Blood test results

[Nemesis123]

I've had results back and would like to hear others comments and explanation.

TSH is 6.13 (elevated?) Does that mean I should ask GP about treatment.

High sensitivity CRP 6.96

Anti-thyroglobulin 447 (high)

B12 high 589

Serum folate low 8.31

I have fibromyalgia, and CRP has always been issue, but GP said nowt needs to be done. Currently being treated for severe back pain. Is my thyroid now a problem? I had hyperthyroidism years back when pregnant which corrected itself, currently always fatigued and hair loss, aches and pains etcetera. I am now confused.com

[SeasideSusie Remembering]

Nemesis

Over range TSH with raised antibodies should be treated. See thyroiduk.org.uk/tuk/about_... >Diagnosis

"The 'UK Guidelines for the Use of Thyroid Function Tests' state that, "There is no evidence to support the benefit of routine early treatment with thyroxine in non-pregnant patients with a serum TSH above the reference range but <10mU/L (II,B). Physicians may wish to consider the suitability of a therapeutic trial of thyroxine on an individual patient basis." If your TSH is above the range but less than 10, discuss a therapeutic trial of thyroxine with your doctor.

Subclinical hypothyroidism (where there are elevated TSH levels, but normal FT4 levels, possibly with symptoms) has been found in approximately 4% to 8% of the general population but in approximately 15% to 18% of women over 60 years of age.

Subclinical hypothyroidism can progress to overt hypothyroidism (full hypothyroidism with symptoms) especially if there are thyroid antibodies present.

If thyroid antibodies are found, then you may have Hashimoto's disease. If there are thyroid antibodies but the other thyroid tests are normal, there is evidence that treatment will stop full blown hypothyroidism from occurring.

Dr A Toft, consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, has recently written in Pulse Magazine, "The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2 But if it persists then antibodies to thyroid peroxidase should be measured.

If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up."

You can obtain a copy of Dr Toft's article in Pulse magazine by emailing Dionne at [e-mail] print it and highlight question 2 where you will find the information about where there are antibodies then start Levo to" nip things in the bud". Hopefully your GP will agree to start you on Levo.

Your raised antibodies confirm autoimmune thyroid disease aka Hashimoto's so you should adopt a strict gluten free diet and supplement with selenium l-selenomethionine 200mcg daily to help reduce the antibodies.

You haven't put the ranges for your results (please always do that so we can interpret them as ranges vary from lab to lab) but if that is serum B12 rather than Active B12 then I don't think it's high.

Is your Folate low in range or below range?

[Nemesis123 in reply to SeasideSusie]

Serum folate low 8.31

[Nemesis123 in reply to Nemesis123]

Just say vitamin b12 high 589?

[SeasideSusie Remembering in reply to Nemesis123]

Is there a unit of measurement for the B12? Is it pg/ml?

[Nemesis123 in reply to SeasideSusie]

It is pmol/L

Also says deficient<145

Insufficient 145-250

Consider reducing dose<569

[SeasideSusie Remembering in reply to Nemesis123]

589pmol/L converts to 798pg/ml.

In the book Could It be B12 by Sally Pacholok she states

"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."

So if you're an older adult, like me, you might want it around the 1000 for the reasons stated.

If you are supplementing you might want to reduce slightly if you don't want it nearer 1000. If you are not supplementing I wouldn't worry.

What about the range for Folate?

[SeasideSusie Remembering in reply to Nemesis123]

Yes, I did see that you put the result in your opening post but no range, so I asked is it below range or low in range.

[Nemesis123 in reply to SeasideSusie]

Serum folate 8.31Low nmol/L

[SeasideSusie Remembering in reply to Nemesis123]

Is it below the range or low in range? It makes a difference as to whether you should see your GP or can self supplement.

[ShootingStars]

Hi Nemesis123. Yes, your TSH is too high, indicating hypothyroid or low thyroid. Your high TG antibody means you have an autoimmune disease. You are hypothyroid so this means Hashimoto's. Is your CRP high? You don't list the reference range so we don't know. If it is, this means that you have inflammation. This could be caused by an autoimmune disease, heart disease or other things. Hair loss, body pains, fatigue are all hypothyroid symptoms.

What are your thyroid hormone levels? TSH is not one, but they are called FT3 and FT4. Also need the reference ranges for your results.