Blood tests results

[St12]

I recently got these results from medichecks. I'm a bit confused. I've been diagnosed hypo and undiagnosed. I've been told over the years I'm low on iron and have been on iron tablets. At my last appointment with endo I was told he was going to send me for iron infusion. My gp said vit d was ok. I have most of the hypo symptoms. Just don't know what's going on..

[SlowDragon Administrator]

Your results are not typical

First you have very low TSH, yet below range FT4 and low Total T4 and extremely low FT3

Antibodies are low so you don't appear to have autoimmune thyroid disease

These suggest you do not have primary hypothyroidism but central hypothyroidism. This can be secondary or tertiary depending on if problem is with the HPA axis or pituitary

Have you ever had bump on head, or bad whiplash or heavy bleeding during or after labour (Sheehan syndrome) ?

You will need referral to an endocrinologist specialising in Thyroid and pituitary.

I think greygoose has a good link about central hypothyroidism

Also are you taking any B vitamins or B12?

Your B12 level is high.

Also your ferritin is very high. You need further investigation, especially if you say iron is low

humanbean may be able to advise on that

Your vitamin D is definitely too low. Most need it at least around 80-100nmol

Supplementing a vitamin D mouth spray and retesting in 2-3 months via vitamindtest.org.uk

[St12 in reply to SlowDragon]

Hi SlowDragon

Thank you for taking the time to reply. It's taking time to go through everyone's replies and reading all the links. I had a nasty bump to my head but that was when I was a child about 50 years ago and I was out cold.. but more recently, about 10 years ago, I had benign intracranial hypertension for which I had to have many lumbar punctures. I am taking b12 and vit D tablets. My ESR has been consistently high usually 70 - 80 and although I've had many tests they can't seem to find the cause of the high inflammation. At the moment my biggest problem is sore ankles and really bad burning feet. I do not have diabeties. Yesterday I went to for an appointment with a doctor at the hospital who is suggesting iron infusion again ( had one about a year ago)..

Also I was on t4 and t3 and recently tried thyroid s. Should I not be taking these? Does having a low tsh etc need medication?

[SlowDragon Administrator in reply to St12]

Burning feet may be due to peripheral neuropathy

This can be low B5 or other B vitamins

It's recommended to supplement a good quality Vitamin B complex to keep all B vitamins in balance

There used to be a great article explaining this, but website has just changed (annoying)

drgominak.com/vitamin-d/

Might be on this podcast

podtail.com/en/podcast/high...

How that improving low vitamin D can increase our need for B vitamins, as body starts to heal, leading to peripheral neuropathy.

I experienced this myself

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...

[St12 in reply to SlowDragon]

Hi SlowDragon

I'm taking 1000ug a day of Vit B12

Vitabiotics ultra Vitamin D 1000iu (25ug)

Active Curcumin 12,460 mg

I will get some B complex

I've stopped taking iron tablets as suggested on this site and I will not be going for the iron infusion

Do you think I should take some form of thyroid medication?

[SlowDragon Administrator in reply to St12]

You need referral to an endocrinologist who can investigate possible causes of central hypothyroidism

[St12 in reply to SlowDragon]

Should I stop taking B12 as it is high and is it bad to have high levels?

[SlowDragon Administrator in reply to St12]

Yes probably reduce to 2-3 times a week

[St12 in reply to SlowDragon]

Thank you

[Heloise in reply to St12]

It's a bit concerning to have a B12 at that level by only taking 1000 mgs. Your folate is very low by comparison and they are supposed to work together so if you supplement, you should take both. Serum tests only see what is floating in the bloodstream but you need to get all the nutrients into the cells. The body tries to regulate what is in the bloodstream if it can. All that B12 can be floating around but not being used because of lack of folate. Perhaps one of the the links you've been given will explain this. healthyeating.sfgate.com/hi...

I wonder if you should have another type of doctor look at all this.

[SlowDragon Administrator in reply to Heloise]

Taking a good vitamin B complex may help. Other B vitamins like B5 can be too low as well, causing all B12 to float around not used.

[SlowDragon Administrator]

If your iron is low, but ferritin is high this needs investigation

Link about low iron and high ferritin

irondisorders.org/anemia-of...

