Thyroid UK
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Confused with blood tests

Hi

Can anyone help me with blood test results.

Everything is 'normal', I have had adrenals checked and full thyroid back. I am not diagnosed with hypothyroid but have a lot of symptoms.

Basically I have high rt3 ratio. I am reading things but trying to find out what I do about it and not getting anywhere.

Thanks

Results:

CORTISOL (SALIVA) WAKING 9.180 nmol/L 6.00 - 21.00

CORTISOL (SALIVA) 12:00 2.750 nmol/L 1.50 - 7.60

CORTISOL (SALIVA) 16:00 <1.5 nmol/L 0.00 - 5.49

CORTISOL (SALIVA) BEFORE BED <1.5 nmol/L 0.00 - 1.99

ENDOCRINOLOGY

Thyroid Function

THYROID STIMULATING HORMONE 0.937 mIU/L 0.27 - 4.20

FREE THYROXINE 13.7 pmol/L 12.00 - 22.00

TOTAL THYROXINE(T4) 94.0 nmol/L 59.00 - 154.00

FREE T3 3.8 pmol/L 3.10 - 6.80

REVERSE T3 20 ng/dL 10.00 - 24.00

REVERSE T3 RATIO *12.37 15.01 - 75.00

THYROGLOBULIN ANTIBODY <10 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES <9.0 IU/mL 0.00 - 34.00

HAEMATOLOGY

Vitamins

ACTIVE B12 *> 256.0 pmol/L 25.10 - 165.00

FOLATE (SERUM) 11.35 ug/L 2.91 - 50.00

25 OH VITAMIN D 75.7 nmol/L 50.00 - 200.00

Interpretation of results:

Deficient <25

Insufficient 25 - 49

Normal Range 50 - 200

Consider reducing dose >200

BIOCHEMISTRY

Inflammation Marker

CRP - HIGH SENSITIVITY *7.1 mg/l 0.00 - 5.00

Iron Status

FERRITIN 48.4 ug/L 13.00 - 150.00

7 Replies
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If you post your results along with their ranges someone will comment on them.

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As Greybeard says, post your results, with reference ranges, no-one can help unless we see them, 'normal' means nothing other than they are somewhere in range and it's where in the range that's important.

Reply

Results now there.

Reply

THYROID STIMULATING HORMONE 0.937 mIU/L 0.27 - 4.20

FREE THYROXINE 13.7 pmol/L 12.00 - 22.00

TOTAL THYROXINE(T4) 94.0 nmol/L 59.00 - 154.00

On the face of it at a quick glance there is no problem, your TSH is nice and low. However, your FT4 and FT3 are very low in range, lower than one would expect to see in a healthy non-thyroid disease person.

It's possible that you could be looking at Secondary Hypothyroidism which is where the problem lies with the hypothalamus or pituitary gland, low TSH and low Free Ts can indicate that. Your GP may not have heard of it and many endos wont either as most of them are diabetes specialists. You would need a thyroid specialist to know about it. Maybe do some research and see if it fits.

**

THYROGLOBULIN ANTIBODY <10 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES <9.0 IU/mL 0.00 - 34.00

Your antibodies are nice and low, no hint of autoimmune thyroid disease with those levels. However, one negative doesn't completely exclude it, you'd need a few negatives over a period of time.

**

REVERSE T3 20 ng/dL 10.00 - 24.00

REVERSE T3 RATIO *12.37 15.01 - 75.00

There's no need to worry about these even though the ratio is low. The ratio is worked out on the rT3 and the FT3, your FT3 is very low and this will have an effect on your rT3 ratio.

**

ACTIVE B12 *> 256.0 pmol/L 25.10 - 165.00

Are you supplementing with B12?

**

FOLATE (SERUM) 11.35 ug/L 2.91 - 50.00

Your folate is low, it should be at least half way through it's range. Eating leafy greens can help, and taking a good B Complex containing 400mcg methylfolate will help raise it, eg Thorne Basic B.

