TSH HAS GONE DOWN FROM 6.01 TO 3.68 IN SPACE OF 3 WEEKS - CAN ANYONE HELP WITH WHAT IS GOING ON WITH BLOOD TEST RESULTS BEFORE I SEE GP NEX

[Redlester]

NHS TEST RESULTS 19/06/19

Folate - Serum 13 ug/L (Range: 3.89 – 19.45)

Vitamin B12 – Serum 485ng/L ( no Range given)

25 hydroxy Vitamin D 57nmol/L (have been advised this is ‘normal’)

Thyroid Hormones

TSH 3.68 mU/L (Range: 0.27 - 4.2)

Free T3 4.3 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 13.3 pmol/L (Range: 12 - 22)

Ferritin 14ug/L (Range: 13 - 150)

Serum CRP 0.9mg/L ( no Range given)

Red Blood Cell count 4.52 10* 12/L (Range 3.8-4.8)

Platelet count 318 10*9/L (Range 150-400)

Mean Corpuscular Volume 85fL (Range 78-104)

Mean Corpusc Hb conc 330gL ( no Range given)

Mean Corpusc Haemoglobin 27.9pg ( no Range given)

Haemoglobin estimation 126g/L

Haematocrit 0.38L/L (range 0.36-0.46)

Serum transferrin 3.16g/L ( no Range given)

Transferrin Saturation index 23.8%

Serum Iron level 18.8 unol/L ( no Range given)

Serum LH 7U/L

Serum FSH level 7.5 U/L

Serum progesterone 23.9 nmol/L

Serum oestradiol 521 nmol/L

I did ask a the surgery for ranges to be given but I don’t think they understood what I meant so not all of the above figures are accompanied by a reference range. Ferritin has crept up from 10 to 14 since medichecks test done at start of June but is still at bottom of range. My GP describes this as an iron profile – is it a full testing of all the factors needed to test for iron deficiency anaemia? My vitamin D levels look like they need to be higher despite the fact that I take vitamin D supps and try to make vitamin D from sunlight whenever possible.

From a diagnosis perspective what concerns me most is that TSH is fluctuating strangely – 4.04 on 11 March 2019, 6.01 at start of June 2019 (Medichecks), 3.68 on 19 June 2019. Can anyone suggest why that would be?

FT4 and FT3 have declined – FT4 was 13.4 on 11 March 19, 14.9 at start of June 2019 (Medichecks), 13.3 on 19 June 2019

FT3 was 5.2 at start of June 2019 (Medichecks) and was 4.3 on 19 June 2019

I am seeing my GP next Weds [10 July] to discuss these and the next steps. I would imagine that based on these she will continue to refuse to treat me because my TSH has come down despite my FT3 and FT4 also dropping. The last time I saw her she seemed determined to focus on my age and imminent menopause; while menopause may be a factor I don’t want the GP to home in on it and miss a possible metabolic problem [have had Fibro for 25years+ and ME/CFS for 18 years]. My symptoms are incapacitating me. I am very confused by these results and would be grateful for advice about what people think is happening and how to approach my appointment with my GP. Many thanks

[greygoose]

Have you had antibodies tested? Could be that you have Hashi's. That would make your levels jump about.

But, were the blood draws all don't early morning and fasting?

[Redlester in reply to greygoose]

The blood draws were both done at about 8.30 am and fasting. I have had my antibodies tested too - medichecks results showed Thyroglobulin Antibodies 16.4 kU/L (Range: < 115) and Thyroid Peroxidase Antibodies 10.8 kIU/L (Range: < 34). The only difference was that in between the 2 tests I was so panicked about my low ferritin levels [medichecks showed my ferritin to be 10] I had been trying to eat iron rich food sources or certainly up my game in that respect.

[radd in reply to Redlester]

Redlester

Do you supplement biotin ?

This can alter TSH results on some assays.

[Redlester in reply to radd]

Hi Radd

I used to supplement biotin but stopped well before my Medichecks test at the start of June and have never gone back on it - I was off all supps for a full week before the latest NHS tests which is why I am so confused by the results

[SlowDragon Administrator]

One in five patients with autoimmune thyroid disease (Hashimoto's) never have raised antibodies

Ask GP for ultrasound scan of thyroid, this can help diagnose autoimmune thyroid disease

Your ferritin is very low, especially considering you have been supplementing. Aiming for at least half way in range

Vitamin D too low. Again you say you are supplementing How much have you been taking?

GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve 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.

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet




(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)




Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Few links about fibromyalgia


healthrising.org/blog/2019/...


thyroiduk.org/tuk/research/...


thyroiduk.org.uk/tuk/relate...


stopthethyroidmadness.com/f...


prohealth.com/library/new-t...


chriskresser.com/low-t3-syn...


clinicaltrials.gov/ct2/show...


holtorfmed.com/download/chr...

prohealth.com/library/new-t...

