Advice please

[Angela]

Hi I had private blood test done tomorrow I have a Dr appointment because I had a 72 hour ECG monitor was diagnosed with atrial fibrillation about 2 months ago so I thought I’d have some tests done Thyroid Check UltraVit

22 Jan 2019

I note that you are taking this test to monitor a condition.

Your tsh is high indicating that your thyroid is underactive. If you are on medication then this may indicate that your dose is too low.

Your thyroid peroxidase antibodies are elevated. This antibody is commonly associated with autoimmune thyroid disease. It is frequently seen in conditions such as Hashimoto’s disease (where the thyroid becomes underactive) but confusingly can also be seen in Grave’s disease (where the thyroid becomes overactive). Are they saying I could have Hashimoto or Graves ? I am asking because I don’t think the Dr will have a clue (like me) I have also posted the results I would be very grateful for someone to help PLEASE ..

[greygoose]

I don't think you could possibly have Grave's with a TSH of over 10! You have Hashi's and you are hypo. And, they really should tailor their responses to fit the individual instead of these standard cut and paste replies that just get people worried! In general, it's not worth having the doctor's comments on these private tests, because they're not worth the paper they're written on.

Your TSH is too high and your Frees are too low. If you had Grave's, the TSH would be very low and your Frees well over-range. So, you definitely have Hashi's.

[Angela in reply to greygoose]

Thank you for your response I forgot to say I am on 100mg thyroxine your right they should be tailored for each individual

[greygoose in reply to Angela]

You're welcome.

[SeasideSusie Remembering]

Angela

With an over range TSH and extremely low FT4 and FT3, this is hypothyroidism - Hashimoto's.

There is no treatment for Hashi's, the subsequent hypothyroidism is treated. Your GP should prescribe levothyroxine. Due to the AF he may wish to start you on a low dose, 25mcg.

Point out to your GP your below range Folate result therefore Folate deficiency. He should prescribe folic acid.

Also point out your Vit D level, check the local guidelines as anything below 30nmol/L is Vit D deficiency and you should be prescribed loading doses of D3 totalling 300,000iu over a period of a few weeks.

Please come back and tell us what your GP is going to do.

You have omitted your Ferritin result. I expect that may be low too. Hashi's tends to cause low nutrient levels or deficiencies.

[Angela in reply to SeasideSusie]

Thank you for getting back I forgot to say I am on 100mg and now taking warfarin.my ferritin surprisingly is normal 42.9 ug/L..13.00-150.00 I will definitely let you know what he comes up with I am anxious of the out come ...

[SeasideSusie Remembering in reply to Angela]

So you are currently very undermedicated and need a dose increase. You need an immediate increase of 25mcg and repeat testing in 6-8 weeks, another increase if necessary followed by another retest 6 weeks later, etc.

As Hashi's causes fluctuations in test results and symptoms due to fluctuating antibody levels, dose adjustments may be necessary when swings from hypo to hyper and back to hypo again take place.

Are you addressing the Hashi's with a strict gluten free diet and supplementing with selenium l-selenomethionine 200mcg daily to help reduce the antibodies?

Your Ferritin is in range but it's too low. It needs to be at least 70 for thyroid hormone to work properly, recommended is half way through range. You can help raise your level by eating liver once a week , maximum 200g due to it's high Vit A content, liver pate, black pudding and other iron rich foods.

[overnighthearingloss]

Let me mention something that could be related to the a fib. My fella has been diagnosed with a fib in the past although it is now very much better. He is not a thyroid patient. He is now on rivaroxiban and a beta blocker. But what he thinks has helped is NOT keeping his mobile permantly in a shirt pocket over his heart. He also takes magnesium regularly.

He rarely feels the effects of it now.

[Angela in reply to overnighthearingloss]

Hi that’s interesting thank you.I am on warfarin will be seeing cardiologist on Tuesday

[SilverAvocado]

Angela, I'm sad to hear you're already taking thyroid replacement and still have these results. This is pretty extreme hypothyroid and under medication. As others have mentioned you need a dose increase ASAP, and then need to have another test in 6 weeks and another dose adjustment, and then a test 6 weeks after that, etc, etc. Everyone is different, but it's likely you'll need more than one increase to get your dose optimal.

At the moment your freeT4 and freeT3 are right on the floor, the rule of thumb with dosing is to get your freeT3 in the top third of the range. Unfortunately NHS tests will probably only test freeT4, or even only TSH. For freeT4 you want it high in the range, some people even need it slightly over range to feel well, and if you have to dose on TSH you want it to be close to 1 or below.

Of course vitamins are also important, they're needed to allow your body to use the hormone properly. Deficiencies will also cause symptoms in themselves.

Follow symptoms as well as blood tests. Are you feeling really crappy at the moment?

[Angela in reply to SilverAvocado]

I had my TSH done by the DR in October which was 1.04U/L which was normal barley 3 months later it changed even the DR couldn’t believe it,he gave me vitamin D 20,000 for a week and then 800 for 3 months and folic acid I came out of of there confused the ecg didn’t show barely any blips he said do I get stressed well yes unfortunately I do especially when my daughter and 2 grandchildren came to live with me so I asked if I still needed to take the warfarin he said yes I am soooo pleased I am seeing the cardiologist on Tuesday hopefully will get some straight answers silveradvocado I am exhausted dizzy and my concentration and being forgetful it’s not be great 😪 thank you for your reply

[SilverAvocado in reply to Angela]

Your TSH was 1 in October and has gone up to 10 in a recent test?

Straight away I'd suspect that is a mistake, as it's a very strange result. Mistakes can be made with these tests, as they get handled by a lot of people sent off to the lab, entered in computer, etc. All 3 of your results do match up in this result, but you might want to get a retest ASAP to see if it sheds anymore light.

Are you taking 20,000 per day, or 20,000 in total? If it's only 1 dose, 800 is very low and probably won't improve things. You can buy this over the counter, though, and take a few thousand per day. Make sure the Vit D gets retested in 6 months to a year to confirm your levels are raising - doctors tend to just prescribe and then never check up again.