21yr old son finally got blood results back

[jbthyro]

Hi all,

I have been battling my sons (21yr old) health for over 3 or 4 years now and it is an exhausting journey!

Finally his blood tests have crept upwards and am hoping that the GP will look at them tomorrow, seeing that they are not 'normal' after all!

Please can someone help me because I've forgotten the meaning of these results!

I'm battling B12 deficiency with him too, alongside his brother, dad and grandad! I am more swatted up on B12 than the thyroid now so cannot remember what it means if the FT3 and FT4 are both elevated despite the TSH creeping slowly upwards but still in the range still atm.

Serum free triiodothyronine level 7.3 pmol/L [3.1 - 6.8] (Above high ref limit )

(Thyroid function test - suggest repeat in 6-8 weeks or earlier if symptomatic).

Serum TSH level 3.29 miu/L [0.27 - 4.2]

Serum free T4 level 22.7 pmol/L [12.0 - 22.0]

- Above high reference limit

Serum folate level 8.9 ng/mL [3.9 - 26.8]

Serum ferritin level 105 ng/ml

Serum cortisol level Report, Borderline, Make an appointment to see doctor (Patient Informed)

Serum cortisol level 321 nmol/L

(no range given!) anyone know what the range should be?

Serum sodium level 144 mmol/L [133.0 - 146.0]

Serum albumin level 51 g/L [35.0 - 50.0]

thanks in advance for any advice. I am taking him to the doctors for 9am

[Marz]

No anti-bodies tested ? TPO & Tg need testing - NHS usually only test the first - sigh ! Could be Hashimotos - Docs prefer to ignore this condition. No B12 result or VitD. Sorry cannot help with Cortisol.

With Hashimotos results can vary and can look both Hyper ( over range T3) & Hypo - raised TSH.

Do not supplement Folate before knowing or treating B12 status.

Hope you have a knowledgeable GP. If not come back to the forum for more advice. 😊

[HLAB35]

The doctor may do a Graves antibody test and ignore looking for Hashi's antibodies. Essential that all are done. In the absence of either set of antibodies they could investigate a pituitary or adrenal issue. Be warned. Many GP's seem to lack thoroghness and the knowledge that an accurate diagnosis of a thyroid condition requires.

[jbthyro]

B12 came back as 680 and Vit D is 82. I was surprised as he has hidden from the sun all summer!

I am hypothyroid so familiar with lots of info thanks to this amazing group over the last 4 years, but these symptoms are fooling me so are bound to fool the GP this morning.

I have sent off for a private full thyroid panel with all antibodies yesterday so should be done by next week.

GP is not knowledgeable but knows that I generally am! She is amazing, she does whatever she can to help me but has no idea about the condition AT ALL!

He has not been supplementing with anything for 9 months, hence he is worse than ever, but the only way to find out what is really going on sadly.

I have found an expert, and recommended thyroid private specialist locally from a friend who is under him now. I guess despite the cost, this may end up being the only route to good health for my son.

Who should I ask for a referral to, endocrinologist or neurologist with these test results and knowing that they probably won't know what they are doing?

Obviously the full thyroid panel and saliva cortisol (4) and DHEA that I have sent off for should shed some kind of light by next week too.

thanks

Julie

[greygoose in reply to jbthyro]

Was this reply to Marz ? She won't see it because you didn't click on the 'Reply' button under her post. I've alerted her, now.

[jbthyro]

I'm thinking I want an MRI to rule out pituitary? Or Sub Acute Spinal Degeneration?

Any thoughts on other things to ask for which I cannot do privately?

He has SO many symptoms I couldn't even list them here!

I was convinced that it was going to be P.Anaemia or B12 related deficiency but is looking all the time now that it may be thyroid?

symptoms:-

NEURO - brain fog, lost words, enormous anxiety, panic attacks that are almost like having an epileptic fit he shakes so much, depression, changed character, diminishing motivation to rock bottom now (job literally keeps him going)

DIGESTIVE - dreadful hiccup/belch after eating or drinking anything, falls asleep directly after main evening meal at table, lactose intollerant, incredibly skinny.