Suggest you consider getting DIO2 gene test to see if you have common genetic variation (20% of thyroid patients)

thyroiduk.org.uk/tuk/testin...

[Redlester in reply to SlowDragon]

Thanks Slowdragon

I take 1000iu of vitamin D per day and have been doing so for years. As I said I also make it from sunlight wherever possible. How much vit d should I need to take to get levels up to about 80 and how long should that take [so I can make a note in my diary when to do another test]?. I have had coeliac blood test and biopsy by endoscopy years ago and results came back negative. I was gluten and dairy free for 3 years - it made no difference. I had been thinking of DIO2 test as I thought I might have a conversion problem. I am also thinking of getting RT3 tested. I had been thinking that, in conjunction with having FM and ME I either have a conversion problem and hence low T3 which has recently come to prominence in ME/.FM research, or failing that I could have a problem using T3 at the tissue level [ie enough T3 circulating in blood but tissues cannot use it] ala Holtorf's treatment protocol. I would doubt GP will be familiar with either of these. I cannot go on like this much longer as things get progressively worse and I am literally unable to function.

[SlowDragon Administrator in reply to Redlester]

With thyroid disease it's common to need higher dose vitamin D than average

It's trial and error what each person needs

Suggest you increase to 3000iu daily and retest in 3 months. You may need higher dose

vitamindtest.org.uk

ncbi.nlm.nih.gov/pubmed/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

endocrine-abstracts.org/ea/...

Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.

ncbi.nlm.nih.gov/pubmed/300...

ncbi.nlm.nih.gov/pmc/articl...

Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency

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...

[Redlester in reply to SlowDragon]

Hi SlowDragon

Thanks for these links. I have done some reading and think, looking at my results, especially the progesterone and estrogen, that my hypothyroid symptoms could be stemming from estrogen dominance - there is a good explanation in this article of what is going on.

outsmartdisease.com/how-est...

In essence they symptoms I am experiencing are hypo, but their cause is originating in the way in which the unopposed estrogen is impacting the ability of the liver to convert T4 to T3. I am seeing my GP this afternoon. I very much doubt that she will have any idea of estrogen operating in this way, and will probably focus on it as a peri-menopause/menopause issue to be treated with HRT which, from what I understand, would only serve to make things worse.

As I am not hypo per se, but do have hypo symptoms from the estrogen dominance, I wonder would it still be a good idea for me to up my vitamin d levels?

Best

Redlester

[SlowDragon Administrator in reply to Redlester]

Personally I would concentrate on improving terribly low ferritin and vitamin D

Not unusual to need higher dose of vitamin D than 1000iu. Perhaps try 3000iu mouth spray by Better You and retest again in 3 months

Your low vitamins suggest poor gut function, likely because of being hypothyroid

Getting vitamins optimal is first step

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

healthunlocked.com/thyroidu...

drhedberg.com/ferritin-hypo...

restartmed.com/hypothyroidi...

Why not ask GP for ultrasound scan of thyroid - this can diagnose Hashimoto's in absence of antibodies

[Redlester in reply to SlowDragon]

Hi Slowdragon

I saw GP on Wednesday. It went quite a lot better than I thought it would. I put the ED issue to her and she seemed to get it and has arranged for a blood draw to test for thyroid binding globulin, which is a marker for ED. She said that the lab might refuse to do the test irrespective of how highly she argued for it, so it might be the case that we just have to cross our fingers and hope that they will test the sample when it comes in. If they refuse to do so I will probably have to get that done privately. She was concerned about the TSH pattern and in light of my strong fam hist she is arranging a referral to an endo. she doesn't think I am anaemic per se and doesn't intend to prescribe iron until I am seen by endo, so I will just have to work on ferritin by dietary means myself. I asked about thyroid ultrasound - she said if she attempted to refer it would be turned down, and while I could have one done privately it would still need to be analysed by someone; the endo may order one. So I am in a sort of limbo situation, doing what I can on my own while waiting for the endo referral.

However, having read the excellent Dr Hedberg article on ferritin, it could be the case that rather than estrogen dominance it could be the low ferritin which is at the root of all my problems, as the problems of low ferritin seem to have the same effect as excess estrogen in terms of their impact on conversion of T4 to T3 and the ability of cells to utilise the active form of the hormone. I wish I had had it to hand to take with me to see her on Wednesday.

having read these articles about iron I am less inclined to take my Gp's advice about waiting to see endo as boosting my iron levels could make massive difference to me in terms of symptoms. My sister takes dessicated liver but this article

restartmed.com/hypothyroidi...

makes a convincing case for taking liquid iron to bypass absorption issues. What do you think?

[SlowDragon Administrator in reply to Redlester]

I have no personal experience of iron supplements. I have the reverse problem....my ferritin is always too high! (But not my iron - so it's not hemochromatosis) Pity, because I love liver!

Iron rich foods plus daily vitamin C frequently help many on here

I found getting vitamin D optimal extremely beneficial, more on my profile