate to your results so only use the lab ref ranges given with your results. One-off abnormal high or low results are usually not significant but if you want to check what above range or below range evaluations mean Google "high alanine aminotransferase" and "ANA titre >1:80" etc.

[muddlemand in reply to Clutter]

Thanks for replying, Clutter!

About Grave's disease, I have no idea why I wasn't tested fully for that. I suppose they thought they'd do it if the carbimazole didn't work after the default length of time (18 months). So in short, it's still not ruled out and yes I know I need to go private. Oh well.

My other reason for looking back at old results was to see if anything showed up such as low B12, but something else that I'm not familiar with,, which would be the same until something was done about it. But Grave's was the main question and you have answered that.

I will google the ANA titre and the rest. It's just that my internet is headline-making slow (rural area, can't always load any page, stupidly slow etc etc) plus all the ways of getting online are painful (fibromyalgia) so I'm hoping someone knowledgeable can tell at a glance whether there's anything worth giving my attention to.

[Clutter in reply to muddlemand]

Muddlemand,

I don't think you need to go private. If you're not hyperthyroid and taking Carbimazole now then both hyperthyroidism and Graves (if you have it) appear to be dormant.

If you want to know whether B12 is low you can order a B12 blood test. It would make sense to order folate, ferritin and vitamin D too. Blue Horizone Thyroid Plus 11 and Medichecks UltraVits offer comprehensive thyroid and vitamin and mineral testing via thyroiduk.org.uk/tuk/testin... I don't think Blue Horizon or Medichecks offer TSI or TRab Graves antibody testing on their menu but if you contact them I'm sure they'll be able to advise whether they are able to do them.

[muddlemand in reply to Clutter]

Sorry, only just got back online after the time-of-year chaos. I'm not taking carbimazole now - I took it for 15 months 2012-13, and at the time that "cured" the hyperthyroidism. I'd been told I had a chance of it being a one-off and was happy to think I was in that subset, didn't ask any more. Now, I am certain I'm getting hyper again (for example it's 2deg Celsius out there, and I have all doors open, sitting here in a strappy summer top). Also throughout 2017 my motivation has been oddly low, very unlike me to procrastinate or fail to engage with what needs to be done, and feel detached instead of concerned at what isn't getting done... not depression exactly (I'd recognise that) but I think it would meet the criteria in a tickbox way. Something's definitely up.

This winter is mirroring my experience in 2012: higher energy and felt the cold less through the winter (2011-12), losing weight slowly but without trying. I took it as a step in my recovery from long-term serious illness, as invalids feel the cold more and I put the weight loss down to being able to be more active. Felt fine until I caught a cold in Jan '12, which didn't go away, until they did the bloods in Mar '13 which I posted above. Really seriously ill by then, couldn't keep a mouthful of water down, couldn't sit up, and too ill to be aware that I needed a doctor.

I cannot afford to get as ill as that again, as I'm single now and without any help (back then I had an assistant via Social Services, and "officially" a husband though he was so unconcerned that he didn't notice I was ill - this is why he's now my ex! lol). Anyway knowledge is power and I want to deal with this *before* it knocks me flat like that other time. I can't really afford to catch a cold let alone anything more time-consuming, everything will collapse around my ears if I take my eye off the ball as regards finances, groceries, laundry, all the routine survival jobs!

Today is Thursday so I hope to look at those Thursday discounts you mention. Today's busy, so if I can't get to it i'll wait till next Thursday. I'm certain I won't get anything through my GP, at least without blood test evidence. I'll go for the one that checks the eleven things. Thank you for pointing me at the discount.

[muddlemand]

Sorry to reopen this question but I've just realised what I really wanted to ask. I gather that Hashimoto's can start with hyperthyroidism instead of hypo. Do my 2012 results rule out Hashi's? In other words can the ups and downs of Hashi's be THIS much up?

FT3, >30 pmol/L (range 3.9-6.7)

T4 >95 pmol/L (range 10-24.5)

pretty extemely off the scale!

Also I'm wondering if carbimazole would have fixed it (temporarily), if it had been Hashi's, or does that mean it can't have been?