I was wondering if anyone can please help me interpret these results just back from a Thyroid Utravit check (Medicheck)? Thank you very much indeed if anyone has time to help. The doctor says my TSH is slightly raised, as well as peroxidase antibodies which suggests either Hashimoto's or maybe even Grave's. He also says low serum Folate and suggests checking my red cell Folate to see significance.
What would be your advice here please? (Gluten free diet, go back to the doctor and share results, wait for my Specialist appointment in November and take it from there)?
Just tried attaching pdf but don't think it worked so here they are:
I don't think there's any question that your raised TPO antibodies confirm autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.
Because your TSH is over 4 you can suggest a diagnosis of Subclinical Hypothyroidism, and because TPO antibodies are positive then you can ask to be prescribed Levothyroxine. See
If TSH is between 4 and 10 mU/L and FT4 is within the normal range
◾In people aged less than 65 years with symptoms suggestive of hypothyroidism, consider a trial of LT4 and assess response to treatment 3–4 months after TSH stabilises within the reference range — see the section on Prescribing information for further information on initiation and titration of LT4. If there is no improvement in symptoms, stop LT4.
The 'UK Guidelines for the Use of Thyroid Function Tests' state that, "There is no evidence to support the benefit of routine early treatment with thyroxine in non-pregnant patients with a serum TSH above the reference range but <10mU/L (II,B). Physicians may wish to consider the suitability of a therapeutic trial of thyroxine on an individual patient basis." If your TSH is above the range but less than 10, discuss a therapeutic trial of thyroxine with your doctor.
Subclinical hypothyroidism (where there are elevated TSH levels, but normal FT4 levels, possibly with symptoms) has been found in approximately 4% to 8% of the general population but in approximately 15% to 18% of women over 60 years of age.
Subclinical hypothyroidism can progress to overt hypothyroidism (full hypothyroidism with symptoms) especially if there are thyroid antibodies present.
If thyroid antibodies are found, then you may have Hashimoto's disease. If there are thyroid antibodies but the other thyroid tests are normal, there is evidence that treatment will stop full blown hypothyroidism from occurring.
Dr A Toft, consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, has recently written in Pulse Magazine, "The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2 But if it persists then antibodies to thyroid peroxidase should be measured.
If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.
In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that thethyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up."
You can obtain a copy of the article from Dionne at ThyroidUK
tukadmin@thyroiduk.org
print it to show your GP. This information is in answer to Question 2 in that article.
**
ACTIVE B12 94.300pmol/L25.10 - 165.00
This is OK. Personally I'd want mine a bit higher.
FOLATE (SERUM) *2.7ug/L2.91 - 50.00
This is obviously below range. Folate and B12 work together. Your GP should prescribe folic acid.
25 OH VITAMIN D 70.4nmol/L50.00 - 200.00
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L.
Your GP wont prescribe anything because it's within range, but during the winter we can't make Vit D naturally from the sun so I would be supplementing to get my level to the top end of the recommended range.
For your level, the Vit D Council suggests the following
To achieve 100nmol/L take 2000 IU D3 daily
To achieve 125nmol/L take 3700 IU
To achieve 150nmol/L take 5800 IU
If this was my result I'd be taking around 5000iu D3 daily for 3 months then I'd retest.
As you have Hashi's, then an oral spray is recommended for best absorption. BetterYou do a 3000iu dose so I'd be taking 6000iu daily for 6 weeks followed by 3000iu daily for 6 weeks and then check my level.
Once you've reached the recommended level (100-150nmol) 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/
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
OK, I thought it was, but the 0.00 - 5.00 in the middle confused me.
141 (13-150) is OK if you are still menstruating. Are you supplementing? If not then keep an eye on as you don't want it higher.
Also, my apologies as I missed out some important information about Hashi's - I should have added:
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Again thank you. I haven't menstruated for years. I don't understand the significance this has with high ferretin reading. Are you able to help here as well?
When we menstruate, the iron within those blood cells is also lost. If we don't replace that iron - usually we can do that by diet - then our iron levels become too low. So if we are still menstruating, a level slightly higher than a non-menstruating female is like a buffer zone, we hopefully wont go too low during menstruation. That's my very simple take on it anyway.
I've seen it said that 100-130 within a range of 13-150 is good for a menstruating female.
Because your level is within the range, I don't think your GP will be concerned. You could keep an eye on it, maybe your GP will be willing to retest in 3 months and if it has risen then maybe look into it further.
A one-off highish ferritin probably wont be a concern because inflammation and infection can cause high ferritin which, of course, would be temporary. Also, inflammation can be involved with Hashi's and it could be connected with that.
Again I just want to convey my absolute gratitude to you for taking so much time helping me. Thank you very much. (I just had my first gluten free sandwich and it was disgusting. I need to find a gluten free blog for pointers I think :)
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