Obtained my results as advised by the community, after being advised by GP to go for repeat test in 4-6 weeks as borderline thyroid issue...

[DizzLizzie]

Hi

Just done the repeat blood test for thyroid and as I asked why my B12 was so high they are retesting B12 in case of a mistake in the lab. (I was expecting a low B12, as my sister has B12 injections, she is hypothyroid, Hashimotos and has MS. Mum and auntie also the hypothyroid condition. I don't take any vitamins or supplements so strange B12 result...)

Did like you guys recommend- had the blood test early - at 8.40am and didn't do breakfast first. Last time the test was after 4pm.

Currently, I take omeprazole for GERD, hiatus hernia, indigestion etc, atenolol betablockers for the horrendous migraines I used to get. (BB stopped them!)

However, over the last couple of months suffering with sore headache when I wake, lasts most of the day (on and off) and have a constant low pitch hissing in ears, red sore tongue, very dry skin on hand and feet, constant fatigue, sleepy during the day especially during and after eating. I put the forgetfulness, fatigue and aching and sore hip and knee down to menopause and old age as advised by my GPs for the last 6 years. I have 58, and carrying lots of weight around my waist, up and below, but still skinny on bottom and thighs!

Look forward to your comments...….

Test results 6th December 2018 (will get retest results next week)

Thyroid function test Report, Borderline, Need to repeat test

Serum free T4 level 14 pmol/L [11 - 22]

Thyroid function test

Serum TSH level 6.5 miu/L [0.27 - 4.2]result

Serum vitamin B12 level Report, Satisfactory, No Further Action (Patient Informed)

Serum vitamin B12 level 1,044 ng/L [197 - 771]

Test result

Urea and electrolytes;Liver function tests;Serum C reactive protein level;Serum cholesterol level;Serum HDL cholesterol level;Cholest./HDL ratio;Serum ferritin level Report, Borderline, Need to speak to doctor, Other (high cholesterol)

Urea and electrolytes

Serum C reactive protein level < 5 mg/L [0 - 5]

Serum cholesterol level 7.7 mmol/L

Serum alanine aminotransferase level 19 iu/L [0 - 34]

Serum total bilirubin level 4 umol/L [< 21]

Serum HDL cholesterol level 1.2 mmol/L [> 1.1]

Serum ferritin level 56 ng/ml [30 - 150]

Serum cholesterol/HDL ratio 6.4 mmol/mmol

Serum non high density lipoprotein cholesterol level 6.5 mmol/L

Serum urea level 7 mmol/L [2.5 - 7.8]

Serum creatinine level 71 umol/L [45 - 84]

Serum sodium level 142 mmol/L [133 - 146]

Serum potassium level 4.6 mmol/L [3.5 - 5.3]

GFR calculated abbreviated MDRD 73 mL/min/1.73m*2

Serum albumin level 45 g/L [35 - 50]

Serum alkaline phosphatase level 84 iu/L [30 - 130]

Liver function tests

Serum total protein level 73 g/L [60 - 80]

Serum folate level Report, Normal, No Further Action

Serum folate level 5.2 ng/ml [> 3.9]

Test result

Haemoglobin A1c level - IFCC standardised Report, Normal, No Further Action

Haemoglobin A1c level - IFCC standardised 37 mmol/mol [20 - 41]

Full blood count Report, Normal, No Further Action

Mean cell haemoglobin level 27.7 pg [27 - 32]

Total white blood count 5.9 10^9/L [4 - 11]

Haematocrit 0.38 [0.36 - 0.47]

Mean cell volume 84 fL [79 - 101]

Neutrophil count 2.9 10^9/L [2 - 8]

Eosinophil count - observation 0 10^9/L [0.1 - 0.7]

Basophil count 0 10^9/L [0 - 0.2]

Lymphocyte count 2.6 10^9/L [0.5 - 4.5]

Monocyte count - observation 0.5 10^9/L [0.2 - 1.2]

Platelet count - observation 328 10^9/L [150 - 450]

Red blood cell count 4.51 10^12/L [3.9 - 5.4]

Full blood count

Haemoglobin concentration 12.5 g/dL [11.5 - 16.5]

[Peanut31]

Hi

The more experienced members may be able to comment more on your B12, as you say your not supplementing?, but, your TSH results are not normal at 6.5, and you have said the GP states it borderline.

I see that you are waiting for your December 18 thyroid test results to come in.