[St12 in reply to SlowDragon]

Thanks I will have a look at that

[Justiina]

Your ferritin and crp are way to high. Iron can feed harmful bacteria , any type of harmful bacteria and some of your symptoms as well as low thyroid could be caused by infection/inflammation. I would ignore thyroid numbers until the ferritin/crp is dealt with. Infection/inflammation can affect thyroid numbers. If the cause is iron overload it should be fixed first.

[St12 in reply to Justiina]

Thanks for your reply. I do have chronic inflammation

[greygoose]

Oh, yes, SlowDragon , that looks very much like Central hypo!

St12 , Central hypo is when the fault lies with the pituitary (Secondary hypo) or the hypothalamus (Tertiary hypo), rather than the thyroid (Primary hypo). It means that not enough TSH is being produced to stimulate your thyroid to make thyroid hormones. So, the FT4 and FT3 are very low, but so is the TSH.

Doctors know very little about it. GPs very often don't even know it exists. But, it needs investigating because the pituitary produces a lot of other hormones, apart from the TSH, and they could also be making you feel bad if they're low. So, this needs investigation asap. Tell your doctor you think you have Central hypo and ask him to refer you to an endo for testing. Below, is a good explanation of Central hypo - your could even print it out and give it to him - and a list of test to do to check the pituitary.

endocrinologyadvisor.com/en...

pituitary.org.uk/informatio...

Hope this helps you get a diagnosis.

[St12 in reply to greygoose]

Thank you so much for all your help. I will be looking into this. I have see two endos, one privately, both were absolutely useless

[greygoose in reply to St12]

Par for the course. Didn't know what they were looking at, probably. You have to help them out by giving them a clue.

[St12 in reply to greygoose]

Hi greygoose

I have never heard of Central Hypothyroidism and didn't know about the Pituitary. Doctors keep telling everything's in range expect for the ESR for which they can't give me an explanation.

[greygoose in reply to St12]

Well, your FT4 is not in-range there! It's under-range. And there's no reason why you should have heard of Central hypo, that's supposed to be your doctor's job. But doctors rarely do their jobs properly where thyroid is concerned. But, for the reasons I give below, you have got to get your pituitary investigated. It is vitally important to do so. And before you start taking any thyroid hormones. That would be like putting a sticking plaster on a broken arm!

So, suggest it to them, give them copies of the articles I linked to. Do your own research, but you have got to get them to take notice if you ever want to be well.

[St12 in reply to greygoose]

Ok I will make an appointment and take this information with me.. I probably won't get an appointment for at least 2 weeks then the gp will have to send a referral to an endo... this could take months

[greygoose in reply to St12]

I realise that, but unless you can persuade your doctor to put you on levo, I really wouldn't take it. You will destroy the evidence. You at least need to have your doctor on your side.

[Heloise]

I haven't much to add except vitamin D is a prohormone or prehormone which means it is needed by other hormones to work. You have to get it to a much higher level.

Were you taking supplements before the blood test, often the results are skewed.

These are the tests for anemia recommended by STTM. Was your serum iron that low?

stopthethyroidmadness.com/l...

[St12 in reply to Heloise]

Thanks for your reply.. I will take a look at that

[St12 in reply to Heloise]

Hi Heloise

This is all new to me.. I didn't take anything for a five days before blood tests. Serum iron? I may be being completely stupid here but is that the same as iron?

[humanbean]

I hope you are still checking the site for replies and will read this ...

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I am not clear from your post whether you have had an iron infusion or not, and whether your results are from before an infusion or after.

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Do NOT agree to have an iron infusion.

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Your ferritin level (a measure of your body's stored iron) is already over the reference range, and having an infusion will push it even higher. The body can't cope well with excessive amounts of iron and has nowhere to store it safely other than in ferritin. So excess iron gets deposited in various places around the body - and that can include the liver, the heart, and other organs. The body has no natural means of getting rid of excessive iron. Please read this link :

en.wikipedia.org/wiki/Iron_...

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Your CRP is also high. Just to put it into perspective :

Most people who post results on here have CRP levels which are well within the reference range i.e. less than 5.

Last year I saw someone on a medical program on TV having their CRP level measured. It was 50. The patient had a chest infection that required antibiotics to fix it.

