Hello, I am new to this forum and would appreciate some help interpreting my recent test results - I had a full thyroid profile as I have been feeling unwell for a while and some of my symptoms seemed to fit thyroid problems. However my results do not seem to indicate that there is a problem. I am seeing my GP on Wednesday with my results and would appreciate any advice that people can give. Thanks
If both Thyroid Peroxidase (TPO) and Thyroglobulin (TG) antibodies were raised, it would confirm Hashimoto's. However, Thyroglobulin on it's own doesn't. TG antibodies can be found in Graves disease (overactive thyroid).
However, antibodies fluctuate and although your TPO antibodies are low at the moment, it doesn't mean that they wont be raised if tested another time.
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TSH 0.543 Miu/L (0.27 -4.3)
Free thyroxine 20.7 pmol/L (12-23)
Free T3 4.79pmol/L (3.10-6.80)
Looking at your current results, with such a low TSH and a relatively high FT4, plus raised TG antibodies, it's worth trying to rule out (or in) Graves disease and for that you need TSI(thyroid stimulating immunoglobulin)/TRab (thyroid receptor antibodies) testing.
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Thyroxine 104nmol/L (66-181)
Free thyroxine 20.7 pmol/L (12-23)
This is a bit of an anomaly. Your total thyroxine (measures bound and unbound [free] thyroxine) is on the low side compared to your free thyroxine (FT4). This may or may not be something to do with the antibodies fluctuating.
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Active B12 50.1 pmol/L (25.10 -165.00)
This is low and according to this article viapath.co.uk/our-tests/act... anything <70 suggests testing for B12 deficiency.
Check for signs of B12 deficiency here b12deficiency.info/signs-an... and if you have any then list them, show to your GP and ask for testing for B12 deficiency/pernicious anaemia.
Folate 8.90 nmol/L (8.83 -60.8)
B12 and folate work together. Your folate has barely scraped into range. It will need supplementing but hold back because folic acid/folate will mask signs of B12 deficiency. So further testing of B12 should be done before supplementing for this low folate level.
Ferritin 240 ug/l (13.00 -150)
Have you been supplementing? If not then discuss your very high ferritin with your GP.
25 OH vitamin D 36.8 mnol/L (50-200)
This is very poor, only 6.8 points away from where you would be prescribed loading doses of D3 for deficiency.
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L. You could discuss with your GP but may only be prescribed 800iu D3 which wouldn't be sufficient.
The Vit D Council recommends for your level the following:
To reach 100nmol/L take 3200 IU D3 daily
To reach 125nmol/L take 4900 IU
To reach 150nmol/L take 7000 IU
As you have raised antibodies, to avoid poor gut function and for best absorption then an oral spray is recommended, eg BetterYou who do a 3000iu dose spray. I would suggest you take 6000iu daily for 2 months, then drop down to 3000iu daily and retest 3 months after starting. When you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
Your doctor wont know, because they are not taught nutrition, but there are important cofactors needed when taking D3 as recommended by the Vit D Council -
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 such as hardening of the arteries, kidney stones, etc.
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. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium 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
TG antibodies can be found in Graves disease (overactive thyroid).
I'm sure I read somewhere that when the Tg antibodies are really high, like the OP's, then it's going to be Hashi's. They're not that elevated with Grave's.
I actually do think it's Hashi's GG, just covering all bases as there have been so many cases of Graves diagnosed without testing the right antibodies lately.
Just an update, saw GP today (managed to get an earlier appointment) will try to be concise.
Vitamin D - lots of people are deficient - I will self medicate
She said thyroid tests were normal and seemed a bit unsure about the antibodies but she felt my neck and feels that there is smelling on one side and mentioned a goitre. She has ordered more bloods, FBC, U&E,s, LFT, Ferritin, CK, TPO, Folate, serum B12, HBAC1 ( I think her writing is terrible) and a lipid profile. She has also said that once she has the results she will refer me to endo. She did not say much about my B12 or folate, so not sure if I should start self medicating or not. She also said that the NHS does not test thyroglobulin anti bodies.
She also said that the NHS does not test thyroglobulin anti bodies.
Yes they do, but maybe not at GP level, possibly only with an endo. But that doesn't alter the fact that you've got a positive TG result from your private test, you'd think your GP would be a bit interested in that.
She did not say much about my B12 or folate, so not sure if I should start self medicating or not
No, don't self medicate at the moment. Wait until your GP tests for these come back. Did you check the list of signs and symptoms of B12 deficiency? Do you have any? If so did you list them to show to your GP? They should go by symptoms, not numbers. Many people with a serum B12 result in the 300s end up on B12 injections because of their symptoms, so follow this up if you have any.
Vitamin D - lots of people are deficient - I will self medicate
That doesn't make it OK to have such a low level. Follow the suggestions above about Vit D supplementation, and I would suggest you get the BetterYou D3/K2 300iu spray (saves a separate K2 supplement) and take 6000iu daily for 8 weeks, then reduce to 3000iu daily, and retest 3 months after starting with City Assays (link above). Once you've reached the recommended level then you'll need to find your maintenance dose as mentioned above.
Don't forget you also need magnesium so that the body can use D3.
When you have the results of the new tests you GP has ordered, post them on the forum for comment, include the reference ranges.
Thank you for replying, I have been reading through the links/information you have provided, and will certainly be going to the GP informed. On a personal not I have found it really interesting reading.
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