Test results: ok I don't know where to start here... - Thyroid UK

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Test results

sam295 profile image
17 Replies

ok I don't know where to start here. Please if you can assist

Thyroid function test

Serum Free T4 level 13.6 pmol/L 10.60-23.20

Serum TSH 1.06 mU/L 0.30-4.20 U/L

Se Thyroid peroxidase Ab conc 12 Iu/mL <34.00IU/ml

Serum total 25-OH vit D level -(RM)- normal 95 nmol/L

> 50 nmol/L sufficient . 30-50 insufficient .

note change of reference ranges using osteoporosis society guidelines 2013

B12/folate level serum 348ng/L range 197-771ng/L

serum folate 16.2 ug/l range 3.90-26.80ug/l

serum sodium 141 mmol/L 133-146

serum potassium 4.3mmol/L 3.50-5.30

ast serum level 25 U/L 0-32

serum gamma GT 57 U/L 5-36U/L

serum cholesterol 6.5 mmol 2.8-5

glucose 5.4 mmol/L 4-7.8

serum calcium 2.38 mmol/l 2.15-2.55

What do you think? I have a high white cell count as well.

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sam295
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sam295 profile image
sam295

I should add some more results

RBC 4.55 10 12/L 3.80-4.80

Total white cell count 3.8 range 4-10

neutraphils 56.4 %

lymphocytes 30.8%

monocytes 9%

eosinophils 2.7%

basophils 1.1%

neutraphil count 2.13 range 2-7

lymphocyte count 1.16 range 1-3

monocyte count 0.34 range 0.2-1.0

eosinophil 0.1 range0.02-0.5

basophil 0.04 range 0.02-0.1

ShootingStars profile image
ShootingStars in reply tosam295

Thank you. Your WBC is under range in these results, not high. Your neutrophil is normal. Normal range is 45-70, or 50-80. Are you taking any antibiotics? Slightly low WBC could be from that, an undiagnosed autoimmune disease (Hashimoto's?), an infection, malabsorption or low vitamins, and so on.

What are your complete iron panel and B12 (by itself, not with folate. they are two different vitamins) levels?

On your first set of results, your gamma GT is too high and over range. What did your doctor say about this? This relates to your liver and can be caused by multiple things. This needs investigating. A slow thyroid slows everything down in the body, including gall bladder and liver issues. Your doctor only tested one liver enzyme, AST. There are two others, ALT and ALP, plus two bilirubin tests, albumin, and total protein. These are called a liver panel and are needed when GGT is too high.

ShootingStars profile image
ShootingStars

Hi sam295. Well....these are incomplete thyroid tests. I know you're in the UK and that some doctors there fail to correctly test the thyroid, but there some that actually do complete testing. There are two thyroid hormones that work together, not just one, T3 and T4. The correct tests are called FT3 and FT4. There are also two thyroid antibodies, not just one. In addition to TPOab, the other one is called TGab. You will need to test TGab to rule out Hashimoto's as the cause of your hypothyroidism and symptoms.

Despite the incomplete testing, your FT4 is too low at 13.6, which indicates some sort of hypothyroidism. Optimal FT4 is over 50% of range but not too high. Your FT4 should be at least 16.9. Too low in range or too high in range, and that's where you get symptoms.

What are your symptoms?

There's no way to know why your WBC is high without a lot more information and diagsnostics. How high and what's the range? Do you have other blood work? Have you had an illness of any type recently?

sam295 profile image
sam295 in reply toShootingStars

Thanks symptoms are extreme tiredness, hairloss and eyebrows only half there, difficulty concentrating, sleeping 24/7, depression, anxiety, fainting, I could go on

sam295 profile image
sam295 in reply toShootingStars

irregular heart beat, heart pausing so I now have a pacemaker.

ShootingStars profile image
ShootingStars in reply tosam295

Hi sam295. How scary! I'm so sorry you've got all of these symptoms! These are all hypothyroid symptoms, including irregular heat beat, which can be caused by too slow of a thyroid.