CRP is a measure of inflammation and/or infection but unfortunately won't tell you where the problem actually is. You clearly have some inflammation or infection. Either you were ill/infected at the time the test was done or you have a chronic problem of some kind keeping your CRP level high - arthritis of some kind? fibromyalgia? lung problems? gut or bowel problems? something else?

labtestsonline.org.uk/tests...

labtestsonline.org.uk/tests...

Note in the above links that clicking on any + signs will display more information.

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Suppose you had a bacterial infection or some kind of parasites or a viral infection or a cancer. Each of these things need iron to live and grow and reproduce just like humans do. And the body has evolved to protect itself from invaders like these by storing iron which you don't need in ferritin. Invaders can't get iron out of ferritin. The body will also keep serum iron ("loose" iron in the bloodstream) at a low level, and will reduce the amount of haemoglobin to a minimum because haemoglobin contains iron that could be of use to an invader. So, you might well have low serum iron, low iron saturation, and low haemoglobin. But this is not a good reason to give you an iron infusion because of your high ferritin.

If you had an infection or similar, then giving you an iron infusion could allow the thing you are infected with to massively increase in severity.

Some links on the subject :

1) irondisorders.org/anemia-of...

2) irondisorders.org/iron-over...

3) See page 8 : irondisorders.org/Websites/...

4) The chart at the bottom of the page is useful : irondisorders.org/Websites/...

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Hope this helps.

[humanbean in reply to humanbean]

I should also point out that with high ferritin you shouldn't be taking any iron supplements or medications that contain iron.

[St12 in reply to humanbean]

Thank you for taking the time to help. I had an iron infusion about a year ago. I went for a hosptial appointment yeaterday and he is suggesting iron infusion again. As I wasn't sure I wanted to go for this he has taken some blood to test iron etc again.

ESR rate is high at 77 but they don't know what causing this. I do have pain in my ankles, feet and joints and excessive heat with burning feet.. You've kindly sent me a lot to read up onwhich I'm on to..So should I stop taking iron tablets and not got for the iron infusion?

[Heloise in reply to St12]

Dr. Kaslow has some explanations for certain blood tests. The RDW is an indicator for iron. It may be good to explore what is going on since iron can have negative effects.

Random Distribution of Width (RDW)The RDW stands for Random Distribution of red cell Width. This value tells how consistent are the size of the red blood cells. Newly made cells (reticulocytes), B12 and folic acid deficient cells are larger than iron deficient cells. This is an electronic index that may help clarify if an anemia has multiple components. The high RDW helps determine if there is only a B12 and/or folic acid deficiency (with normal RDW showing the red cells are mostly the same size) or with concomitant iron deficiency (a high RDW due to small and large red blood cells).

drkaslow.com/html/blood_cel...

[St12 in reply to Heloise]

I have been told my red cells are smaller? What does that mean?

[Heloise in reply to St12]

Moderately elevated ESR occurs with inflammation but also with anemia, infection, pregnancy, and with aging. A very high ESR usually has an obvious cause, such as a severe infection, marked by an increase in globulins, polymyalgia rheumatica or temporal arteritis.Mar 12, 2018

An erythrocyte sedimentation rate (ESR) test is sometimes called a sedimentation rate test or sed rate test. ... The speed at which the red blood cells fall to the bottom of the tube is measured. Inflammation can cause abnormal proteins to appear in your blood. These proteins cause your red blood cells to clump together.Oct 13, 2015

[humanbean in reply to St12]

he is suggesting iron infusion again. As I wasn't sure I wanted to go for this he has taken some blood to test iron etc again.

So, he was suggesting an iron infusion without having tested your iron first? I would not be happy about that, at all! At the very least he should have given you a full Iron Panel and a Full Blood Count. The tests shown in these links are what I mean (you've already had the ferritin and CRP done obviously, but he won't know that) :

medichecks.com/iron-tests/i...

medichecks.com/tests/fbc-fu...

Burning feet and pain in the feet is common in untreated and under-treated hypothyroidism. I used to have it, until I got my Free T3 level a bit higher, then it went away.

