Hello All. Further to my post a few days ago I have now received the results of the complete thyroid tests I had done here in Moscow just after I posted. As I wrote last time, my impression is that I have a B12 problem, which probably explains my symptoms of brain fog, balance, fatigue etc . Nevertheless I have been persuaded to rule other things out, and the thyroid seems a good place to start. The results below seem, on the face of things, to be quite normal. My B12 is off the scale due to injections over many months. I would be most grateful to hear the opinions of more knowledgeable people than I on this forum. Many thanks!
T3 free 4.0 pmol/l [2.6 - 5.7]
Т4 free 11.59 pmol/l [9.00 - 19.05]
TSH 0.828 m/l [0.4 - 4.0]
TG < 3.0 u/ml [<18.0]
TPO < 3.0 u/ml [< 5.6 ]
Vitamin D 37 n/ml
Ferritin 112 mcg/l [20 – 250]
Folate 40.1 ng/ml [3 – 17]
Magnesium 0.73 m/l [0.66 – 1.97]
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Frank77
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Do you have the range/ranges for Vitamin D result? Not sure if it's insufficient, in.which case you will need supplement. Have you seen your Doctor since these results?
Sorry. Here are the Vit D references they gave me:
<10 - very low; <20 - low; 20-30 - insufficient; 30-100 - adequate; >150 - possible toxic effect.
I should say that my Vit D was measured in September and it was 25 I think. So I have been supplementing since then. Now it is 37. I have not seen a doctor since receiving these results.
If so, I would have thought that your GP would have prescribed 800 IU colecalciferol (d3) x One daily as a daily maintenance dose.
Your Thyroid Antibody results above do not indicate Hashimoto's Autoimmune Thyroiditis. Have you had an Ultrasound scan of your Thyroid ?
Your TFTs (Thyroid Function Tests results ) are Euthyroid (ie within normal range). However, T4 is at the lower end of the range. So I assume you are not on any Thyroid replacement medication ??
Don't understand why your doctor stopped maintenance dose of Colecalciferol (D3) though.
You could consider including more foods containing Vitamin D - and also magnesium in your diet.
Hello Mary. Yes, I am frank77 - the name I use on both the PAS forum and on this thyroid forum.
No I have not had an ultrasound scan of my thyroid. Do you think I should?
I am not on any thyroid medication. If my T4 is low - what does this mean? I am afraid I am new to this thyroid business.
Why do you say my doctor "stopped maintenance doses of D3"? I never said anything about my doctor in previous posts. Possibly there is a confusion with someone else. But in general my GP in September did nothing about my low Vit D (25), though I decided to take daily Vit D supplements of 1000iu anyway. Now my Vit D level is 37. I will try to increase this dose. Also to increase my magnesium. Many thanks for your advice.
replied to me on your post - it was her reply that I replied to. If you look at the top - the arrow points to the name of the person replied to.
I've no idea why, but the notification of your reply has only just come through.
I think you might find it helpful if you read through the whole thread ! Seems it was accidentally sabotaged!
Ultrasound scan -
I only asked this as you have not tested positive for the Thyroid Antibodies blood tests you've had , the scan is the only remaining test that I'm aware of that might reveal/ eliminate Thyroiditis. But, not having relevant symptoms, doubt you would get it. Have you any throat issues?
I, personally, would not increase colecalciferol dose. In the UK, GP would prescribe for deficiency or insufficiency in a Vitamin D result.
Your T4 is not LOW and I did not say it was low - it is at the lower end of the normal range.
I am not medically qualified.
If you have symptoms - you need to keep going back to your GP until you are diagnosed. Keep pestering.
Ask for a referal to an Endocrinologist. Ask about other tests ( eg adrenal function, Pituitary hormones, liver function tests, full blood count - purely to eliminate any possibilities )
ASK why your TSH is low, whilst your T4 is at the lower end of the normal range.
Are you eating a healthy balanced diet, drinking plenty of water, taking regular gentle exercise .
Ask for Free's to be tested (FT3 &FT4) an Endocrinologist should do these, I would hope.
Many thanks Mary-intussuception. I have had liver and kidney function tests, and a full blood count. Nothing very interesting in any of these. Will consider this scan idea though I don't think I have any of the relevant symptoms, apart from a slight sore throat for the past couple of weeks. I put that down to the Moscow air... I don't drink enough water though diet is reasonable. Thanks again for your help.
