Hi all, I'm looking for some advice/help interpreting my recent blood test results.
I went to the doctors after feeling really rundown, headaches and dizziness when standing etc. The doctor I saw I did not get on with at all she was very defensive and generally unhelpful. My ferritin was 7 so I was given iron tablets 3 times a day for that and my TSH was above range 6.34 (0.38 - 5.33).
I then decided to get bloods done privately through Medichecks and I have just got the results which are as follows:
My TSH is now in the normal range, is it normal for this to change so quickly? There were only 10 days between the tests but I took the GP test in the morning and the Medichecks test at 12:30pm, would the time affect the results?
Is it true 25% of the population test positive for antibodies but have normal thyroid function? This is what the Medichecks doctor advised. I noticed also the other antibodies are nearing the top of the range.
Really, what I would like to know is if my results indicate an issue with my thyroid and if I should speak to a doctor about the results and ask for any treatment?
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My TSH is now in the normal range, is it normal for this to change so quickly? There were only 10 days between the tests but I took the GP test in the morning and the Medichecks test at 12:30pm, would the time affect the results?
Yes, TSH level varies throughout the day. It's highest in the early hours of the morning and lowest in the afternoon. So your Medichecks test at 12.30pm would be lower than your GP test done earlier in the morning. Eating can also lower TSH.
These results indicate you likely have autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. 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.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies
If you can get a TSH result between 4 and 10, with low FT4 and symptoms, you can be diagnosed with subclinical hypothyroidism. When antibodies are present then Dr Toft, past president of the British Thyroid Association and leading endocrinologist, says that starting Levothyroxine can "nip things in the bud". See the Pulse article he wrote (Pulse magazine is the magazine for doctors) and this information is in reply to question 2. You can obtain a copy of the article by emailing Dionne at ThyroidUK
tukadmin@thyroiduk.org
You should take your iron tablets with 1000mg Vit C to aid absorption and help prevent constipation.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. You should now get Vit D, B12 and Folate tested, they are also likely to be low considering how low your Ferritin was.
Thank you for taking the time to reply I really appreciate your feedback.
Do you think it's worth re-doing the test first thing in the morning?
Thanks for the diet recommendations I will look into that and also read through the information on the links you provided.
I did actually have B12 and folate tested but no D12.
B12 - 334 (180 -915)
Folate - 6.0 (3.1 - 19.9)
My white blood count was also on the low side at 4.3 (4.0 - 10) but nothing was said about this and I don't know if it's relevant. I will be speaking with a new gp when I go back to the surgery as I wasn't happy with the GP I saw to discuss my results last time.
You can try and get a TSH of over 4 with your GPs test and that may help get the diagnosis. Do the test as early as possible in the morning, certainly no later than 9am. Fast overnight - eat your normal evening meal the night before, then water only untill after the blood draw (have breakfast afterwards, and no coffee, etc, just water).
B12 - 334 (180 -915)
Folate - 6.0 (3.1 - 19.9)
These are low but not low enough for your GP to do anything about them because they're within range.
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
If you have no signs of B12 deficiency (check here b12deficiency.info/signs-an... ) then you could supplement with sublingula methylcobalamin lozenges, 5000mcg daily to start, use one pot then change to 1000mcg.
When supplementing with B12, we need a good B Compex to balance all the B vitamins. My suggestion would be Thorne Basic B or Igennus Super B at the recommended dose on the pack, that gives 400mcg methylfolate which would boost your folate level, which needs to be at least half way through it's range.
Your raised TPO indicate Hashimoto's Autoimmune Thyroiditis. You could go back to GP (is there a different one you could see?) take a written list of your symptoms and ask for a referal to an Endocrinologist.
Have you had any tests to check your Adrenal function?
You could ask GP to test some nutrients levels : Vitamin D, B12, Folate and Ferritin.
Thanks for your reply I appreciate your help and advice.
Yes I will definitely ask to see a different GP at the practice and see if they are more helpful and I think that's a good idea re asking for a referral to a specialist as the GP's don't seem to be that clued up by the looks of things especially where hashimotos is concerned.
I did have my B12, folate and ferritin checked but not D12.
B12 - 334 (180 -915)
Folate - 6.0 (3.1 - 19.9)
My white blood count was also on the low side at 4.3 (4.0 - 10) but nothing was said about this and I don't know if it's relevant. I will be speaking with a new gp when I go back to the surgery as I wasn't happy with the GP I saw to discuss my results last time.
I haven't had any checks for my adrenal function is this something I should ask for?
GPs seem to go by ranges and not where results are in range.
I wouldn't be concerned about low White blood cells count - as I understand it's when it's raised this means there's an infection.
I don't know much about Adrenals either. Just that my Endocrinologist checked mine first before I started my Levothyroxine. I think any Adrenal issue needs to be sorted before starting Levo. There's something about this in the Levo patient information leaflet too. Mine were OK anyway.
Next time you see GP you could ask for the Vitamin D test?
In the late 80's a Medical Consultant thought I had a Thyroid problem and wrote to my GP saying "her results have come back clear but I am not happy" and " . needs keeping an eye on . . .". I didn't know about this letter till I got copies of my records decades later.
In 2008 I had Hypothyroid Blood results but wasn't told. A different Consultant (Rheumatologist ) saw these in 2010 and retested. It was afternoon and I wasn't as ill as in 2008. He told me ' Thyroid 's ok, you have Fibromyalgia'. When I got copies of records again the 2010 bloods were reported as Euthyroid but were only just in range. T4 near bottom and TSH at the top.
I didn't have TPO test till a week before Endocrinologist appoinment at his request in late 2011.
In reply to your question about '25% of the population test positive for antibodies but have normal thyroid function', I would suppose the answer has to be 'yes'. BUT, it depends when they were tested. Levels can vary alarmingly when you have Hashi's, and it also depends on the time of day the blood was drawn, so the law of averages says that a lot of people will be tested right at the time when their antibodies were high and the TSH/FT4/FT3 were in range.
However, a blood test is like a photograph, it only tells you what was going on at the time it was tested, not what happened last week, nor what will happen in a months time.
Besides, just because people's levels are in what they call the 'normal range', doesn't mean that they are normal. Most ranges are far too wide. So, if you have, say:
TSH 4.9 (0.2-5.0)
FT4 12.1 (12-22)
FT3 3.2 (3.1-6.8)
your results are in-range, but you are hypo. So, that statement depends on your interpretation of so many factors that it can be true, but at the same time, is wrong.
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