SeasideSusie profile image
SeasideSusieRemembering

sam295

Serum Free T4 level 13.6 pmol/L 10.60-23.20

Serum TSH 1.06 mU/L 0.30-4.20 U/L

You appear to be undermedicated. 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. Your FT4 is only 23% through the range, far too low. Your FT3 will also be low as there's not enough T4 to convert to T3. You really need an increase in your Levo, 25mcg now, retest in 6 weeks to see where your levels lie then.

In support of your request for an increase, refer to NHS Choices recommended source of information for thyroid disorders (Thyroid UK) and this information on their website

thyroiduk.org/tuk/about_the... > Treatment Options

Dr Toft 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)."

Dr Toft is past president of the British Thyroid Association and leading endocrinologist. You can obtain a copy of the article by emailing Dionne at tukadmin@thyroiduk.org print it and highlight question 6 to show your doctor.

**

Serum total 25-OH vit D level -(RM)- normal 95 nmol/L

Just bordering on OK. The Vit D Council recommends a level of 100-150nmol/L. Do you supplement?

**

B12/folate level serum 348ng/L range 197-771ng/L

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."

serum folate 16.2 ug/l range 3.90-26.80ug/l

That's OK, folate should be at least half way through it's range.

**

serum gamma GT 57 U/L 5-36U/L

Raised so you should discuss with your GP.

**

serum cholesterol 6.5 mmol 2.8-5

Slightly raised but should sort itself out when optimally medicated thyroid-wise.

**

Total white cell count 3.8 range 4-10

Slighly low, can be due to vitamin deficiency, amongst other things.

**

Everything else in range.

You need ferritin testing.

sam295 profile image
sam295 in reply toSeasideSusie

I take 800ug fultium x2 daily but only realised lately that I should take with a fatty meal. I am on 100mg levo daily for years.

Thanks for any help

SeasideSusie profile image
SeasideSusieRemembering in reply tosam295

Sam295

Yes, D3 is fat soluble so needs to be taken with some dietary fat. Also, do you take D3's important cofactors 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.

You need an increase in your Levo, as I mentioned.

sam295 profile image
sam295 in reply toSeasideSusie

I am really considering cutting out Gluten, that is new for me and have recently stopped all soy

SeasideSusie profile image
SeasideSusieRemembering in reply tosam295

Sam295

You may feel some benefit from that, but you still need an increase in your Levo. And you still need ferritin testing. Low ferritin means that thyroid hormone can't work properly and it brings it own symptoms, so you need to know your level.

sam295 profile image
sam295 in reply toSeasideSusie

and I have stopped taking my levo in the morning and switched to night time away from food

sam295 profile image
sam295 in reply toSeasideSusie

if I get ferritin bloods tested do I need to fast?

SeasideSusie profile image
SeasideSusieRemembering in reply tosam295

Sam295

I fast for every blood test but it's not essential for Ferritin.

I D you are supreme ting iron then leave it off for a week, if you eat liver then don't eat it for a few days before the test, if you take B Complex then leave that off for 3-5 days before any blood test as it may skew results.

sam295 profile image
sam295 in reply toSeasideSusie

I ahve sent the email to Dionne. This is a start I know my GP will fixate on statins for the cholesterol and need to direct him/her to the thyroid importance.

SlowDragon profile image
SlowDragonAdministrator

You likely need dose increase.

FT4 should be near top of range and FT3 at least half way in range

Suggest you retest 6 weeks after changing to taking Levo at bedtime and going strictly gluten free, both may give slight improvement

Absolutely essential to test your FT3 and TG antibodies. So you are likely to need to get private testing done. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Vitamins look oK - presumably you supplement. ?

B12 could be higher, a good vitamin B complex may be of benefit

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Cholesterol is likely high due to being under medicated

nhs.uk/conditions/statins/c...

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 otherwise we need high FT4 and suppressed TSH in order to have high enough FT3

rcpe.ac.uk/sites/default/fi...

sam295 profile image
sam295 in reply toSlowDragon

thankyou for anything I am feeling very low right now

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