Test results

[FitzUK]

Hello. This is my first post. I just received results from medichecks, any feedback would be very welcomed.

TSH 5.32 range .27 - 4.3

Free T3. 3.67 range 3.1 - 6.8

Free Thyroxine 9.34 range 11-22

Vitamin D 36.6 nmol/L Range 50 - 175

Thanks

[Marz]

You posted two months ago and had good advice. 😊 Where are the anti-body results ? B12 - Folate and Ferritin ?

Your results suggest you are Hypo and your VitD needs treating.

Are you taking any other medications ?

[FitzUK in reply to Marz]

Marz, your right! I did receive good advice. I guess I meant results 😊 The rest of my results were in the normal range.

inflammation CRP HS 0.94 mg/L (Range: < 5) Iron Status Ferritin 73.7 ug/L (Range: 13 - 150) Vitamins Folate - Serum 6.25 ug/L (Range: > 3.89)

Vitamin B12 - Active 44.300 pmol/L (Range: 37.5 - 188)

Vitamin D X 36.6 nmol/L (Range: 50 - 175) Thyroid Hormones TSH X 5.32 mIU/L (Range: 0.27 - 4.2)

Free T3 3.67 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine Autoimmunity X 9.340 pmol/L (Range: 12 - 22)

Thyroglobulin Antibodies <10 kU/L (Range: < 115)

Thyroid Peroxidase Antibodies 12.3 kIU/L (Range: < 34)

Thanks

[FitzUK in reply to FitzUK]

The only meds I’m on are antidepressants

[Marz in reply to FitzUK]

Your depression could be due to the LOW in range T3 - just off the bottom of the range. It is LOW T3 that causes so many symptoms in the body. Every one of the trillions and trillions of cells have receptors for T3 - so if low in range there simply is not enough in the blood to service all the cells. Like trying to drive to Bristol from London with just a few liters of petrol !

Are you treating your LOW VitD - would be better at 100 ++

Active B12 is also LOW and would be better over 70 I have read. Folate is also low in spite of the quoted range !

What does your GP say about these results ? An under range FT4 is not good even though your GP may only look at the TSH - which of course is very wrong. GP may insist as your TSH is below 10 - all is well - NOT

Raised cholesterol is a HYPO symptom and has been discussed on this Forum 100;s of times ... so information can easily be accessed. Even the NHS website mentions that the thyroid should be treated BEFORE starting Statins ...

[FitzUK in reply to Marz]

I see my GP July 11 and want as much information as possible. I’m not treating anything except the depression

[Marz in reply to FitzUK]

Not sure your GP will support the comments I have made above ...

[Hidden in reply to Marz]

"It is LOW T3 that causes so many symptoms in the body. Every one of the trillions and trillions of cells have receptors for T3 - so if low in range there simply is not enough in the blood to service all the cells. Like trying to drive to Bristol from London with just a few liters of petrol !"

That is a brilliant explanation, thank you. It makes sense of something I've often wondered about - the way symptoms vary so much.

To use your illustration, if you dont have petrol to get to London from Bristol you might decide to go to Weston Super Mare instead. Or Gloucester

[Marz in reply to Hidden]

Oh hell - I will make sure I fill up first and go via the Cotswolds 😊😊

[jimh111]

This looks like hypothyroidism, we would expect TSH to be much higher with such a low fT4. What are your symptoms? Do you have any other illnesses or medication? Are you on a calorie restricted diet?

[FitzUK in reply to jimh111]

My symptoms are fatigue and depression. Although I never thought my depression could be linked until I discovered this group. I restrict my calories so that I don’t gain weight but I am not really overweight. I’m 59 years old and don’t have any other illnesses except high cholesterol. I have refused statins and was interested to read that hypothyroidism can cause an increase in ldl.

[Hidden in reply to FitzUK]

Restricting calories doesnt help much if weight gain is due to hypothyroidism. In fact it is likely to make things worse. If you diet long term your body is likely to try to adapt by lowering metabolism even more to try and save energy. So instead of losing much weight you are likely to become more ill.

