Private bloods result: Hi there, I guess the... - Thyroid UK

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Private bloods result

Wyre profile image
Wyre
8 Replies

Hi there,

I guess the first thing I should say is what an amazing resource this is! Thank you so much to everyone who takes the time to help everyone. I have done a lot of reading here and it has helped so much.

I have felt bad for so long, utterly exhausted, brain fog, hair loss, dry itchy skin, constantly cold and the newest symptom wrists and finger joints that hurt so much. I suspected hashi's for some time and believe I am on the come down from a flare, I was dead on feet, aching so much that the thought of walking a few yards to the shop had me in tears that I used money put away to pay for a blue horizon test. I tried the finger prick test but discovered I don't bleed well so had to arrange a blood draw. Of course I started to feel a little better in the time between ordering the test and resorting to a blood draw!

I fasted and it was the earliest appointment I could get although was still 8.50 as they were running late.

I should mention I have polymorphic light eruptions (particularly bad already this year even overcast has caused them) and avoid the sun so low vit d was no surprise, I didn't expect this low.

I am completely unmedicated and no supplements (this is obviously going to change).

Bluehorizon Results

Ferritin 5.2 13-150

TSH 6.15 0.27- 4.20

T4 total 80.1 66 - 181

Free T4 12.40 12.0 - 22.0

Free T3 4.30 3.1 - 4.8

Anti-thyroidperoxidase abs 11.4 <34

Anti-thyroglobulin abs 425 <115

Vit D (23OH) 19 Deficient <25

Vit B12 238 insufficient 145- 250

Serum Folate 2.43 8.83 -60.8

I have booked a GP appointment but I hate doctors with a passion for various reasons so need as much info as possible to throw at them!

Many thanks in advance

Wyre

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8 Replies
SlowDragon profile image
SlowDragonAdministrator

Good grief, no wonder you feel terrible

Your vitamins are extremely low. SeasideSusie will hopefully be along shortly will detailed supplements advice

Your levels are so low GP needs to prescribe and test further

Ferritin is so low you need full iron panel done. Likely need iron infusion, if not, then definitely ferrous fumerate supplements

B12 and folate are both dire so you need full testing for Pernicious Anaemia before starting B12 loading injections and then folic acid supplements should not be started until 48 hours after first B12 injection

I suggest you also post on PAS healthunlocked for B12 advice

Vitamin D is seriously deficient so you will need loading dose prescribed for 6-8 weeks and then maintenance dose

Thyroid

TSH is above range and FT4 towards bottom of range. Your GP should recognise you need starting on Levothyroxine

They like TPO antibodies high before recognition that it's Hashimoto's

High TG antibodies can be high with Hashimoto's or a number of other things, including Pernicious Anaemia

healthline.com/health/antit...

Wyre profile image
Wyre in reply to SlowDragon

Thank you for your reply. I have to admit I am actually terrified of going to the doctor. Scared of not being believed I guess. I went for a thyroid test about 19 years ago and was told it was 'in range'. I didn't see the result, I'm not sure they would have let me then? I'm only in my early 40s, only one child left at home so I should be living life!

I thought I ate well but I guess I could have absorption issues. Going to need a complete rework of my diet!

shaws profile image
shawsAdministrator in reply to Wyre

No need to be afraid as members on the forum have diagnosed you before the doctor tells you so.

One of the lessons we've learned on this forum is never to accept, 'normal' 'o.k.' or fine with regard to blood tests for thyroid hormones. Always get a print-out of your blood test results with the ranges. Ranges are figures in brackets after the result. Most doctors only refer to the TSH result. It is highest very early a.m. and drops throughout the day and may mean the difference of being diagnosed or not.

Blood tests have to be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose and test and take afterwards. This helps keep the TSH at its highest (which is early a.m.) and drops throughout the day and p.m. test may mean that you remain undiagnosed.

Wyre profile image
Wyre

I quickly googled pmle and autoimmune as I haven't in a while and in the first few results indicate a link with autoimmune thyroid disease.

Marz profile image
Marz in reply to Wyre

Isn't it amazing how Docs just cannot do dot-to-dot ? :-) There's a consultant for every known condition - and a pill - and they never meet except in the canteen or the pub !

There are over 300 conditions linked to the Thyroid. Also Thyroid testing is inadequate which seems to be a plan to keep people ill and make money out of prescribing drugs for this and that.

Stick with everyone here and they will have you well in no time .... Welcome !

SeasideSusie profile image
SeasideSusieRemembering

Ferritin 5.2 13-150

You definitely need a full blood count and iron panel to see if you have iron deficiency anaemia. Low ferritin suggests this and I'd be surprised if you don't have it. If it is confirmed then this is the NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines):

cks.nice.org.uk/anaemia-iro...

How should I treat iron deficiency anaemia?

•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).

•Treat with oral ferrous sulphate 200 mg tablets two or three times a day.

◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.

◦Do not wait for investigations to be carried out before prescribing iron supplements.

•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.

• Monitor the person to ensure that there is an adequate response to iron treatment.

If you are prescribed iron tablets then take each one with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds (if and when prescribed) and two hours away from other medication and supplements as it will affect absorption.

However, with such a low ferritin level then an iron infusion would be best as it will raise your level within 24-48 hours, whereas tablets will take many months.

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. To help raise your level, and to maintain it once the optimal level is reached, eat liver regularly, maximum 200g per week due to it's high Vit A content, and include lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

**

Vit D (23OH) 19 Deficient <25

I would class this as severely deficient and you need loading doses - see NICE treatment summary for Vit D deficiency:

cks.nice.org.uk/vitamin-d-d...

"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the local guidelines or this summary and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu so post your new result at the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

Come back and let us know what your GP prescribes.

Your doctor wont know, because they are not taught nutrition, but 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.

**

Vit B12 238 insufficient 145- 250

Check for signs of B12 deficiency here b12deficiency.info/signs-an... and list any symptoms to show your GP. I believe you should be tested for Pernicious Anaemia and you may need B12 injections.

I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Serum Folate 2.43 8.83 -60.8

Folate and B12 work together. You are folate deficient and need folic acid prescribing. However, don't start this until further investigations into your B12 have been done and B12 supplementation in the form of injections or otherwise has been started.

shaws profile image
shawsAdministrator

Looking at your blood test results, you may be better off treating yourself. These results are absolutely woeful. The doctor may tell you that he cannot diagnose until the TSH is 10 - being mindful that other countries diagnose if it goes above 3+. Hopefully he will diagnose you due to a TSH of 6.15 along with clinical symptoms.

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

You can start statement to the GP by saying

"you are now a member of Healthunlocked Thyroiduk, the NHS Choices for information/advice on dysfunctions of the thyroid gland. You have had all the blood tests recommended and find you are deficient in all of them.

This is due, you believe, to the medical profession being completely unaware of clinical symptoms and not taking notice of symptoms until the TSH reaches 10. All vitamins/minerals have to be at an optimal level and if deficient also give clinical symptoms plus dangerous for our health if not supplemented to optimum level.

Wyre profile image
Wyre

Once again thank you all for your replies.

My GP appointment is Tuesdsy morning. I am very nervous that she will attribute everything to the vit and iron problems - which obviously direly need addressing - and not touch the thyroid issue.

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