Help interpreting results

[Padders12]

Hi,

I am visiting from the B12 site and have had B12 deficiency for many years (although undiagnosed for most of that). I am much better now I am on injections but am nowhere near how I used to be. Someone suggested I have my thyroid tested so I did a medichecks test. Although I am in range for them all, there are a couple that a low. I know that the B12 range in the UK is considered low elsewhere and am not sure if it is the same with thyroid tests. Can I ask that someone have a look and give me their opinion? I would be very grateful x

Having a mare trying to upload photo so going to type results!

FT3/rT3 - Range 15-75 - result 18.92

TSH - Range 0.27 - 4.2 - Result 2.95

Free T3 - Range 3.1 -6.8 - Result 4.94

Free thyroxine - Range 12 -22 -Result 13.9

Reverse T3 -Range 10-24 - Result 17

[greygoose]

The problem with thyroid tests and ranges in the UK, is the TSH. Doctors only know how to diagnose by TSH - which is totally wrong, of course - but not only that. The top of the range is often very high, but then they go on to ignore it and say that the TSH needs to reach 10 before treatment is needed! It blatantly obvious that this is rubbish, but this is what they have been advised to do, and most of them stick to that advice as if it were a cast iron rule. It's sadistic and it's wrong, but that's the NHS.

In the real world, you are hypo when your TSH gets to 3, and in many countries, you would be started on thyroid hormone replacement at that level. Your TSH is just under 3, so your thyroid is struggling mightily to produce enough thyroid hormone to keep you alive, and it wouldn't be surprising if you had symptoms at that level, although not everybody does. We're all different. But, it's obvious that you need to keep an eye on things to see how they evolve.

Having said that, your FT3 isn't too bad at the moment - it's low T3 that causes symptoms. But, your FT4 is low, so conversion of T4 to T3 is obviously being driven hard by the extra TSH. The question is, how long can that situation last? Eventually, your failing thyroid will no-longer be able to make enough T4 to convert, your TSH will rise and you will become overtly hypo.

Your antibodies are low enough to think that you don't have an autoimmune problem, but who knows. Do you have Pernicious Anemia?

I see you got your rT3 tested. In future, I wouldn't bother with that, if I were you. It's expensive, and doesn't give you much in the way of additional information. It would be more helpful to get iron/ferritin and vit D tested.

[Padders12 in reply to greygoose]

Thank you greygoose for your reply. I have been tested for pernicious anaemia but had a negative result. We all know the test is unreliable though. I am having to inject twice weekly at present. I only had my rt3 tested as it was part of the test I bought. My iron has been tested and is fine. My vit d and folate were both lowish and I am supplementing.

The results I included were tested last June ‘18 and I thought they were ok until having a look earlier and medichecks have changed their site to show the results differently.

My GP tested my T4 and TSH in Sept ‘17 and the results were T4 range 7.70 -15.10 result 11.4 and TSH range 0.34-5.60 result 3.23

Do you think it’s worth getting tested again now to see if they have changed. And should I ask the gp who only checks T4 and TSH or do a self test like I did before?

I do have some symptoms but don’t know if they are just caused by my B12 issues or if there is something else going on. Thanks.

[greygoose in reply to Padders12]

Symptoms of low B12 and low thyroid hormone are very similar, so that does make it more difficult. Which is where blood tests come in, to guide us. If your TSH was over 3 in 2017, you were hypo at that point. But, were the tests in 2017 and in 2018 done in the same way - early morning and fasting?

Also, if those results were a year ago, a lot can change in a year, so yes, I would think it would be a good idea to do a private retest, rather than the incomplete NHS testing, because the FT3 is the most important number - although they do all need to be considered as a whole and not individually. And, it really would be a good idea to get the vit d tested.

[Padders12 in reply to greygoose]

Thank you. I can’t remember if they were both fasting or not. I will get another test done and no doubt will be back again to ask for help with results 👍

[Padders12 in reply to greygoose]

Will the medichecks £39 test for TSH, FT4 & FT3 test be good enough? I have already ordered vit d test along with folate, magnesium and zinc (nutrition check).

[greygoose in reply to Padders12]

It would be better to test for antibodies again. You cannot rule out Hashi's on the basis of one negative result. But, that doesn't have to be done immediately. Just remember it for some time in the Future. For now, the Fab Three would be enough to give you a clue where you're going with this.

[Padders12 in reply to greygoose]

Great, will get on it!