Help with interpreting test results

[Sharoosz]

Help! I have test results that don't make much sense to me b/c the tests given in UK and Poland have different names and ranges (as do some tests I had privately in UK as compared to NHS.) TSH is standard so that is not a problem in interpreting. In which tests is it better to be at low end of range and which at high end?

From Poland (2016): FT3 2.33 (range 2.00-4.40) (bottom end of range) (Is is not better to be at top of range?)(Range narrower than UK tests

FT4 1.72 (range 0.93-1.70), (very narrow range compared to UK)

TSH 1.58 (range 0.27-4.20)

The only other test I had there was Anti-TPO - 9.2 (range <34.0)(previous test was 5.0)

Medichecks (2018): Free Thyroxine 13.2 (range 12.0-22.0)

Total Thyroxine (T4) 73.8 (range 59.0-154.0)

Free T3 3.3 (range 3.10-6.80)

TG Antibodies <10 (range 0.0-115.0)

Thyroid Peroxidase Antibodies 9.01 (range 0.0-34.0)

B12 103.0 (range 25.10-165.00)

Folate (serum) 11.44 (range 2.91-50.0)

CRP - High Sensitivity 2.39 (range 0.00-5.00

Ferritin 72.8 (range 13.00-150.00) (82.0 in 2012)(Serum ferritin NHS - March2019 -121.0 (range 14.0-186.0)

NHS: 2018 Serum free T3 5.7 (range 0.0-7.0), 2019: 4.5 (Is a drop good or bad?)

Serum free T4 25.9 (range 11.5-22.7), 2019: 21.0 (Is a drop good or bad?)

Serum troponin T level: < 5 (range 0.0-14.0) (Never had this one before - meaning?)

Current TSH 1.16 (up from .92 in March)

TP antibodies: <25.0 (range 0.0-33.90) This is quite a lot higher than last check.

B12 - 469 (range 223-1132) (why is range so different from Medichecks above? How to compare?)

Vit D - 75 (range 50-125)

My questions and comments are in italics. Thank you in advance for help in understanding this!

[greygoose]

I probably won't be able to answer all your questions, but I'll have ago.

First of all, it doesn't matter what the range is, what is important is where your result falls in that range. So, if you work out the percentage through the range, you can compare the results - but don't count on me to calculate the percentages, because I'm useless at maths! lol

So, the TSH needs to be around 1 or under, whatever the range - a TSH is always a TSH, as you say. But, TSH varies throughout the day - highest early in the morning and dropping throughout the day and after eating. So, if you want to be able to compare results, you need to have the blood draw at the same time of day, every time.

FT4 and FT3 need to be at least over mid-range, but where exactly depends on the person. Optimal is very individual.

However you results from Poland show poor conversion of T4 to T3 - FT4 over-range, FT3 bottom of the range.

Your Medichecks results show very low FT4 and FT3, but I can't see a TSH on those, so they're not very helpful.

In the NHS tests, 2018 and 2019, we're back to poor conversion again. But, that FT3 range is rather strange. If you has 0.00 FT3, you'd be dead.

Antibodies fluctuate all the time, but yours stay pretty low, so you probably don't have Hashi's.

Serum troponin T level: I've no idea what that is.

As for the vit B12 tests, one is a serum test, and the other is an active test. Two different tests, so you can't compare them. The serum test says that your B12 could be higher, because not all of the B12 in the serum is available for you body to use. The Active test says that your B12 is sufficient.

Your vit D needs to be higher.

I think that's all, isn't it?

[Sharoosz in reply to greygoose]

Vit D - I've been taking for years on advice of my former endo. (1000mg April-Oct, 2000mg the rest of the year. I've been taking 2000mg for a longer period since being here.) So probably my biggest problem is poor T4 to T3 conversion? (TSH on Medichecks was very high (over 6) but I wasn't taking Thyroxine at the time, so I didn't bother putting it on.) I always take blood in the morning, fasting and without taking any tablets beforehand. (In Poland all endocrinologists will tell you that - doctors don't seem to do that here.)

[greygoose in reply to Sharoosz]

Doctors in the UK don't know that!

But, yes, it does look like your problem is poor conversion. Although the vit D could do with being higher.

If you weren't taking levo at the time of the medichecks test, it was even more important to put the TSH. That's when it's of most use. And, I would have expected it to be higher with such low Frees. But, as you've been diagnosed, anyway, no problem. Just avoid doctors that dose by the TSH.

[SeasideSusie Remembering]

In which tests is it better to be at low end of range and which at high end?

The answer is different depending on whether or not you are diagnosed hypothyroid and on hormone replacement.

A normal healthy person would have TSH usually no higher than 2, with FT4 and FT3 possibly mid-range-ish.

For someone diagnosed hypothyroid and on hormone replacement, they usually feel best when TSH is 1 or below with FT4 and FT3 in the upper end of their ranges.

NHS: 2018 Serum free T3 5.7 (range 0.0-7.0), 2019: 4.5 (Is a drop good or bad?)

Serum free T4 25.9 (range 11.5-22.7), 2019: 21.0 (Is a drop good or bad?)

Hormone levels vary throughout the day so you can only compare results if the tests were done at the same time.

See the graph in the first post in this thread to see variation of thyroid hormones over 24 hours:

healthunlocked.com/thyroidu...

Serum troponin T level: < 5 (range 0.0-14.0) (Never had this one before - meaning?)

No idea, Google should help.

TP antibodies: <25.0 (range 0.0-33.90) This is quite a lot higher than last check.

That doesn't give you a proper result, it just tells you your level is less than 25 so you have no idea where between 0 and 24 it is. I think it's a pretty ridiculous way of giving a test result.

B12 - 469 (range 223-1132) (why is range so different from Medichecks above? How to compare?)

Because they're two different tests. Medichecks will say Active B12 and has the lower range. This one is Serum B12 which is the total amount of B12. Active B12 test shows what's available for the cells to utilise. You can't compare them. Active B12 is the more useful test because you can have a good level of total B12 but the actual Active B12 level may be low.

[Sharoosz in reply to SeasideSusie]

Thanks for the reply. As mentioned in reply to Greygoose, I always take my bloods in the morning, fasting. (Blood tests are generally not done after 10am in Poland unless they are checking more than once in a day for something or the test needs to be done later.) So I guess I'll keep taking B12 (I started about 2 months ago.) I think generally some of these tests are given inconsistently and sometimes with a ridiculous way with giving results! FYI, I'm hypo and have been on thyroxine for about 11 years.

[MaisieGray]

Troponins are proteins found in cardiac and skeletal muscles, and when the heart is damaged, it releases troponin into the bloodstream - so it's measured to detect whether or not you’re experiencing a heart attack. Are you sure though, that you haven't misread thyrotropin, aka TSH?

[Sharoosz in reply to MaisieGray]

You are indeed right. Why they did this test, I don't know, no heart problems here! Perhaps the receptionist couldn't read the doctor's handwriting when she put it on the computer? Maybe she got the wrong test ordered? (TSH was 1.16, it was done.)

[MaisieGray in reply to Sharoosz]

Ah yes, I'd bet there's every possibility that someone along the line has input or read thyrotropin as troponin. Interesting though, that your Dr doesn't input the blood test request himself - less opportunity for a third party mistake I would have thought.

[Sharoosz in reply to MaisieGray]

Will have to ask about that....