FT4 is low and FT3 is just under half way through range indicating great conversion.
Vit D is low and requires supplementing.
Folate is “off the scale” which is probably good given that your Vit B12 is “off the scale” and they are frequently found in the same biochemical pathways.
High serum Vit B12 can also indicate a Vit B12 deficiency when there is enough Vit B12 in the body but the cells are not able to use it properly. In this instance they would export it back to the blood where is builds up bound to haptocorrin. After about a week, the haptocorrin-bound Vit B12 is imported by the liver and recycled via the bile to the gut. This is the salvage and recycle pathway for Vit B12 which cells in general are not able to use and only the liver can import. The other transporter of Vit B12 in the blood is transcobalamin, and this is the one that carries Vit B12 from the gut to the cells in general.
You mentioned in another forum, a few months ago, that you were intending to begin taking iodine supplements - did you? They are not generally advised as they are a thyroid disruptor, and until treatment for hyperthyroidism was developed, iodine was used in solution as a treatment for the control of excess thyroxine. I ask because your thyroid levels aren't good - your FT4 is not even midway in the range - although your FT3 is relatively good in comparison to that, so you seem to be converting well what little T4 you are producing.
Frank77 That's strange. I read this in a post with your name from 5 months ago:
Frank77 in reply to Sanders1
5 months ago
Thank you Sanders1. I have been looking at this bromine poisoning business - had never heard of it until now. I think I will try the iodine supplements suggested on several sites. You are right that this has nothing to do with B12 though. Petachiae are another matter: they do seem to be connected with vitamin deficiency, including B12.
So sorry: you are quite right. At this time I had severe brain fog - one of my recurring symptoms that is now considerably better after B12 injections. In short I have never taken iodine supplements and do not intend to do so for now. Thanks for your help.
You may not be intending to take iodine supplements, but I do think it would be a good idea to get your iodine tested, if you can. It is not usual for the FT3 to be higher in range than the FT4. And, when that does happen, it can be early stages of iodine deficiency. The thyroid starts making more T3 than T4 because it uses less iodine. So, a good thing to check.
However, if you get tested and find you level is low, do not start taking iodine supplements on your own. It needs to be over-seen by a specialist.
Are you still taking that PPI? Because if so, that will leave you with low nutrients all round.
OK, but don't stay on them long-term. If you are hypo, your stomach acid will be low, and PPIs will make that worse. I'm not sure about the stomach erosion, but the symptoms of high and low stomach acid are the same, and doctors don't seem capable of telling the difference. However, I'm pretty sure that H Pylori only affects people with low stomach acid, because high stomach acid would kill the virus that causes it.
When you stop the PPIs, make sure you get your nutrients tested immediately - not much point before - and supplement where necessary. We can help you with that. So, you need vit D, ferritin and iodine tested. I imagine you're already supplementing with B12 and folate, as you're on the PA forum.
In the above tests, your ferritin doesn't look too bad, but they didn't test your CRP. If that is high, then the ferritin result won't be reliable, because inflammation raises ferritin.
There's not much point in testing magnesium because of the way the body handles magnesium, making sure blood levels are always good, to the detriment of magnesium in the cells. Even so, yours is on the low side, so you should be supplementing that.
If you can, it would be a good idea to get zinc and copper tested, too.
And, keep on testing those antibodies. They fluctuate, so one negative test doesn't mean much.
All very interesting... I know about this problem of high v low stomach acid and mentioned it to the gastro doctor a couple of months ago just after the endoscopy. But she insisted that I had high acid, not low. She also knew about the h pylori as she gave me antibiotics for this. So she was perfectly aware that I had h pylori - and therefore probably low stomach acid - and yet prescribed me with PPIs. Now I don't know what to think. Hard for a non medical type like me to argue with a gastroenterologist. But I hate taking these PPIs and will definitely stop taking them in a couple of weeks, if not before. Actually I have had frequent diarrhea since starting them … So, if I understand you correctly I should have the following nutrient tests when I finish these PPIs: Vit D, ferritin, iodine; possibly zinc and copper? I already supplement with B12 and folate.