I also see that your GP has not tested T3 either, it essential that when testing thyroid that TSH, T4 & T3 are tested. T3 is so important as its an active hormone, it regulates so much, but, GP's are only concerned with TSH results.

Everything you have mentioned symptom wise relates to thyroid, unfortunately, you may struggle with your GP to be put on levothyroxine as until your TSH reaches 10 or above then normally the NHS will not step in. Some GP's will step in before this, if, they are sympathetic.

You have a few options:

1: Wait for your thyroid December test results and hopefully your TSH results may of gone up even if they don't reach 10, I would tell the GP that you want to start Levo.

Make sure you get 50mcg not 25mcg as a starter dosage, you take this for 6 weeks then have another blood test, testing TSH, T3 & T4, don't take your levo the morning of your bloods, don't eat and only drink water. Book the bloods for as early in the morning as possible, after 6 weeks you increase you levo by 25mcg and repeat the process until your TSH is 1 or below and your T3 & T4 are in the higher figures of the ranges, but, most importantly you feel well.

I can't recall if you mentioned what time you have your December thyroid bloods taken. You need to make sure all thyroid blood testing is done as early as possible in the morning before 9am. Why? well we pass this tip onto people here and we ask that this is not mentioned to the nurse/GP/Endo as this will help YOU out.

Your TSH is always higher in the morning, the earlier the better. This helps patients obtain either an increase in levo due to that result, or, to start on thyroid medication.

2: If your GP will not help now, then you have to wait for your TSH to increase to 10, this can be a living hell as you will get worse waiting for this to happen, mine took about 8 months to reach over 10, but, at the time I was like you results were about 6 and the private endo said no medication would help. It was only when I started researching I learnt about the NHS guideline and the issues use thyroid suffers face. If you have hashimoto's like some of your family members you TSH will fluctuate.

3: self medicate on NDT, you will then be in control of your own health, you will need to pay for blood tests and of course your meds, but you are in control. We are sometime left with no option but, to do this.

I now self medicate as I just couldn't get on with levo.

Best Wishes

Peanut31

[DizzLizzie in reply to Peanut31]

Thank you- I should get this mornings Thyroid result early next week so will post. Last results from December were T-SH 6.6 were done at 4.15pm.

Maybe GPS don’t want to start you on Thyroid meds’ due to the patient then able to have free prescriptions for any medication they are on now and In the future .....

Thanks again

[Peanut31 in reply to DizzLizzie]

Hi

Well if your TSH results were 6.6 at 4.15pm, then it could possibly be that had you had them early in the morning they would of hit 10, everyone is different. Fingers crossed for the next lot of results.

I see that seasideSusie has given you some very useful information and I have to say that this forum has really helped me improve my quality of living. I have given up listening to GP's and endo's.

I am still not 100%, but, as I have said I have started self medicating, so increases need to be carried out slowly.

Best Wishes & Good luck

Peanut31

[SeasideSusie Remembering]

DizzLizzie

TSH: 6.5 miu/L [0.27 - 4.2]

free T4: 14 pmol/L [11 - 22]

You currently have what is classed as "subclinical hypothyroidism" which is where the TSH is between 4 and 10 with a normal FT4. Your GP is waiting until your TSH reaches 10 (current guidelines) to give a diagnosis of primary hypothyroidism. Many other countries diagnose hypothyroidism when TSH reaches 3. However, there are some GPs who will start Levo when TSH is over range but hasn't reached 10.

NICE Clinical Knowledge Summary - Subclinical Hypothyroidism

cks.nice.org.uk/hypothyroid...

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.

◾In older people (especially those aged over 80 years), follow a 'watch and wait' strategy, generally avoiding hormonal treatment. If a decision is made to treat, prescribe LT4 and recheck TSH two months after starting and adjust the dose accordingly.

◾In asymptomatic people, observe and repeat thyroid function tests (TFTs) in 6 months.

If you have thyroid antibodies tested and they are raised, this would confirm autoimmune thyroid disease (aka Hashimoto's) and some doctors will start Levo when antibodies are present.

Serum folate level 5.2 ng/ml [> 3.9]

Although this above the low limit and classed as normal, it's still quite low.

Serum vitamin B12 level 1,044 ng/L [197 - 771]

I would personally get an Active B12 test done. Serum B12 test shows what's in the blood, the Active B12 test shows what is taken up from the blood into the cells. I've just sent for an Active B12 test from Medichecks to check mine (I've only had serum B12 done before), it costs £39 but with code THYROIDUK giving 10% discount I have paid £35.10

Serum ferritin level 56 ng/ml [30 - 150]

For thyroid hormone to work (that's our own as well as replacement hormone) it's said that ferritin needs to be at least 70, preferably half way through range. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

You need Vit D testing, and I would test thyroid antibodies - Thyroid Peroxidase and Thyroglobulin.

