Help with interpretation of results please.

[Peacefull]

Hello,

I just have my latest set of results and was wondering if anyone could help with an interpretation please? I'm currently on 50mcg Levothyroxine.

TSH - 2.93 mU/L (0.35-5.50) mU/L

Free T4 - 12.8 pmol/L(0.0-19.8) pmol/L

Free T3 - 4.3 pmol/L (3.5-6.5) pmol/L

Thyroid peroxidase antibody - 216 iu/ml (0-60) iu/ml

Tissue transglutaminase IgA antibody - 0.5 u/ml (0.0-6.9) u/ml

Total CK - 121 U/L (25-200) U/L

Thanks so much

Kind regards

Ally

[SeasideSusie Remembering]

Peacefull

TSH - 2.93 mU/L (0.35-5.50) mU/L

Free T4 - 12.8 pmol/L(0.0-19.8) pmol/L

Free T3 - 4.3 pmol/L (3.5-6.5) pmol/L

I think your FT4 range is incorrect, should it be 9.0-19.8 or similar?

You need a dose increase. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well. So 25mcg increase now, retest in 6-8 weeks.

Thyroid peroxidase antibody - 216 iu/ml (0-60) iu/ml

Confirms what was suggested previously with high in range antibody tests, raised antibodies confirm autoimmune thyroid disease aka Hashimoto's.

Fluctuations in symptoms and test results are common with Hashi's.

Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.

Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies.

How are your levels now? Recommended levels are:

Vit D - The Vit D Council recommends a level of 125nmol/L (50ng/ml) and the Vit D Society recommends a level of 100-150nmol/L (40-60ng/ml).

B12 - Serum B12 at least 550pg/ml (ng/L), Active B12 at least over 70

Folate - at least half way through range

Ferritin - minimum 70 for thyroid hormone to work properly, I've seen it said that for females a good level is 100-130 and for males 150.

[Peacefull in reply to SeasideSusie]

Hi Susie,

Thanks for your response, Apologies, Yes it seems I omitted a 1 in front to the FT4 range 10.0- 19.8.

I suppose i thought with the results for Antibodies still being in range, it was unlikely that it could be Hashimoto's. I guess it was just lucky (?if you can call it that?) that it was raised in the Endocrinologists blood tests as he said that he was reluctant to raise my dose as all my antibody results were within range.

My B12 and Folate below.

B12 - 296.0 ng/L (211.0-911.0) ng/L

FOLATE6.18 ug/L (>=5.38) ug/L

Kind Regards

Ally

[SeasideSusie Remembering in reply to Peacefull]

Peacefull

Your folate is on the low side, only just over the low limit, I'd want that in double figures.

B12 at 296ng/L is low. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Pg/ml is the same as ng/L.

Check for signs of B12 deficiency here (plenty of people with B12 in the 300s have been started on B12 injections due to deficiency or Pernicious Anaemia)

b12deficiency.info/signs-an...

If you have any then list them to discuss with your GP and request further testing for B12 deficiency/PA.

If not then you could supplement to improve your level. You could start with taking a sublingual methylcobalamin 1000mcg plus a good quality B Complex containing methylfolate and methylcobalamin, eg Thorne Basic B or Igennus Super B. Both contain the bioactive forms of ingredients. Once you've finished the sublingual methylcobalamin your B12 should hopefully be at a level where just the B Complex will be enough.

When taking B Complex containing Biotin (B7) remember to leave it off for 7 days before any blood tests (including thyroid) as it will cause false results if biotin is also used in the testing procedure as many labs do.