Awaiting thyroid scan for nodules etc...

But recently got some blood results back...most ok, but a bit 'concerned':

Haemoglobin 173 g/l (range 120-160g/l)

Red Blood Count 5.46 10*12L (range 4.20 - 5.4010*12L)

Haematocrit 0.5 L/L (range 0.34 - 0.47 L/L)

Calcium adjusted level 2.15 mmol/L (2.18 - 2.62 mmol/L)

Serum alkaline phosphatase 150 u/L (30 - 130 u/L)

Serum folate 3.4 ug/L (3.90 - 26.80 u/L)

Been given 4 months prescription for folic acid but looking at Medichecks results for last July (6.2 u/L folate at the time)...TSH was 2.11...now 0.67....no change in meds 50/75 levothyroxine alternate days..I know only 'slightly out' but we keep being told we know our body best..and I do not (and haven't felt 'right' in a long time)...any advice...what to ask the doctor next time I see them? What to push on?

Update: Thanks for all your replies now referred to ENT after ultrasound referral returned to the doctors for ENT referral! Being sent for PTH blood tests for parathyroid...vid d came back borderline deficiency so as low calcium as well put on combined meds for that along with folic acid meds. Fingers crossed xx

[SlowDragon Administrator]

You need B12, vitamin D and ferritin tested too

Calcium is below range. Likely vitamin D is low. Calcium levels naturally rise as vitamin D improves

What supplements do you take?

Obviously folate is below range and needs improving. B12 MUST be tested

As you have Hashimoto's are you on strictly gluten free diet?

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels. Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

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

Ideally ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first




Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

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

thyroidpharmacist.com/artic...

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

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

[Hidden in reply to SlowDragon]

Hi, thanks for your reply. Really helpful I'm not GF but I don't eat a great deal that contains it (well the obvious stuff) but it's hidden in all sorts isn't it! Lot's to think about and get checked....it's like a mine field of info to take on and try to understand. Really grateful for this site....Been very helpful

[Nanaedake]

Ask the doc about your calcium level. It's in range but very low in range. Is your vitamin D level sufficient?

[Mary-intussuception in reply to Nanaedake]

Calcium is below range

[Nanaedake in reply to Mary-intussuception]

So it is, thanks.

[Hidden in reply to Nanaedake]

Thanks Just waiting on vitamin d results...Doctor didn't say anything about my other results? I wonder if that's because I'm waiting for a scan?

[Mary-intussuception in reply to Hidden]

I've read that Vitamin D supplements is the treatment for Hypoparathyroidism, but if you have Vitamin D deficiency or insufficiency your GP should presribe Vitamin D anyway.

[Mary-intussuception]

If you haven't had PTH tested and haven't had Kidney blood tests then I would ask for them now. If your PTH is low, then you may want to look up the symptoms of Hypoparathyroidism. I'm surprised your GP hasn't tested Parathyroid Hormone yet. Are you waiting to see an Endocrinologist?

Google "Hypoparathyroidism NHS "

You mention a scan - are you having an Ultrasound scan of your Thyroid & Parathyroids or just Thyroid?

Google search - " low calcium and high phosphatase ". But try not to jump to any conclusions. You need PTH tested. Also Kidney blood tests.

Google 'high haemoglobin ' and "high red cell count". Ask your GP about these raised results and slightly raised haematocrit.

Could you be dehydrated? Do you drink plenty of water, eat any fresh fruit & enough vegetables?

Also - as you haven't had Vitamin B12 tested yet you may want to delay taking the Folic Acid. Ask about B12 test and testing for Pernicious Anemia.

Politely insist on Vitamin D test too.

[Hidden in reply to Mary-intussuception]

Thanks Mary Some of the blood tests were for kidney and liver and came back ok (apparently) but I'll check with doctors and get them to explain further. Doctor mentioned about possibly being dehydrated but I always make sure I drink plenty of water...probably more than I need to, so not sure. Thanks again x

[Mary-intussuception]

How old are these blood tests results? Always give full information including dates of tests.

What's being done about all the abnormal results? Are you being retested?

I would have thought PTH test could be requested because your Calcium is LOW (2.15).

[Hidden in reply to Mary-intussuception]

Doctor didn't mention anything about my results other than being given folic acid for 4 months. Waiting on vitamin d levels...tests on done about 2 weeks ago. Apparently the ultrasound scan referral has been returned to the doctors for them to do another referral to ENT. I'm going to get another appointment with doctors and mention this...some of the FBC results where out of range too (high)...haven't got them to hand though so will post later x

[Mary-intussuception in reply to Hidden]

ENT for Parathyroid Gland investigations . . .

As it happens, that's how I got back to the Endocrinologist - via ENT following urgent appointment for throat closing up. I asked ENT to refer me on due to my concern that Thyroid problem was contributing to throat narrowing. Am now having annual scans of Thyroid & Parathyroids.

[Hidden in reply to Mary-intussuception]

Hopefully I'll get ENT appointment soon. Need to check with doctors. I'm not under an endocrinologist yet but thanks to all the info you and others have given, I'll be pushing for that

[Hidden]

ENT next week...Thank God...as I've also just noticed an indentation/pitting in my upper arm...near the armpit. Hope it's nothing nasty fingers crossed