Following a recent blood test result: B12 -Serum 333 ng/L (150.0 - 883.0)
GP offered to give a B12 loading dose 6 injections in 2 weeks. I had my first injection then had a message from GP that she had discussed with colleagues and decided to stop these. She has referred me to a gastrointorologist due to gut and constipation problems and she seemed to be saying best to do one thing at a time. I am seeing her today and wondered what thoughts any of you may have on this and how to follow this up with the GP.
I have also had a recent antibodies result:
Thyroid peroxidase Ab conc
932 iu/mL (0.00 - 6.00iu/mL
And I think the following is for Coeliac:
Auotimune profile
Antigen IgA TTG 0.6 U/mL
(Normal range <7.0)
What does this mean?
Have I had all the tests needed re: antibodies?
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SmPea
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It's good that your GP is following up with colleagues and taking the time to think about what is causing your problems. I assume you've had a printed copy of your blood test results but if not then ask your GP for them. Ask your GP whether you need more antibodies tests but antibodies for coeliac is not conclusive I believe, so you will need further investigations by gastroenterology to rule out coeliac disease. Elevated thyroid peroxidase antibodies means you have thyroid autoimmune disease otherwise known as Hashimotos.
If you are having further investigations for coeliac then don't go gluten free as it may skew results. Check out the coeliac disease society website for detailed information.
Many people with thyroid conditions find that going gluten free is a great help so once investigations are complete and you know whether you have coeliac disease or not you could look into going gluten free anyway as many without coeliac disease have benefited. SlowDragon has links to information you can read up.
It sounds like your GP is being helpful, do you know what your vitamin levels are including vitamin D? You could ask GP to check them out.
Thank you for giving me a positive outlook on GP. I am struggling to keep a balanced perspective as I am increasingly suspicious of decisions being made not necessarily in the best interests of the patientI need to keep this in check!
I am now getting print outs of all tests - having learnt from this forum.
I have recently had Vit D, B12, Folate and Ferritin. Vit D severely deficient and the others too low.!
Your Thyroid Peroxidase antibodies are high this is Hashimoto's, also known by medics here in UK more commonly as autoimmune thyroid disease.
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's. It's very common
You say you have low vitamin D, folate and ferritin as well as low B12 .
Can you add results and say what's been prescribed
Presumably you have also had thyroid tests - TSH, FT3 and FT4. Add results for these if you have them
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels can affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Your GP seems very on the ball to have referred you to gastroenterologist. You must keep eating gluten until further tests, but should probably have endoscopy before changing to strictly gluten free diet. This helps very many with Hashimoto's to reduce symptoms, help gut heal and slowly lower TPO antibodies
Your Thyroid results showed you needed dose increased
Will need retesting in 6-8 weeks. Perhaps get TSH, FT3 and FT4 tested privately then
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Professor Toft recent article saying, T3 may be necessary for many
Your IgA is low, so if there is a possibility that you may have Coeliac Disease, you may not be able to get a CD diagnosis via the standard blood test. Important to ask the gastroenterologist about this when you see them.
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