Please help with my latest blood result

[katwin]

I'm new here and am not on any treatment as yet for hypothyroidism. But am more than grateful for all the helpful and knowledgeable advice I have received here already.

I've had one full blood test on the 23rd January which I have posted previously but asked my doctor on the 6th Feb to also test me for Vitamin D; Coeliac; FT4 and FT3. These are the results. I really don't understand the Tissu transglutaminase lgA level result, and/or whether anything about FT4 and FT3 is shown here.

Also I wasn't expecting to be sent for my blood test straight after seeing the doctor at 10 a.m. on the 6th, and I had already had breakfast (which I did mention to her, as I was feeling bloated and sick)! I am now thinking these results may not be of any use because I did not fast.

My TSH level has dropped even more and is now showing as normal and subclinical hypothyroidism. My appointment with my doctor is on the 19th to discuss the results, but I'm worried she will pay more attention to my TSH result than the previous anti-body results. I believe my next full blood test will be the beginning of March, but I will definitely be fasting for that one!

My Vitamin D appears to be deficient. I did buy Vitamin D3:25ug last month but stopped taking them after three days...will these be sufficient to take now? I was worried that taking too much of any vitamin would be toxic.

I'd be very grateful for any advice and understanding of the first result.

[Clutter]

Welcome to the forum, Katwin.

Your GP wants to speak to you about the low vitD result. 25mcg (1,000iu) D3 isn't sufficient to correct vitD deficiency. Your GP should refer to local guidelines or the cks.nice.org.uk/vitamin-d-d... Do NOT accept a prescription for 800iu which is a maintenance dose prescribed after vitD is replete >75. VitD should be taken 4 hours away from Levothyroxine.

Your TSH would have been a little higher if you had fasted. If you are taking Levothyroxine you are a little undermedicated and should ask for a dose increase.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

If your thyroid antibodies were positive it means you have autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

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

[katwin in reply to Clutter]

Thank you so much Clutter.

I am not on Levothyroxine or anything else at the moment, as I was only diagnosed last month during a cholesterol blood test, with TSH above normal range.

The full blood test on 23rd Jan showed TSH of 4.38 and Thyroid peroxidase antibod lev 109 lU/mL <60.00lU/ml. I believe that means I am Hashimoto's. Although this time 6th Feb my TSH has now dropped below range.

I don't know now if my GP will prescribe Levthyroxine because of the TSH drop to 2.59.

[Clutter in reply to katwin]

Katwin,

The antibody result confirms autoimmune thyroiditis (Hashimoto's) as I posted above. Hashimoto's causes TSH and thyroid levels to fluctuate. I doubt GP will prescribe until TSH is over range.

Read Dr. Toft's comments about positive antibodies and the pragmatism of starting Levothyroxine if you are symptomatic, bearing in mind high cholesterol is a symptom of hypothyroidism. thyroiduk.org.uk/tuk/about_...

[Clutter]

Katwin,

The lab hasn't been able to do the coeliac screen due to low IgA levels. Your GP will have to explain what that means and what happens next.

I note you are not taking Levothyroxine. It's unlikely your GP will diagnose hypothyroidism with TSH 2.59. NHS usually needs to see TSH >4.20 before making a diagnosis.

[katwin in reply to Clutter]

Thank you Clutter,

If my antibody level remains elevated (it was 109 and should be <60.00) but my TSH level is still remains below 4.20. Does that mean that no treatment would be necessary?

What I mean is whether the TSH level is more important than the antibody level?

[Clutter in reply to katwin]

Katwin,

There is no treatment for antibodies. It is the TSH level which determines whether your GP will treat you and, as I've said, NHS doesn't usually treat until TSH is >4.20.

[katwin in reply to Clutter]

Thank you Clutter for being so patient with me and explaining what I should have understood sooner.

I had to read what you said above once more, but i've now got it into my thick head that there is no treatment for antibodies; only for TSH when it is >4.20.

[Clutter in reply to katwin]

Katwin,

You got it You're not thick for not getting this stuff straight off. None of us is born knowing it and not feeling well makes it hard to understand.

[katwin in reply to Clutter]

Thanks for your understanding Clutter. I'll try to stay more with it in future!

[katwin]

Oh this is even more worrying. If I am Hashimoto's with antibodies destroying my thyroid but nothing can be done about it because my TSH is not high enough. I'm sure my doctor will be very pleased my TSH has dropped below the NHS level but it leaves me with an incurable disease and symptoms to be anxious about.

Sorry Clutter, I didn't mean to sound ungrateful to you for all your help and knowledge about the effects and consequences. I am sincerely grateful to you for putting me in the picture.

Perhaps my best shot is a gluten free diet which may help to lower the antibodies eventually as well as the TSH. I'll also sort out my Vitamin D deficiency too!

[Cooper27]

Had you been eating gluten consistently before these tests? You need to have gluten in your diet for the test to be effective.

Many find their antibodies can be reduced through eliminating certain food groups from their diet. Around 80% find a gluten free diet is helpful, while 70% should avoid dairy. Izabella Wentz has some good information on which food groups cause issues. You should also focus on healing your gut, as there is a strong link between auto-immune disease and gut damage.

[katwin]

Thank you for your reply Cooper27

I had been eating gluten before the test but perhaps not so much that morning - (normal porridge oats/raspberries and blueberries/yogurt).

My gut is constantly bloated and constipation is an issue. I take Senna Tablets for relief. Perhaps I should ask my doctor next week if I should have an endoscopy?

I will be having a full blood test beginning of next month. So perhaps I should wait to go gluten free until after my next test?

[Cooper27 in reply to katwin]

Hard to say - the result could just mean you tested negative. I don't think it would matter that you didn't eat gluten that morning, as the antibodies like to linger. If your next doctor's appt is in the next week or so, keep eating gluten until then at least, until you discuss your options through. They may put you forward for an endoscopy anyway, but it's up to you if you do it though - waiting lists in some area are 6 months long...

[katwin in reply to Cooper27]

Thanks Cooper27

Meanwhile I'll look for the link for Izabella Wentz and read up about food groups which cause issues. I do worry about gut damage and want to avoid anything worsening!

[Cooper27 in reply to katwin]

Izabella explains it better than me! But thankfully gut health seems to be a growing dietary movement this year, so there are a few good books coming out about it, with some good recipes too.