PPIs are horrible things. They completely messed up my digestive system and it's taking me ages to get back to anything like normal. But, doctors love prescribing them! They seem to think they're some sort of panacea for all ills!
Some people need PPIs. May I suggest you read Treepie's post.
He now has Barretts which is a pre-cancerous condition and other (hopefully) treatable conditions.
This damage occured because he stopped his PPI after reading about it on this forum.
He now regrets this.
" one size" doesn't fit all.
If people have a Hiatus hernia causing stomach acid Reflux causing GORD and in some cases Laryngopharyngeal Reflux - they need their PPI to protect the Oesophagus and Throat from damage from rising stomach acid.
It's not a case of 'high" or "low" acid but stomach acid getting into parts of the body it shouldn't be and cannot be tolerated.
Untreated rising stomach acid can cause cancer of Oesophagus and throat.
Anyone prescribed a PPI should insist on a Barium Swallow investigation
(and Laryngoscope or Nasendoscope if damage is to throat)
That does not stop them being horrible things. And, I have read Treepie's post, thank you very much! There are other ways of treating rising stomach acid. And, I wasn't talking to Treepie, I was talking to Frank77. As you said, 'one-size' does not fit all.
And I was only talking to one individual. And I wasn't talking about surgery. If you want to advise the OP, post your own comments, don't tack them on to mine.
I repeat, PPIs were never designed for long-term use. It can be just as dangerous to keep taking them. A doctor that leaves his patient on PPIs for years and years is negligent because, as I said, there are other ways of handling the situation. So, reserve your self-righteous anger for them. And, that is my last word on the subject.
I didn't reply out of self - righteous anger. Just stating facts that have been reported on forum or to me.
There is really no need to respond in that way.
Sorry you are so upset.
I notice that no one on here who advises to not take PPIs responded to Treepie 's post last month.
It's really up to people to check things out for themselves and discuss their concerns with their specialists before stopping cancer preventing medication.
HealthUnlocked does state that any advice on here does not replace your doctor's advice (or something like that) - I don't have the time to look it up.
Another poster, a while back, posted that she now suffers Vitamin D toxicity after upping her dose to daily 5000 IU long term - because that was "the advice" she read on here. Not everyone on here regularly monitors there conditions & nutrients levels with private tests.
Are you a qualified medical Specialist - this not being declared - I didn't know.
I think that the only thing I can add to that is that I did not have reflux or heartburn or anything like that. I still don't. So the decision by my gastro doctor to prescribe PPIs was based solely on the endoscopy results, which apparently showed 'erosion' or GERD which necessitated PPIs.
I came off PPIs almost as soon as being diagnosed with "Subclinical" hypothyroidism. Thankfully I only needed Omeprazole occasionally, maybe about twice a week. After starting on Levo my digestive problems improved anyway.
The leaflet that comes with the Levothyroxine tablets warns about possible interference with thyroxine if you take PPIs, or even antacids. I do occasionally take a Gaviscon tablet, but well away from the Levo.
greygoose , Mary-intussuception , don't PPIs stop working if you take them for years? And it seems likely that someone who already has long standing severe reflux might develop GERD anyway, with the associated risk of cancer, even if they continue to take PPIs.
Hope that helps. Would hate to see my friends on here falling out
Hello reallyfedup. Thanks for your advice. I have been looking on the internet to try to establish what the norms are for magnesium. Trouble is that the reference system used (mg/dl) is different to the one used by my Russian clinic ( mmol/l). According to them my result is within range (0.66 - 1.07) though possibly on the low side. Do you know how to convert this result to mg/dl?
Actually I have just found this on Wikipedia: "Normal magnesium levels are between 0.6-1.1 mmol/L (1.46–2.68 mg/dL) with levels less than 0.6 mmol/L (1.46 mg/dL) defining hypomagnesemia" So, my level of 0.73 mmol/l is presumably within range?
Yes, but that doesn't mean you're not deficient, as I was trying to explain above. Most people are deficient because soils are depleted. Excess magnesium is excreted, so best to take some to be on the safe-side.
Also the range is so small and levels in the blood are cleverly maintained by the body. When magnesium levels drop in the blood then it is drawn out from bones. Which is another good reason to take Magnesium.
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