Blue Horizon Blood Results

[Karenlb64]

Re posting my results as I’ve only had one person give me their opinion on them. Can anyone else please tell me thoughts on them. Thanks in advance.

[anonymous45]

TPO antibodies are present, therefore indicative that you have autoimmunity against your thyroid gland. This is consistent with Hashimotos.

Your TSH is in range but on the high end, and fT4 is in range but towards the lower end. Most people agree that fT4 should be in the upper 1/3 of the range.

My opinion is that you are in the beginning of subclinical hypothyroidism, and you can likely expect your TSH to to rise and free T4 levels to drop as your immune system attacks your thyroid. As this happens, hypothyroid symptoms are likely to become apparent.

If you have no hypothyroid symptoms at all, get thyroid function tests done as often as your GP will allow, e.g. every 6 months, but no intervention is necessary right now.

However, if you have symptoms consistent with hypothyroidism, it would be wise to discuss starting on a low dose of thyroxine with your doctor to keep your TSH level down, and also initiate regular monitoring.

Finally, you could probably do with a vitamin D and B12 supplement to push your levels away from the insufficient range. Nothing drastic, just a little extra in your diet or via a supplement wouldn't go amiss.

[Karenlb64 in reply to anonymous45]

Thankyou for your advise. I’m going to go back and have a chat with my gp.

[Fruitandnutcase]

Well your ferritin is above the upper limit - believe it or not mine is similar - that can be caused by various things and can be a sign of inflammation of some sort. You will probably know if that makes sense, in my case I have Graves Disease and a load of other autoimmune conditions.

Your TSH is Higher than I’d want mine too be, I’d say you are probably hypo. Your other T4 etc I don’t know, I’m not good at interpreting.

Your vitamin D and B12 look low to me. I’d want mine higher up in their ranges, you would probably feel better. I test my bloods regularly and if they’re low I supplement with a vitamin D3 and K2 combination and sublingual B12.

Plus you’ve got antibodies. I reduced mine by going completely gluten free some years ago but that was because I knew I wanted to calm my autoimmune system down a bit because I have several other autoimmune conditions as well as Graves Disease. I didn’t test first to see if I was Coeliac but it is probably a good idea to test first because if you’re like me you won’t want to go back to eating gluten again just to be tested.

Don’t know if that’s any help to you.

[SlowDragon Administrator]

Looking at your previous posts, I think you are already on Levothyroxine

How much are you currently taking?

On Levothyroxine the dose should be high enough to bring TSH down to around one and FT4 towards top of range and FT3 at least half way in range

So your results show you need a 25mcg dose increase in Levothyroxine

See GP to discuss

New NHS England Liothyronine guidelines November 2018 clearly state on pages 8 & 12 that on Levothyroxine TSH should be under 1.5

sps.nhs.uk/wp-content/uploa...

Your vitaminD and B12 are slightly too low as direct result of being under medicated. But are not low enough for GP to prescribe

Is folate being retested?

Did you know you have Hashimoto's?

Are you on strictly gluten free diet? If not, ask GP for coeliac blood test

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

anonymous45 thought you were not on Levothyroxine

[Karenlb64 in reply to SlowDragon]

Hello and thanks again. Yes I’m on thyroxine 50mcg which was reduced in September from 75mcg. I’ve never been told that I have Hashimotos but then again I’ve never been told anything much by my gps. I’m going to book an appointment and discuss all this. Blue Horizon have not offered to re test my folate. They said if I want an accurate result I’d have to retest but I assume I’d have to pay for another test. I’m going to explore the gluten free thing too. Feel a bit like my brains fried at the moment, confused by what the doctors tell me and will have to read up on going gluten free. I sound like I’m being a bit thick but this is all new territory for me so please bear with me.

[humanbean in reply to Karenlb64]

I found going gluten-free difficult, maybe because I was really cheesed off about feeling I had to try it. The only advice I can give is to remember that perfection isn't required from day one, and you're allowed a few mistakes while you get used to it. But the ultimate aim should be to go 100% gluten free sooner rather than later, because being "almost" gluten free is like being "almost" pregnant. Neither makes any sense.

Some people have found that they benefit from becoming members of Coeliac UK. You don't have to be coeliac to join the society :

coeliac.org.uk/home/

They have a comprehensive directory of gluten-free foods, both fresh and processed, and they have gluten free recipes available too, plus lots of other helpful information.

If you don't get any benefits from going gluten-free after about 2 - 3 months then you could go back to eating it again. Personally, I noticed my first benefits after about five days of being gluten-free, even though I had been thoroughly tested for coeliac disease and been told I didn't have it.