I fasted several days - liquids only - last year. I felt ok but had even less energy than usual. It took a couple of weeks to recover.

[Hidden in reply to FitzUK]

Although, strangely, some hypothyoid people don't gain weight and may even be skinny. I've gained some weight but not much.

We are all different

[jimh111 in reply to FitzUK]

Depression can lead to hypothyroidism by reducing the TRH hormone that stimulates the pituitary to produce TSH. On the other hand hypothyroidism can cause depression. I don't know if a doctor would agree but to me the sensible approach is to try and tackle both problems at the same time, given that it is almost impossible to find out which was the original problem (especially as your antibodies are low). It's also quite possible that if depression was the original problem that the resultant hypothyroidism inhibits any attempts to overcome depression.

I would ask your doctor to give you sufficient levothyroxine to bring your fT4 up to the upper half of the reference interval. This might help resolve your depression and fatigue. In cases like this patients sometimes need liothyronine (L-T3), there are studies that show it works in patients with depression but it would be very difficult to get a doctor to prescribe it. An easier route would be to get a psychiatrist to prescribe, but I would hold off for now and see if levothyroxine works.

If you can get your doctor to prescribe levothyroxine you could then try to set a routine of having regular exercise and sleep pattern, this can often help with depression. Ceretainly your thyroid blood tests are abnormal, it is normal to have a very high TSH when fT4 is low.

[SlowDragon Administrator]

Your TSHis above range, FT4 below range and FT3 very low in range

This shows you are hypothyroid

But you don't have high thyroid antibodies. However 20% of Hashimoto's patients never have raised antibodies so it could still be that hypothyroidism is due to autoimmune thyroid disease (Hashimoto's)

healthunlocked.com/thyroidu...

Ask GP for trial of Levothyroxine and ultrasound scan of thyroid

Vitamin D, folate and B12 are all very low, almost certainly as direct result of being hypothyroid

Vitamin D is far too 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 .







Once you Improve level, very likely you will need on going maintenance dose to keep it there.




Retesting twice yearly via vitamindtest.org.uk




Vitamin D mouth spray by Better You is good as avoids poor gut function.




It's trial and error what dose each person needs. Frequently with Hashimoto's we need higher dose than average

Local CCG guidelines

clinox.info/clinical-suppor...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Low B vitamins can be linked to low vitamin D

drgominak.com/sleep/vitamin...

B12 and folate on the low side. 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...

Suggest you start with vitamin D supplement

Wait at least ten days before adding a good quality daily vitamin B complex

Daily vitamin c can help support adrenals and immune system too

Do you have any gut symptoms?

[SlowDragon Administrator]

Ask GP to test for Pernicious Anaemia BEFORE starting on B vitamins

Any Active B12 test under 70 is considered suspicious and warrants more investigation. If GP will not agree to further testing, then you will just need to start self supplementing

Or can get further testing privately here

nutris.viapath.co.uk/pages/...

NHS doesn't routinely ever offer active B12, MMA or homocysteine testing

Using test of Homocysteine levels to check for low b12

b12-vitamin.com/homocysteine/

Good explanation on homocysteine

veganhealth.org/b12/hcy

Oral as good as injections

aafp.org/afp/2003/0301/p979...

B12 generally

drjockers.com/warning-signs...

Symptoms of low B12

b12deficiency.info/signs-an...

[FitzUK in reply to SlowDragon]

Wow thanks so much for such a thorough response. 🤩. I mostly eliminate gluten and dairy as they cause gut problems.

[SlowDragon Administrator in reply to FitzUK]

So this strongly suggests you have autoimmune thyroid disease (Hashimoto's)

Politely, but firmly insist with GP that they arrange ultrasound scan of thyroid, as antibodies are negative. This can confirm diagnosis

Link showing that if active B12 is under 70 more tests are warranted

viapath.co.uk/our-tests/act...

[FitzUK]

Thanks. I am with a new GP surgery, but I do have private health so I should at least get a referral.

[klr31]

You need thyroxine.