trying to understand test results

[LP321]

I'm posting on behalf of my 22 year old daughter, currently in her final year at uni. She's been suffering for several years from anxiety, panic attacks, tiredness, tremor in her hands, dry skin and acne, constipation, irregular menstruation and IBS. Her GP has diagnosed her with a general anxiety disorder. Having just been diagnosed myself with an underactive thyroid I recognise some of the symptoms and arranged to have her thyroid tested by Bluehorizon. Results are as follows:-

TSH 5.59 (0.27 - 4.2)

Free Thyroxine 14.9 (12 - 22)

Free T3 5.7 (3.1 - 6.8)

T4 93 (59 - 154)

Folate 6.5 (>2.9)

Ferritin 14 (13 - 150)

Vitamin B12 214 (197 -771)

Vitamin D 52 (50 - 200)

Antibodies: Thyroglobulin 10.6 (0 - 115)

Peroxidase 15 (0 - 34)

She is unable to get an appointment to see GP at student health centre until end of Feb. In the meantime can anyone advise on supplements - from what I've learned on this site, her vitamin D and B12 are very low as is her ferritin level. What dosages would you recommend? Should she start supplementing now or wait til she sees her GP who I assume will order more blood tests? My understanding is that as antibodies are low, she does not have Hashimotos. If this is the case, why else would her TSH be elevated? Any advice or insight into whats happening would be much appreciated.

Thank you.

[Schristie1992]

Hi LP321, Im 25 and Ive just recently been diagnosed with under active thyroid. I decided to get tested as my mum had just been diagnosed, so it can be genetic. Your daughters TSH level is a bit high. My TSH level is currently 5.51 and Ive just been increased to 50mcg Levothyroxine. Is your daughter taking Levothyroxine?

As for the supplments, I would wait until she sees the GP. My Vitamin B12 level I learned today is very low (107) and Im having to start injections next week as its so low. If she waits to see GP she can be prescribed exactly what she needs. Her vitamin levels may be low because her TSH is high.

Im no expert, Im still learning myself but hope this has helped!

[Greybeard]

Your daughters results are a little odd to my eyes. Her tsh is over range indicating hypo but her ft3 looks good at 5.7 near top of range. Ft4 is low in range. Vitamins d and b12 are low and need supplimenting as does ferretin. Not sure about folate. Seasoned hands will comment shortly.

[SlowDragon Administrator]

Her TSH is too high, but FT4 is in range, though low.

GP may say watch and wait

Improving low vitamin levels is essential. These can cause symptoms in their own right and/or also be upsetting thyroid too

Yes both TPO and TG antibodies are low so probably not Hashimoto's. (Some people never have high antibodies even with Hashimoto's so can't definitely rule it out)

Any goitre? Pain or difficulty swallowing?

Her GP should probably test her for Pernicious Anaemia, though they may think B12 not low enough to do so

Does she have any symptoms of low B12?

b12deficiency.info/signs-an...

Folate is probably OK

Is she vegetarian? Vegan?

Vitamin D is too low. GP would only prescribe 800iu if lucky. She needs higher dose. May be 3000iu daily and retest in 2-3 months. Looking st getting levels around 100nmol

Important to retest twice yearly, she may need maintenance dose

Better You vitamin D mouth spray is good as avoids poor gut function

IBS and gut issues combined with low vitamins suggests she needs testing for coeliac

Even if result is negative she may benefit from Gluten free diet.

Or does she have reaction to dairy?

Both are common

[Cooper27]

GPs only prescribe vitamin D when levels fall below 25, so she will likely need to self supplement anyway. Better You do a mouth spray, I would suggest she gets the 3000IU spray. Sprays absorb better into the body, so this is preferred over tablet form.

Low B12 affects memory, in her shoes I'd take a supplement up until seeing the GP, and stop a few days before blood tests. I would want to limit its impact on my uni work...