Recently appetite has diminished drastically, stools are loose/mucus'y yet often constipated and cannot clean up after himself easily

[FancyPants54 in reply to jbthyro]

Has the celiac test been done? If not, ask for that one on the NHS.

[jbthyro in reply to FancyPants54]

I have celiac and he is gluten free already, has been for 5 years now, thanks though x

[greygoose in reply to jbthyro]

Reply to HLAB35 ?

[Hidden]

What time was his blood taken? Cortisol levels vary throughout the day so it's difficult to say if they are normal. Cortisol levels should be the highest in the morning, so around 9am they should be nearer 500nmol/ls.

[jbthyro in reply to Hidden]

PaulineS, this was done at 8am in the morning. So it is lower than expected then at that time on that day?

[Hidden in reply to jbthyro]

It probably warrants more investigation, it's not ever so low, but is on the low side of normal.

[HLAB35]

I've been doing some research on your behalf - as I have been reading about carnitine (for my dog!) ... In humans though, deficiencies in L-carnitine can increase serum concentrations of thyroid hormone and cause retardation in adolescents (linked to autism as well). It is known that l-carnitine can help reduce thyroid levels in those with hyperthyroidism. Book a telephone call with the doctor and ask for serum carnitine to be checked..

epainassist.com/metabolic-d...

[jgelliss in reply to HLAB35]

HLAB35

How Right you are . My Dr gave L-Carnitine and after a few days I started to have hypo symptoms . I was wondering Why ? As yourself did some research and sure enough L-Carnitine is given for Hyper thyroid patients . On that note from my own experience as well Alpha Lipoic Acid gave me hypo issues as well . Nutrients are very good but buyer be ware it can also be detrimental too . We have to be Very Mindful and vigilant with anything we ingest . Thyroid patients are more sensitive in many ways .

[HLAB35 in reply to jgelliss]

Interesting - though in this study, hypothyroid patients improved in their mental / physical fatigue on carnitine which backs up Dr Myhill in her approach..

press.endocrine.org/doi/abs...

(It's already known to help in hyperthyroidism.)

Dr Myhill prescribes it to her patients with M.E / Fibromyalgia (invariably they suffer from sub-clinical hypothyroidism) so I think there's something more subtle than serum blood tests can detect that's going on with carnitine. I wondered that it 'mops up' excess t4 which in many (hyper and hypo) can cause symptoms. It's actually not technically an amino acid, but a co-enzyme - a bit like co-enzyme q10 that has had more press. Both enhance each other in helping with cardiomyopathy.

hhhummingbirds.com/coq10-ca...

[HLAB35 in reply to jgelliss]

Actually, re-reading the article it could be that your free t3 was too low to cope with carnitine - as it says - those with free t3 > 4 responded well. That's probably the crucial factor!!

[jbthyro in reply to HLAB35]

This is very interesting, I'm intrigues by this information and will research further.

Thank you

[kiefer]

While most people advocate a saliva test for cortisol, the serum cortisol test isn't completely useless. Like the saliva tests, you need to record when it was done, usually in the morning, as that's when cortisol is supposed to be the highest.

I looked up what is considered a normal range for serum cortisol: 10-20 mcg/dL on one page and 6 -23 mcg/dL on another. Using an online calculator, 321 nmol/L translates to about 11.64 mcg/dL, which, as somebody on this thread suggested, is definitely lower than the morning ideal level of 500 nmol/L or 18.13 mcg/dL.

What was the concentration of the vitamin D result?...it can be reported in several ways:

ng/mL and nmol/L.

*****************************

Deficient: 0-40 ng/mL 0-100 nmol/L

Sufficient: 40-80 ng/mL 100-200 nmol/L

High Normal: 80-100 ng/mL 200-250 nmol/L

vitamindcouncil.org/for-hea...

[jbthyro in reply to kiefer]

Oh,interesting, it is in fact nmol/L! I'd not noticed that at all! So deficient in fact! Oh my! How could I have missed that!

Because the range was not printed so i assumed!

[jbthyro]

Something I forgot to mention actually, in hindsight, is that I tested myself last year for gene D101 and D102 and do have the gene defect for both.

Does this affect absorption? Therefore highly likely that it's passed on to both my boys who I'm battling to sort health issues with and a slowly rising TSH and T3/T4?