Confused by surprising test results - Please help?

[Venus77]

Test results:

. . .

2015 (Sept 2nd): Genova Diagnostics Thyroid Plus:

* TSH . . 0.36 . . (0.40 - 4)

T4 . . 91 . . (58 - 161)

FT4 . . 18.8 . . (11.5 - 22.7)

FT3 . . 3.1 . . (2.8 - 6.5)

rT3 . . 0.47 . . (0.14 - 0.54)

* FT4 : FT3 Ratio . . 6.1 . . (2.0 - 4.5)

TG ab . . <20 . . (<= 40)

TPO ab . . <10 . . (<= 35)

. . .

2017 (Aug 16th): Genova Diagnostics Thyroid Plus:

TSH . . 0.64 . . (0.40 - 4)

T4 . . 84 . . (58 - 161)

FT4 . . 19.4 . . (11.5 - 22.7)

* FT3 . . 2.6 . . (2.8 - 6.5)

* rT3 . . 0.55 . . (0.14 - 0.54)

* FT4 : FT3 Ratio . . 7.5 . . (ref range no longer given)

TG ab . . <32 . . (<= 40)

TPO ab . . <14 . . (<= 34)

. . .

2018 (Jan 29th): MediChecks Thyroid Check UltraVit:

TSH . . 0.77 . . (0.27 - 4.20)

T4 . . 65.9 . . (59 - 154)

FT4 . . 15 . . (12 - 22)

* FT3 . . 2.83 . . (3.10 - 6.80)

TG ab . . <10 . . (0.00 - 115)

TPO ab . . <13 . . (0.00 - 34)

MediChecks doctor wrote, "there may be issues with converting thyroxine to T3 within the target tissues"

. . .

* Active B12 . . 295 . . (25.10 - 165)

Folate . . 18.17 . . (2.91 - 50)

25 OH Vit D . . 60.4 . . (50 - 200)

CRP . . 0.2 . . (0.00 - 5)

* Ferritin . . 220 . . (13 - 150)

. . .

TIMING . . My first two thyroid tests were done in the afternoon (around 3 pm), after I'd eaten breakfast and lunch, whereas my most recent test was done fasting at 9:30 am.

FALLING T4 & FT4? . . Comparing the results from 2015 and 2017, there's a slight decline in thyroid function but why have my T4 and FT4 fallen so much in the last 5 months?

TYROSINE? . . A functional medicine practitioner put me on gigantic doses of tyrosine (3000 mg daily) in an attempt to raise my dopamine level. I recently read that people with hypothyroid should not take tyrosine (so I'm now trying to taper off)! Maybe it caused the deterioration in my health and drop in T4 and FT4?

MEDICATION . . I'm suffering from unbearable symptoms of hypothyroid (including scary heart problems) so planning to try T3 med soon. I would prefer to take NDT but suspect that, because of my conversion issues / elevated rT3, it would not work for me.

B12? . . My B12 is always extremely high, even when I do not take any B vit supplements. Currently taking a B complex, but no separate B12, and I did suspend taking the B complex 5 days prior to latest test.

FERRITIN? . . I've never taken an iron supplement. I suppose my elevated ferritin must be due to inflammation, which worries me as I don't know what's causing the inflammation?

VIT D? . . I've been taking vit D3 2000 IU daily for years. When tested in Feb 2016 my level was 99. Strange that the same dose of D3 is no longer sufficient but I have now doubled my dose.

For further details (eg brief medical history, other test results, diet, etc) please see my profile.

Sorry this was so long.

Any input massively appreciated!

X

[diogenes Remembering]

You are a poor converter of T4 to the active T3 and may need direct T3 supplementation. Your FT3 is low despite reasonable FT4.

[Venus77 in reply to diogenes]

I was hoping that you would comment Thank you for the confirmation!

[humanbean]

I think tyrosine will actually suppress your thyroid function and should be avoided.

helpmychronicpain.com/blog/...

[Venus77 in reply to humanbean]

Thanks lots for your reply That is the article which first alerted me to the potential problems with tyrosine.

[humanbean]

Regarding your B12, it takes a lot longer than 5 days to wash out the effects or use up any extra B12 from supplementing. It actually takes many months.

How much B12 was in the B Complex you were taking?

Do you have a B12 result from before taking any form of B12 as a supplement?

[Venus77 in reply to humanbean]

My B complex contains 400 mcg of B12 (as methylcobalamin).

I have test results from before I was taking any B vits and my B12 was, even then, extremely high.

[humanbean in reply to Venus77]

I think you should ask the Pernicious Anaemia people about this. I know it may have clinical significance, but I can't remember the details. You should mention to them whether or not you have symptoms of B12 deficiency despite the high levels.

You can find them here : healthunlocked.com/pasoc

[Venus77 in reply to humanbean]

Thanks loads for the info and link!

[SeasideSusie Remembering]

My first thought is possible secondary hypothyroidism (pituitary or hypothalamus problem).

We use our store of Vit D during the winter months when we can't make any naturally from the sun, so it's not unusual for level to be lower at this time of year. I need to supplement 2000iu daily in the summer and I double my dose during the winter to keep my level stable and within the recommended range of 100-150nmol/L.

Other than that I can't really add to the comments already given in this and your previous post.

[Venus77 in reply to SeasideSusie]

Thanks ever so much for your thoughtful and helpful response!

[SlowDragon Administrator]

Are you taking any levothyroxine?

Both your TT4 and FT4 are very low

I would try increasing Levo first

Or starting if not on it already

B12 would be high after supplementing a B complex

I also experienced high B12 before any supplement. I suspect other B vitamins (eg thiamine and or B5 being too low, stopping use of all B vitamins. But that’s just conjecture on my part

Yes ferritin can be high

Apparently it can actually mask low iron. You would need to do full iron panel to find out

Vitamin D - winter levels drop

Will send some links about EBV shortly

Have you had adrenal tests?

Are you strictly on gluten free diet

Many with EBV find it helps

Sorry I already know you are autoimmune paleo

I personally would still probably try T4 first

Don’t know if diogenes has a view on that?

[Venus77 in reply to SlowDragon]

I'm not on any thyroid medication yet.

Your theory about elevated B12 is very interesting!

It sounds like I'd better do a full iron panel.

Yes, D.U.T.C.H. revealed that I'm in "stage 3 adrenal fatigue".

Yes, I've been on a 100% grain-free diet for about 18 years.

Thanks massively for your comment!

[SlowDragon Administrator in reply to Venus77]

I always had high B12 for years, no supplements at all.

Started high dose vitamin D, soon after joining here, having got private testing. About month later started getting peripheral neuropathy

Found this website suggests low B5 (which I post a lot ever since)

drgominak.com/sleep/vitamin...

Link about ferritin

restartmed.com/low-ferritin/

EBV links

thyroidpharmacist.com/artic...

drhedberg.com/epstein-barr-...

hypothyroidmom.com/hashimot...

drchristianson.com/epstein-...

[Venus77 in reply to SlowDragon]

Oh wow, I really hope that your peripheral neuropathy vanished?!

I kept losing all sensation in two of my fingers. They kept going totally numb. It was a bit scary. Then I started taking extra benfotiamine (suggested by Izabella Wentz to help with hypothyroid-related fatigue). Then I noticed that my fingers were no longer going numb so I think it's a side benefit of taking the extra benfotiamine

Thanks absolutely loads for all of the links!

[SlowDragon Administrator in reply to Venus77]

Yes peripheral neuropathy went within days

Did need B12 sublingual lozenges too.

I still take both daily