I've taken a closer look at your other results and seen how appalling your thyroid results are. I agree with greygoose that you have central hypothyroidism. This, on its own, could be the cause of the inflammation, the high CRP, the high ESR, the burning feet, painful joints, the Anaemia of Chronic Disease, and everything else you're suffering. Every cell in the human body needs adequate levels of thyroid hormones, and it is because of this that the range of symptoms people may suffer is enormous.

If you were to get your thyroid hormone levels up your body may heal itself to some extent, given plenty of time, but you can help it on its way by improving your folate levels and your Vitamin D levels, which are not good.

Folate - Get it to the middle or upper half of the reference range. Don't take folic acid, take methylfolate. You also need a good quality B Complex.

Vitamin D - you need to get it to about 100 - 150. For more info on vitamin D supplementation and everything that goes with it see SeasideSusie 's replies to others, which you can find here :

healthunlocked.com/user/sea...

But, going back to your iron problem...

It would be good to know if your doctor has considered that you may have Anaemia of Chronic Disease (ACD), rather than Iron-Deficiency Anaemia (IDA). Iron transfusion is a treatment for IDA not ACD. Ferritin is low in IDA, not high like yours.

Also, if you can't get your incompetent doctors to consider that you have central hypothyroidism, test you for it, and treat you for any deficiencies, then you will have to treat your thyroid yourself. That is not easy, but it can be done. Come back and ask for more advice if you get to that stage.

Can I also suggest that you always take a trusted friend, relative or partner with you to doctor and hospital appointments. It helps to keep doctors polite if there is a witness (preferably male). I doubt you can think very well at the moment, and doctors are often rude and ride roughshod over women on their own.

Oh, I forgot to answer your question...

So should I stop taking iron tablets and not got for the iron infusion?

I wouldn't take iron tablets or have an iron infusion with a ferritin level as high as yours. All that will happen is that your body will, given time, shovel all that iron into increasing your ferritin further and increase the risk of iron depositing in other internal organs, like the liver. An infusion probably won't increase your haemoglobin or your serum iron levels for very long. And if it does it may make your inflammation and/or infection problems worse.

Your doctors are trying to fix the wrong problem, in my opinion. They aren't looking for the causes of your ill health, they are only trying to tinker with the symptoms. And in the meantime your body is desperately trying to save your life by trying to stop the iron making your inflammation or infection worse.

P.S. I should point out that I am not medically trained. I've had iron and thyroid problems all my life and eventually decided a few years ago to help myself by learning what I could and treating myself where possible.

[greygoose in reply to humanbean]

Totally agree with everything you say, HB, but self-treating the thyroid will only fix the low-thyroid symptoms. If it is the pituitary at fault, as in Secondary hypo, there will probably be other low hormones, too, causing symptoms. The pituitary makes a lot more than just the TSH. It could affect the adrenals, among other things.

So, St12 , you have absolutely got to get it through their thick heads that they need to test these other hormones, and give you a scan. If it's Secondary hypo, they really need to know and take the appropriate actions.

[humanbean in reply to greygoose]

Oh yes, I agree 100%! St12 clearly needs more help than just fixing the thyroid, and needs proper pituitary testing.

[St12 in reply to humanbean]

Hi humanbean

So I need folate and b complex. Should I take some Levothyroxine and/or t3?

[humanbean in reply to St12]

You could go ahead with the nutrient supplements, but I'd hold off on taking thyroid meds until you've managed to get an endo to test you for pituitary failure. If you take thyroid meds before testing it would probably cause a delay in you getting the appropriate diagnosis.

Don't forget you need vitamin D as well as the folate and B Complex. See SeasideSusie 's replies on the subject, because there are other supplementss to be taken with vitamin D to get full benefit from it.

Once you've got your folate up to mid range or upper half of the range you could stop taking that, because the B Complex should keep you topped up. Make sure you get a B Complex which contains methylfolate, not folic acid.

[St12 in reply to humanbean]

Thank you so much

[SlowDragon Administrator in reply to St12]

Suggest you email Thyroid UK for list of recommended thyroid specialists, see if there's one near you.

please email Dionne at

[e-mail]

Some are NHS and private. You could get seen initially privately then move across to NHS

Roughly where in UK are you?

[St12 in reply to SlowDragon]

Hi I live in North Ayrshire which is South West Scotland. I will email thyroid UK thanks