**

25 OH VITAMIN D 75.7 nmol/L 50.00 - 200.00

This is too low. The Vit D Council recommends a level of 100-150nmol/L. You could supplement with D3 softgels, eg Doctors Best, possibly 2000iu daily then retest in April. If you don't wish to repeat with Medichecks, you can get Vit D fingerprick blood spot tests from City Assays vitamindtest.org.uk/

It's an NHS lab which does this test for the public for £28.

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.

It is possible to get combined D3/K2-MK7 supplements, I haven't used any so can't recommend but an oil based one would be best as the oil helps absorption.

**

FERRITIN 48.4 ug/L 13.00 - 150.00

This is too low. For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range. 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...

**

CRP - HIGH SENSITIVITY *7.1 mg/l 0.00 - 5.00

This result indicates inflammation or infection at the time of the test. It's non-specific so doesn't pinpoint where the infection or inflammation might be.

**

CORTISOL (SALIVA) WAKING 9.180 nmol/L 6.00 - 21.00

CORTISOL (SALIVA) 12:00 2.750 nmol/L 1.50 - 7.60

CORTISOL (SALIVA) 16:00 <1.5 nmol/L 0.00 - 5.49

CORTISOL (SALIVA) BEFORE BED <1.5 nmol/L 0.00 - 1.99

I'm not very good with adrenal results, and really DHEA should be done at the same time as cortisol. It's best if it's done with a company who provide results in a graphic as that shows if you follow the normal curve.

However, cortisol should be highest in the morning and it lowers through the day with the lowest result being before bed.

Your morning cortisol is low, as is your noon result. Unfortunately the 4pm and bedtime results don't give an actual figure, only <1.5 which tells us nothing. I would say your 4pm one is possibly lower than it should be but the bedtime one is difficult to say. If it was 1.49, which is <1.5) it would over half way through the range and far too high for bedtime, when it should be nearer the bottom of the range.

To see a graphic of what the results are like click here regeneruslabs.com/shop/prod... then go to Download Documents on the right hand side (scroll down) and click on the pdf "Labrix Sample Report" (sorry, I can't link PDFs).

Here is Dr Myhill's article on interpreting adrenal tests drmyhill.co.uk/wiki/Adrenal...

**

Your adrenals could be involved in how you feel at the moment, also your low ferritin will play a part. You would do well to optimise your nutrient levels as a start.

Reply

Did you see an endocrinologist? G/P usually only check T3 & T4

TSH also should be checked. T3 4 can check at proper levels but if TDH is high, you have a thyroid problem. Also free T3 direct & last if needed, Thyroid Antibodies. I just went through this but blood was not checked properly until I had been in bed for a year & all of my body fell out. If someone in your family has developed an autoimmune disease, or you, there is a high probability of thyroid disease. Thyroid controls everything in the body. Oh & Dr found thyroid nodules & I actually had pain.

Reply

TSH not TDH

Reply

I would look into adrenal fatigue issues. Have you been under prolonged stress of any type? Your low morning cortisol and high reverse T3 might indicate that your body is saying, "I need a break". I would suggest you work on relaxation, mindfulness, and do some things that help you chill. The high reverse T3 and lowish free T3 may actually be making you feel quite hypothyroid I would guess, even though your thyroid looks reasonably okay otherwise. I agree that a DHEA test would be helpful. Are you sure you don't have that with your cortisol results?

I found Micki Rose at purehealthclinic helpful on adrenal fatigue. purehealthclinic.co.uk/adre... She can order tests for you, and gives you a "steer". Her paid book is also good. We're still in the woods here, but I think we're coming out of them. Micki is helping treat my husband. Dr Sarah Myhill sounds excellent also, but I think out of our budget :-)

Things we did:-

Work on relaxation

"Truly" gluten free (Micki Rose's variety, which is strict!)

Micki Rose's adrenal recovery plan (herbal and nutritional support)

Gentle exercise

I'm no expert, just trying to help a family member and have read a lot...

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