Blood test results help

[Blue-Cat]

I had some thyroid blood test results this year (included below) because I was experiencing hypo symptoms. I get very tired, depressed, can find it hard to think at times, get cold easily, have dry skin and I am putting on weight with a low metabolism (it used to be very fast). I am only 20 years old.

I got my bloods done earlier this year at the GP (01/18 results below) and was told all was fine. But, I noticed my FT3 and FT4 are on the low end of normal.

A few months later I went to a private endocrinologist (05/18 results below) and the results he obtained were virtually identical. But, the endo told me that there’s nothing wrong with me, it’s normal to gain weight on 1600 calories a day, and it must be other hormones causing me to eat more than I think and gain weight that way (not true - I count very exactly).

Thyroid blood test results from this year (2018):

01/18

FT4: 13.3 pmol/L (12.0-22.0)

FT3: 4.1 pmol/L (3.5-7.7)

TSH: 2.47 mU/L (0.27-4.2)

Thyroglobulin antibody: 105 IU/mL (0-115)

Thyroid Peroxidase antibodies: 14.3 IU/mL (0-33)

05/18

FT4: 13.3 pmol/L (12.0-22.0)

TSH: 2.10 mIU/L (0.27-4.2)

Thyroglobulin antibody: 113 IU/mL (0-115)

Thyroid Peroxidase antibodies: 14.3 IU/mL (0-34)

I came across some thyroid blood test results from when I was in hospital two years ago (not from anything thyroid related, thyroid tests were just done as part of routine bloods). And, as you can see, my TSH has risen since 2016 and my FT4 has decreased.

Thyroid blood test results from 2016 (in 2016 my metabolism was slower than it used to be but not as bad as now).

27/09/16

FT4: 16 pmol/L (12.0-22.0)

TSH: 1.02 mU/L (0.27-4.2)

11/10/16

FT4: 16.3 pmol/L (12.0-22.0)

TSH: 1.36 mU/L (0.27-4.2)

8/11/16

FT4: 16.7 pmol/L (12.0-22.0)

TSH: 1.28 mU/L (0.27-4.2)

So, what’s going on here? Am I being a hypochondriac as everyone seems to think? If I’m not, then how do I find a dr/endo will listen to me?

[greygoose]

Well, I'm going to stick my neck out here, and say you probably have Hashi's. Your Tg antibodies are right at the top of the range. And, given that antibodies fluctuate, we have no way of know if that's the highest they get, or if they're at their lowest. And your TSH says your thyroid is beginning to struggle. But, it's not high enough, nor your Frees low enough, for any doctor to take any notice of them.

I very much doubt you're a hypochondriac. I don't believe in hypochondria, it's just doctor-speak for 'I don't know what's wrong with this patient, so I'm going to put the blame on her'. Symptoms often precede abnormal blood tests by quite a while. You could possibly try adopting a 100% gluten-free diet, see if that helps in any way. And try taking selenium. Even with a diagnosis, treatment is always a case of trial and error, so you might as well start trying now.

But, that doctor is entirely wrong. It is not normal to put on weight when eating only 1600 calories a day.

[Blue-Cat in reply to greygoose]

Thank you very much. I did have a medichecks blood test before seeing the endocrinologist which showed up both my antibodies as being higher (and thyroglobulin antibody out of range) but only slightly:

Thyroglobulin antibodies: 138 (0-115)

Thyroid Peroxidase antibodies: 20 (0-34)

(T4 was also at 12 on this blood test)

However, the endo didn’t seem concerened when I showed him and antibodies were in range in his blood test.

If I do have hashimotos, how long will it take before I am “bad enough” for help?

If I go on a gluten free diet and it reduces my antibodies, could that help bring my T4 and T3 up?

[greygoose in reply to Blue-Cat]

There's no connection between T4/T3 levels and antibodies. So, no, I don't think it will.

There's absolutely no way of knowing how long it would take to damage your thyroid enough to attract the attention of a doctor, if you have Hashi's. It's a very individual thing. But it is something that needs regular testing, so don't give up.

[Blue-Cat in reply to greygoose]

Thank you. It’s a shame there’s no way to get my T4 and T3 levels back up again. I miss being able to eat lol but I guess I don’t have it that bad yet. I will keep getting it checked.

[greygoose in reply to Blue-Cat]

The only way to get your T4 and T3 levels back up is to take thyroid hormone replacement. But, with those labs, I doubt you'll find a doctor willing to prescribe it.

[Blue-Cat in reply to greygoose]

Yeah I think you’re right. No worries. Thank you

[greygoose in reply to Blue-Cat]

You're welcome.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies.

Plus very important to test vitamin D, folate, ferritin and B12

These are very often too low and can then affect Thyroid results or can cause symptoms in their own right

Private tests are available. 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. This gives highest TSH and most consistent results. (Patient to patient tip, GP will be unaware)

Is this how you did the test?

