Blood tests - do I need TGAb and TPOAb checking? - Thyroid UK

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Blood tests - do I need TGAb and TPOAb checking?

Keto4Me profile image
21 Replies

Hi there!

I went to the Dr today and asked if I could have the following checked: TSH; FT4; FT3; TGAb; TPOAb; Vit B12 (active); Folate; Vit D; Ferritin; CRP-hs. He was agreeable to all of them except for the TGAb and TPOAb. He said those two aren't necessary as I have already been diagnosed with an underactive thyroid. Is that your understanding too?

Also the B12 blood test he has requested hasn't been marked as "active". Does that make a difference?

He has asked them to test for other things as well like autoimmune conditions, cholesterol, diabetes etc.

My main concern is that the antibodies have been missed off the test and I wondered if they were absolutely necessary.

Thanks as ever for your answers and wisdom.

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21 Replies
SlowDragon profile image
SlowDragonAdministrator

NHS doesn't offer Active B12 test. The standard one is fine

Antibodies......perhaps these were tested when originally diagnosed with hypothyroidism. If so NHS refuses to retest

Do you have access to your medical record and blood test results online? If so look back and see if these were ever tested.

If never been tested then you can get just antibodies tested privately.....but suggest you wait until GP tests come back. NHS lab rarely tests FT3 even if GP requests. So you may need to consider ordering more than just testing antibodies privately

Keto4Me profile image
Keto4Me in reply to SlowDragon

Thanks SlowDragon. Is T3 test the same as FT3 test?

SlowDragon profile image
SlowDragonAdministrator in reply to Keto4Me

FT3 - is free T3 - that's what you want tested

T3 - can mean total T3 though that may be written as TT3 - rarely tested and not especially relevant

Keto4Me profile image
Keto4Me in reply to SlowDragon

Thanks again. So it doesn't look like he's asked for FT4 or FT3 just TSH, T4 and T3 so I may as well treat myself to the Medicheck Thyroid Check Plus, which does TSH, TF4, TF3 and antibodies as I can see it being a battle asking them to look up a blood test from the 90s.

SlowDragon profile image
SlowDragonAdministrator in reply to Keto4Me

T4 and T3 test on blood form will likely mean FT4 and FT3 (though lab may not test if TSH is within range)

Suggest you wait to order until a Thursday to order from Medichecks

Thyroid Thursdays at Medichecks often has money off offer on

SlowDragon profile image
SlowDragonAdministrator

18 days ago you put these vitamin results up

healthunlocked.com/thyroidu...

When were these vitamin tests done?

They are all pretty low and need significant work to improve before retesting

No point retesting until at least 2-3 months on good levels of supplements

As outlined by SeasideSusie your vitamin D, folate and B12 were all low and ferritin borderline

What was reason for partial thyroidectomy ?

Keto4Me profile image
Keto4Me in reply to SlowDragon

sorry, didn't see this...back in 2016. Partial thyroidectomy was because of a goitre with cysts pressing on my windpipe. So they removed some of my thyroid but then took too much. PT was done late 90s.

SlowDragon profile image
SlowDragonAdministrator in reply to Keto4Me

Assuming your vitamin testing was fairy recent ......

I think it would be better to work on improving vitamins for couple of months before using medichecks test .....

At the moment there's little point retesting vitamins....you know they are low

What vitamin supplements are you now taking

You can order Medichecks test a few weeks ahead of when you want to use it

Keto4Me profile image
Keto4Me in reply to SlowDragon

I don't take any vitamin supplements as yet. Open to suggestions though.

SlowDragon profile image
SlowDragonAdministrator in reply to Keto4Me

SeasideSusie replied on previous post in depth 18 days ago

Vitamin D - she recommended 4000iu daily.

Vitamin D is low. GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve vitamin D by self supplementing to at least 80nmol and around 100nmol may be better .


Vitamin D council recommend level 100nmol- 150nmol

Once you Improve level, you may need on going maintenance dose to keep it there.

Government recommends everyone supplement vitamin D between October and April 


Retesting twice yearly via vitamindtest.org.uk

Personally as I have Hashimoto's I use vitamin D mouth spray by Better You as it avoids poor gut function

Only add one supplement at a time and wait at least ten days to assess any reaction before adding another

Read up about magnesium and vitamin K2 Mk7 when supplementing vitamin D

betterbones.com/bone-nutrit...

articles.mercola.com/sites/...

healthy-holistic-living.com...

sciencedaily.com/releases/2...

articles.mercola.com/sites/...

betterbones.com/bone-nutrit...

This article explains should discuss with specialists before taking any vitamin K if you take any blood thinning medication

drsinatra.com/vitamin-k2-su...

Vitamin D research and Hashimoto's

healthunlocked.com/thyroidu...

easy-immune-health.com/magn...

Don't start any B vitamins or folate supplements until GP has tested for Pernicious Anaemia because of low B12.

B12 deficiency symptoms

b12deficiency.info/signs-an...

Low ferritin

Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption

FERRITIN and hypothyroidism

healthunlocked.com/thyroidu...

drhedberg.com/ferritin-hypo...

restartmed.com/hypothyroidi...

