Hi everyone, here are my lab results with comments, if someone has the time to look over them I would be very grateful.
26-Feb-18
Serum B12: 374 ng/L (220.0-700.0)
Serum Folate: 7.8 ug/L (2.6 - 17.3)
Serum Ferritin: 183 ug/L (10.0 - 420.0)
Serum free T4: 17 pmol/L (9.0 - 25.0)
TSH: <0.05 (if not on T4 suggest repeat with FT3)
7 Mar
free T4: 15 pmol/L (9.0 -25.0)
TSH: 0.29 miu/L (0.3 - 5.0) (outside range)
Thyroid Peroxidase: 1006 IU/mL (<60.0)(if thyroid function abnormal - consistent with ATD - suggest monitoring TFT's annually or if symptomatic. TPO not clinically useful
After this result I stamped my feet and insisted on seeing a Doctor face to face to discuss as most of the discussions have been on the telephone. HOW CAN A DOCTOR DIAGNOSE YOU IF THEY CAN'T SEE YOU. PATICULALY WITH THYROID SYSTEMS. BEATS ME!
That worked and I was seen by a doctor. He then requested the following tests:-
21 Mar
Free T4: 12 pmol/L (9.0 - 25.0)
TSH: 6.1 Miu/L (0.3 - 5.0) (outside reference range compensated euthyroidism.Asymptomatic patients require TFT monitoring.Patients with symptoms, high titre of TPO antibody may merit thyroxine replacement
Just thrown this one in because I am not sure what it is??
IgA level <1 U/mL (<4.0) Anti-tTG antibodies equals Ceoliac Disease serology Reflex testing on suspected IgA deficiency.
Diagnosed as hypo and started 50 levo with a blood test after 8 weeks. I do have more energy and my weight is dropping with the help of a metabolism diet and gluten, sugar and dairy free,aches and pains subsided after a week but have crept back in slightly.
Thanks for your time
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barb62
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Can you please add the reference ranges for your test results, ranges vary from lab to lab so we can only interpret your results with the ranges from your lab.
And it would really make it easier to read if you put each result on a separate line, eg
TSH: 2.5 (0.2-4.2)
FT4: 15 (12-22)
You can edit your post by clicking on the downward arrow V below your original post, click EDIT, make the changes then click EDIT RESPONSE.
Thyroid Peroxidase: 1006 IU/mL (<60.0)(if thyroid function abnormal - consistent with ATD - suggest monitoring TFT's annually or if symptomatic. TPO not clinically useful
Here you are, that was your problem but unfortunately doctors are blind to it, labs too considering the comment about TPO not clinically useful! Of course it's useful, it's telling you that your raised TPO antibodies confirm autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results and this is why you have such a difference in your TSH from 26 February to 7 March and then again to 21 March. So your doctor was right to start you on Levo after 21 March result - over range TSH, low in range FT4 and very high TPO antibodies.
Normal protocol is to retest after 6-8 weeks followed by an increase of 25mcg Levo, and repeat every 6 weeks until your levels are where they need to be for you to feel well.
The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo, if that is where you feel well.
It takes time, it may be months of testing and increasing for you to feel the full benefit of Levo, just ensure you get the regular testing and increasing.
When booking thyroid tests, always book the very first appointment of the morning and fast overnight (water allowed) . This gives the highest possible TSH which is needed when looking for a diagnosis, an increase in dose or to avoid a reduction. TSH is highest early morning and lowers throughout the day. It also lowers after eating. Also, take your Levo after the blood draw because if you take it before then your FT4 will reflect this and show higher than what is normally circulating. We usually advise 24 hours between last dose of Levo and blood draw so if you take your Levo in the mornng then delay until after the test, or if you take it at night then delay that dose until after the test.These are a patient to patient tips which we don't discuss with doctors or phlebotomists.
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As for the Hashi's, most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
The IGA test is for coeliac and that appears to be fine. However, as already mentioned, you don't have to be coeliac for a gluten free diet to help a Hashi's patient.
I have seen that you are gluten free, I've just copied and pasted information from my standard phrases used
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Hashi's and gut/absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. From what you posted above
Serum B12: 374 ng/L (220.0-700.0)
This is on the low side. 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."
Check for any signs of B12 deficiency here b12deficiency.info/signs-an... and as long as you have no signs then you could supplement with sublingual methylcobalamin lozenges. With your level I would buy one bottle of 5000mcg strength and take one daily, finish that then change to 1000mcg dose. Jarrows is a brand some members use, they do a 5000mcg one. I use Cytoplan for 1000mcg dose.
When taking B12 we also need a B Complex to balance all the B vitamins. Buy a decent brand such as Thorne Basic B or Igennus Super B.
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Serum Folate: 7.8 ug/L (2.6 - 17.3)
Folate should be at least half way through it's range so you're a bit short. The B Complex will take care of that.
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Serum Ferritin: 183 ug/L (10.0 - 420.0)
Ferritin needs to be at least 70 for thyroid hormone to work so you have no problem there, it's often recommended to be half way through it's range so your level appears to be good.
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You really need to get Vit D tested as well, that's another important one to keep an eye on. If GP wont do it then there's a home fingerprick blood spot test for £29 from City Assays vitamindtest.org.uk/
Muscle and joint aches and pains can be associated with low Vit D.
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