[SlowDragon Administrator in reply to humanbean]

Agree totally with humanbean advice on trying gluten free

I had been tested for coeliac twice,both negative. I had absolutely no gut symptoms but found enormous benefit going gluten free within days.

Others find it's more subtle improvements over months

Slightly raised ferritin due to inflammation of Hashimoto's is pretty common

Your GP was wrong to reduce dose.

Retesting in 6-8 weeks on 75mcg

Getting vitamins optimal is essential too

Likely need further increases in time

Don't think it worth paying to repeat test for folate. Just start supplementing a good quality daily vitamin B complex. One with folate in not folic acid. Retest after dose increase

B vitamins best taken in the morning after breakfast

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[Karenlb64 in reply to SlowDragon]

Thanks for your advice. I see you mention biotin. I take this every morning. When you say it can affect blood results, in what way.

[humanbean in reply to Karenlb64]

For information on biotin read these two posts :

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

There is nothing wrong with taking biotin. But in order to prevent interference in test results it's essential to stop taking it for, say, 3 - 5 days before blood testing. You can then start the biotin again immediately after the blood draw.

[SlowDragon Administrator in reply to Karenlb64]

It's used in some blood assay tests, so if you are taking it, it can possibly affect testing and give false results

Not all labs use it. I noticed that Blue Horizon now mentions on some of their DNA testing to stop biotin before test

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[SlowDragon Administrator in reply to Karenlb64]

Just checking.....you do take you Levothyroxine on its own, on empty stomach and then nothing apart from water for at least an hour after

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription. Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

[Karenlb64 in reply to SlowDragon]

I take my thyroxin first thing in the morning alongside my sertraline tablets and biotin. Wasn’t aware that I had to take it on it’s own and leave it an hour before I eat or drink anything. How will this have affected how it will work for me.

[greygoose in reply to Karenlb64]

It will mean that your absorption will be affected in the gut, But, there will be no way of measuring just how much you have absorbed. And, absorption will vary from day to day unless you eat the exact same thing for breakfast.

Other medication and supplements should be taken at least 2 hours away from thyroid hormone, and food/coffee at least one hour away. That doctors neglect to tell patients this - or that they aren't even aware of it - is most reprehensible.

[SlowDragon Administrator in reply to Karenlb64]

GP will call it autoimmune thyroid disease not Hashimoto's

Invariably they completely ignore the antibodies as they don't uunderstand the significance or have any specific treatment

To them it's the same as being just hypothyroid

Vast majority of hypothyroidism is due to autoimmune thyroid disease

Request coeliac blood test, or order one online, just to rule it out before changing to strictly gluten free

[Hidden in reply to Karenlb64]

"I’m on thyroxine 50mcg which was reduced in September from 75mcg"

Why was it reduced? My guess is because your TSH was low. they seem to think that's a problem, but the real problem is that the reference range is set too high! I still didn't feel all that well when my TSH was down to just under 3. They tend to panic if it goes below range, but when taking thyroxine it needs to be low or even under range.

TSH = Thyroid Stimulating Hormone, produced by your pituitary, not your thyroid. If you have enough thyroid hormones circulating in your blood you don't need TSH, so it isn't produced.

What symptoms do you have now?

[Karenlb64 in reply to Hidden]

Hi. Thanks for your post. I’m feeling just generally out of sorts. Tired, tingling fingers and numbness, brain fog, cold feet, anxiety. I’m on antidepressants at the moment as I just felt tearful pretty much for the whole of last year. They’ve helped with that but I can’t shift this anxiety feeling in my chest.

[SlowDragon Administrator in reply to Karenlb64]

Anxiety and depression are both typical hypothyroid symptoms

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

Low vitamin levels tend to lower TSH and raise FT4

Hence why it's so very important to test vitamin D, folate, ferritin and B12

Many, many of us with Hashimoto's need to test and supplement regularly vitamins to maintain at adequate levels

[Hidden in reply to Karenlb64]

tingling fingers may be more to do with needing supplements, but everything else sounds like hypothyroidism. Can't remember which one though - B12???

[anonymous45 in reply to SlowDragon]

Ah yes, I was mistaken, thanks for pointing it out

[radd]

Karenlb64,

You are under medicated as shown by a high in range TSH and low FT4 & FT3 result.

Thyroid antibodies are elevated. Although your C-reative protein is normal, ferritin is elevated possibly due to inflammation caused by elevated thyroid antibodies. Elevated ferritin due to inflammation does not rule out iron deficiency.

Vit B12 & Vit D requires supplementation. Folate needs repeating.

[cabro2]

I went gluten free seven weeks ago and feel remarkably better. Improvements in brain fog and fatigue are significant enough to keep me far away from gluten. It gets easier when you feel so much better. Join a group or find friends who are GF for support and ideas.