Keto4Me profile image
Keto4Me in reply to SlowDragon

Thank you. I did save SeasideSusie's post and was very grateful to her but have not had chance/felt up to working through it all yet. Thanks again to you and Susie. I hope I have not come across as ungrateful. It must be infuriating when you see the same posts and even previous answers ignored/forgotten. Looking forward to getting rid of the brain fog :)

SlowDragon profile image
SlowDragonAdministrator in reply to Keto4Me

Suggest you get some vitamin D mouth spray as first step - perhaps get 1000iu spray and do four sprays per day

Look at improving iron rich foods in diet

2 weeks after starting vitamin D add daily vitamin C

2 weeks later look at adding some magnesium

Don't start any B vitamins until fully tested by GP

If GP won't prescribe B12 injections

then look at adding a daily good quality vitamin B complex, and one with folate in not folic acid may be more beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).

Or Jarrow B-right is popular choice, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Other supplements that can help

Selenium

Zinc

Keto4Me profile image
Keto4Me in reply to SlowDragon

Thanks SlowDragon.

Keto4Me profile image
Keto4Me in reply to SlowDragon

So I got my new results in. Everything but Vit D seems to be in range...

Serum folate level 4.3 ug/L [3.0 - 20.0]

Serum vitamin B12 level 309 ng/L [180.0 - 640.0]

Serum ferritin level 60 ug/L [15.0 - 200.0]

Serum vitamin D level 29.4 nmol/L [71.0 - 200.0]

TSH 1.68 mIU/L (this is from Medicheck)

TSH level 0.88 mu/L [0.35 - 4.94] this is from Dr both done on the same day with about a 2 hour difference in between, fasted, no medicine.

Free thyroxine 16 pmol/L

Free T3 4.46 pmol/L

TGAb <10 kU/L

TPOAb 15.9 kIU/L

Looks like my Dr was right all along about my thyroid and it's just the way I am. I shall start the Vit D spray today and gradually adding the other supplements that SeasideSusie kindly suggested.

Is it still worth me experimenting with NDT, do you think? Any thoughts please?

SlowDragon profile image
SlowDragonAdministrator in reply to Keto4Me

What's the range on FT4?

Your antibodies appear to be within range

Vitamin D is very low. This needs improving to at least 80nmol and around 100nmol may be better

Starting on vitamin D supplement at perhaps 2000iu or 3000iu daily and retest in 2-3 months

Low B vitamins common when vitamin D is low

Explains why here

drgominak.com/sleep/vitamin...

B12 and folate on the low side.

Folate needs improving to at least be over 10

B12 at least over 500

Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).

Or Jarrow B-right is popular choice, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Ferritin is not bad. Might be better a little higher

Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption

Selenium supplements can help improve conversion of FT4 to FT3

Daily vitamin C helps support immune system and may help improve iron absorption too

Suggest you retest FULL Thyroid and vitamins in 2-4 months once worked on improving vitamins levels

Your vitamins are likely low because of being hypothyroid.

How much Levothyroxine are you currently taking?

Improving vitamins may increase TSH and show that you need more Levothyroxine

Many of us need FT4 near top of range (or over range) in order to get high enough FT3

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is still within range "

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please

email Dionne at

tukadmin@thyroiduk.org

NHS postal kit for just vitamin D if not get full testing

vitamindtest.org.uk

Keto4Me profile image
Keto4Me in reply to SlowDragon

Thanks again for your time SlowDragon. The FT4 range is 12 - 22.

I like black pudding and pate so that's a plus. I am going to get the vit D + K2 spray today and look for some I-methyfolate and sublingual B12.

I take 150 mcg of levothyroxine a day.

SlowDragon profile image
SlowDragonAdministrator in reply to Keto4Me

So if FT4 range is 12-22 and your result is 16 your FT4 is under half way in range

You could push for small dose increase 150/175 alternate days

Personally I need FT4 up around 19-21

Keto4Me profile image
Keto4Me in reply to SlowDragon

Thanks SD. Do you feel that I may benefit from NDT, or not for you to say?

SlowDragon profile image
SlowDragonAdministrator in reply to Keto4Me

Everyone is different

Majority manage fine on high enough dose of Levothyroxine. Make sure it's same brand. Obviously the easiest option

Some of us eventually need addition of small dose of T3 either as Liothyronine or addition of NDT

Extremely difficult to get either prescribed in UK. T3 slightly easier, but high cost charged for T3 by pharmaceutical companies in UK (not rest of world) means extremely difficult, but not impossible, to get NHS prescription

NDT - loads of different makes. Takes a lot of experimentation to find which works best. Very difficult to get prescribed.

Keto4Me profile image
Keto4Me in reply to SlowDragon

I wasn't even going to try and persuade the doctor, just purchase it myself. Not sure whether to start with Lio or NDT though.

Keto4Me profile image
Keto4Me

Thanks JaneyJaney. These are last week's results TGAb <10 kU/L

and

TPOAb 15.9 kIU/L.

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