Thyroid function test results

[hchelsie]

Hi all, when I was aged about 23 (in 2005) I started to think that things weren't right health wise. It wasn't until recently that I had difficulty passing stool and also electric shock like pains in my fingers that I plucked up the courage to see my GP who tested me for thyroid, please see below:

TSH 6.3 (0.2 - 4.2 mIU/L)

Free T4 15.7 (12.0 - 22.0 pmol/L)

Free T3 4.1 (3.1 - 6.8 pmol/L)

Ferritin 17 (15 - 150 ng/L)

Folate 5.2 (4.6 - 18.7 ng/L)

Vitamin D total 30.6 nmol/L (<25 severe....25 - 50 deficiency....50 - 75 suboptimal....>75 adequate)

Vitamin B12 255 (190 - 900 pg/L)

He wants me to repeat thyroid function test in 6-8 weeks time, I am now very worried about what my next results will show. I am on loading doses of vit D too. Any advice would be great

[SlowDragon Administrator]

Ask GP to test TPO and TG thyroid antibodies at next test. This is to check for autoimmune thyroid disease as causevof being hypothyroid

It's normal to not start treating after first high TSH result. But to retest in 2-3 months in case it's due to temporary problem

About 90% of all hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Correcting low vitamins is also very important.

Ferritin is very low too ask GP to run full iron panel to test iron levels for Anaemia.

Low stomach acid is common and can lead to low vitamin levels

B12 and folate are both low, but because they are still within range, GP will most likely ignore this

[hchelsie in reply to SlowDragon]

Hi, I had thyroid antibodies checked as part of an autoimmune profile.

Thyroid peroxidase antibody 804 IU/mL (<34)

Parietal cells antibody negative

Rheumatoid factor negative

Anti Ro antibodies negative

Anti Sm antibodies negative

Thank you!

[SlowDragon Administrator in reply to hchelsie]

Thyroid peroxidase antibodies is TPO. This is high result. Antibodies are above 34 so this confirms as positive test for autoimmune thyroid disease also called Hashimoto's

Link about iron and ferritin

restartmed.com/hypothyroidi...

[Roadrunnergreg in reply to hchelsie]

In addition to the iron you need to get checked is Copper, high copper could be the cause of your low ferretin, plus you need to get your Zinc checked also, as this is most likely low too.

Low zinc equals low thyroid hormone via high cortisol suppressing it. Hope this helps in addition to the other comments...

[hchelsie in reply to SlowDragon]

My iron panel was in range I think.

Iron 9 umol/L (6 - 26)

Transferrin saturation 15 % (12 - 45)

[Nanaedake]

You are hypothyroid as your TSH is elevated above the top of the laboratory range. You need to ask the doctor to test TPO and TgAb antibodies to find out if you have autoimmune thyroid disease. The NHS will probably only do TPO. The reason why it's helpful to know if you have autoimmune thyroid disease (Hashimotos) or not is that TSH can fluctuate with antibodies activity and it can affect your gut function but there are things you can do to manage the symptoms once you know that you have elevated thyroid antibodies.

In the UK, thyroid disease is often not treated until your TSH reaches 10.0 but many people feel very unwell with TSH even slightly over the lab range. Increasing vitamin D may or many not alleviate your symptoms so you may need to be prepared to insist on a trial of levothyroxine on the basis of your symptoms. I hope your doctor is sympathetic?

[hchelsie in reply to Nanaedake]

Hi, I had thyroid antibodies checked as part of an autoimmune profile.

Thyroid peroxidase antibody 804 IU/mL (<34)

Parietal cells antibody negative

Rheumatoid factor negative

Anti Ro antibodies negative

Anti Sm antibodies negative

Thank you!

[Nanaedake in reply to hchelsie]

Thyroid Peroxidase or TPO Antibodies are elevated so you have autoimmune thyroid disease otherwise known as Hashimotos. Doctors call it autoimmune thyroiditis. Low vitamin D is very common.

SlowDragon has best advice on improving gut function.

Your TSH may fluctuate as a result of autoimmune activity, therefore your next blood test may show higher or lower TSH. If your symptoms continue despite improved vitamin D levels, I would insist on a trial of levothyroxine and not wait until TSH reaches 10 because your Hashimotos is not going to vanish.

Hopefully others who have personal exerience of Hashimotos will respond to your post as my hypothyroidism is caused by other factors.

[hchelsie in reply to Nanaedake]

Ok thanks I will see my GP tomorrow and insist on a trial of levothyroxine

[Nanaedake in reply to hchelsie]

Unless you are very young, very frail or have a heart condition, starting dose is 50mcg. YOu may feel worse if started on 25mcg as it will lower existing thyroid function but is not enough to replace missing thyroid hormone.