[Blue-Cat in reply to SlowDragon]

Thank you. I’ve included my results for TSH, T3, T4, TPO and TG thyroid antibodies for 2018 in my original post above. Unfortunately, I only have results for my TSH and FT4 from 2016 but these are also in my original post.

I have had vitamin D, folate, ferritin and B12 tested by medichecks. All appear to be in range.

Vit D: 62.2 (50-200)

Folate: 12.94 (2.91-50)

Ferritin: 27.9 (13-150)

B12: 177 (25.1-165)

No, none of the blood tests I have mentioned in my original post were done under fasting conditions. However, after learning that fasting status and time of day can affect TSH, I did a finger pick TSH test from mediciecks first thing in the morning under fasting conditions. The result was not markedly different as you can see:

TSH: 2.63 (0.27-4.2)

[SlowDragon Administrator in reply to Blue-Cat]

Your vitamin D is too low. Recommended to be at least above 80nmol. Most find around 100nmol better

Ferritin is very low, you will see on many many replies on here it needs to be at least above 70. Eating liver or liver pate once a week should help improve. Do you have heavy periods?

Vitamin B12 is good. Do you supplement?

Folate is low. Taking a good quality vitamin B complex likely to help. One with folate in not folic acid. Eg Igennus Super B or Jarrow B right

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...

Improving vitamins will help improve your ability to use thyroid hormones. Either making you feel better or pushing TSH higher so you get diagnosed

[Blue-Cat in reply to SlowDragon]

Thanks. I already take vitamin D (800IU), so I will increase my dosage. What dose of vitamin D would you suggest?

I will look into finding a good vitamin B complex with folate. Just noticed my multivitamin only has folic acid.

Can you take ferritin supplements? No, I actually haven’t had periods for a few years now. That’s another problem I think may be caused my poor thyroid function as my other hormones are fine and pelvic scans have shown nothing abnormal.

And no, I don’t supplement B12. I do take a multivitamin which contains 2.5ug of B12, though.

Oh, the multivitamin I take every day contains 50ug of Biotin (but that’s equal to only 0.05mg). So, taking biotin can make your FT3 and FT4 appear to be higher than they are? And possibly also make TSH appear falsely low? I wonder if taking biotin may have affected my thyroid blood test results? Could also be why my B12 always comes up so high.

[Blue-Cat in reply to SlowDragon]

Sorry if I am being stupid, but isn’t ferritin to do with iron? I also have had my iron levels tested and they were good:

Iron: 25 (14-30)

The multivitamin I take also contains 14mg of iron. Again, not sure if that is relevant to ferritin.

[SlowDragon Administrator in reply to Blue-Cat]

Better to avoid multivitamins generally. But yes any B12 supplement will push B12 results up

greygoose can explain why multivitamins are generally not a good idea

If you have any suspicion of it being Hashimoto's then avoiding iodine is probably best

drknews.com/iodine-and-hash...

Just increase your vitamin D, perhaps to 2000iu as mouth spray (likely increased absorption) Its trial and error what each person needs. Test twice yearly and once you have increased level to around 100nmol, you will likely still need an ongoing maintenance dose.

Read up about magnesium and vitamin K2 Mk7 supplements as well

articles.mercola.com/sites/...

Link between low vitamin D and low B vitamins

drgominak.com/sleep/vitamin...

You could look at trying strictly gluten free diet too if symptoms remain once vitamins are optimal

[Blue-Cat in reply to SlowDragon]

Thank you very much. I’ll try to optimise my vitamins and look into gluten free.

[greygoose in reply to Blue-Cat]

Ferritin is the protein that stores iron. What you had tested was serum iron. The body takes iron out of storage and puts it back as necessary. So, you do need good stores.

You shouldn't be taking a multivitamin for all sorts of reasons.

* If your multi contains iron, it will block the absorption of all the vitamins - you won't absorb a single one! Iron should be taken at least two hours away from any other supplement except vit C, which is necessary to aid absorption of iron, and protect the stomach.

* If your multi also contains calcium, the iron and calcium will bind together and you won't be able to absorb either of them.

* Multi's often contain things you shouldn't take or don't need : calcium, iodine, copper. These things should be tested before supplementing.

* Multi's often contain the cheapest, least absorbable form of the supplement : magnesium oxide, instead of magnesium citrate, or one of the other good forms; cyanocobalamin instead of methylcobalamin; folic acid instead of methylfolate; etc. etc. etc.

* Multi's do not contain enough of anything to help a true deficiency, even if you could absorb them.

With a multivitamin, you are just throwing your money down the drain, at best, and doing actual harm at worst. Far better to get tested for vit D, vit B12, folate and ferritin, and build up your supplementation program based on the results.

[Blue-Cat in reply to greygoose]

Thank you. I didn’t know any of that about multivitamins!

[greygoose in reply to Blue-Cat]

Not many people do.