[DizzLizzie in reply to SeasideSusie]

Thank you Susie for your helpful information, hopefully the test will either prove yeah or nay for hypo and that the GP may investigate other reasons for the fatigue, weight and pain if I am not hypo.

High Vitamin B12 maybe a clue or just a lab error..

Will up my iron via the diet as per your recommendation, and get a Vitamin D test done.

Thanks again

[SeasideSusie Remembering in reply to DizzLizzie]

DizzLizzie

hopefully the test will either prove yeah or nay for hypo and that the GP may investigate other reasons for the fatigue, weight and pain if I am not hypo.

You are already hypothyroid with a TSH of 6.5, as I said in another country you would have a diagnosis when your TSH hit 3, it's just that our doctors are extremely cruel and make us wait until it reaches 10. This is why it's extremely important to get the highest possible TSH when testing, and you can achieve that by booking the very first appointment of the morning (no later than 9am, refuse any appointment that is later than that), fast overnight (water allowed), this means have your evening meal/supper the night before then delay breakfast until after the blood draw, drink only water, no coffee, tea, etc, before the test.

[HMBradley53 in reply to SeasideSusie]

I have a question for you Im from the US do you happen too know how high your TSH has too be before thdy will medicate ? No inr has ever told me.

[DizzLizzie in reply to HMBradley53]

Hi

The forum has advised that the T-S H has to be 10 before they medicate in England. Mine is 6.5 which is above the 4.2 normal range.

If you read my posts you will see the advice given about having your blood test around 8 a 8.30 when your T-S H is at it highest, and skip breakfast and drinks other than water before the test - this gives a true reading.

Post your results and GP comments

[fruitbuns in reply to DizzLizzie]

I take my levo at night before bed 11: pm on empty stomach. Would morning still be good for test?

[SeasideSusie Remembering in reply to HMBradley53]

I have a question for you Im from the US do you happen too know how high your TSH has too be before thdy will medicate ?

In the UK it's 10, I thought the US was much lower, around 3, but not completely sure.

[humanbean]

If you don't supplement vitamin B12 and yet still have a high serum result, then this link may be of interest. Sorry, it's hard going :

researchgate.net/publicatio...

You can download the full text in a PDF file, which you might find a bit more convenient.

[DizzLizzie in reply to humanbean]

Thanks hi I have been reading up on it.

Thanks- at least I know I can chase up the go if my level of B12 doesn’t go down.

Happy New Yeat

[HMBradley53 in reply to DizzLizzie]

My b12 was 1100 my Dr said no bi deal beacause you pee it out no worrirs. Too me its all bull. Im going for repeat liver function tests today because mine were high but I have read that liver functions will elevate when you have thyroid issues which I found interesting.

[DizzLizzie in reply to HMBradley53]

Hi

Yes do so and even if the liver function comes back ok the GP should be looking into why it is so high, apparently it can be a warning of some other health condition and shouldn’t be ignored.

Basically if you wee any excess out of your body your blood shouldn’t be carrying it so further investigation is required.

I am awaiting the result of a repeat test in case it was a lab mistake.

As I am suffering from symptoms of Vit B12 deficiency eg sore tongue, morning headaches, tingling across the nose near the eyes, painful knee, hip and feet as well as major fatigue., wondering if my body can’t absorb it properly - is that why I am carry lots in the blood?? Will post my results and GPS diagnose next week.

[Saya85 in reply to humanbean]

I was going to add the same thing.

Without worrying you Lizzie very high b12 can be consistent with malignancy of kidney/liver disease.

My father in law had renal cancer and b12 was very elevated - labs suggested consistent with malignancy although he had had a b12 injection a couple months prior to this.

If your kidney and liver function are normal then I hope it's just a blip. If it's repeated then please do investigate further x

[HMBradley53 in reply to Saya85]

This us what worries me ascwe are both in the same boat. Im getting retested today so hopefully we both come back ok on the second round

[Kitten44]

Hi I too had high b12 without oversupplementing. It has steadily gone down as my Levo dose has increased, so I assume it may be related to lack or under treatment.

[DizzLizzie in reply to Kitten44]

Thanks kitten that could be the answer!