Hi, I'm new here. Please help me interpret my blood test results. What I show is all that was tested for thyroid each time, so direct month to month analysis is not always possible. I take 60 mg of Armour Thyroid every morning. All these blood draws were done after taking it in the morning as I didn't know about waiting until after the blood draw. Should I take my medication after the next blood test or keep doing what I have done all along?
January 2019
TSH - 2.696 uIU/mL Range - 0.358 - 3.740
T4 Free - .79 ng/dL Range - .76 - 1.46
Vit B12 - 1173 pg/mL Range 232 - 1245
Vit D-25 (Hydroxy) 51.8 Range 30 - 100
Cholesterol - 216 mg/dL Range 0 -200
Triglyceride - 74 mg/dL Range 30 - 150
HDL 68 mg/dL Range 40 - 60
LDL 133 mg/dL Range 29 - 130
August 2019 - started trying to find out why I can't lose weight and constantly get exhausted with my new doctor's help. She will order any test I ask for. I am in the US, so not restricted by NHS thank goodness.
Thyroid Ultra Sound - Right thyroid lobe - 3 x 0.8 x 0.7 cm - Left - 2.8 x .8 x .7 cm
Heterogeneous echotexture and atrophy. No nodules.
TSH - 3rd Generation 1.442 uIU/mL Range 0.358 - 3.740
T4 Free - .81 ng/dL Range .76 - 1.46
Triiodothyronine Uptake (T3U) - 41.5 Range 32 - 48
Thyroglobulin AB 151.10 UI/mL Range 0 - 15.00 (Very high, indicates Hashimoto's)
Cholesterol - 202 mg/dL Range 0 - 200
Triglyceride - 98 mg.dL Range 30 - 150
HDL - 54 mg/dL Range 40 - 60
LDL - 128 mg/dL Range 29 - 130
November 2019
TSH 3rd Generation - 1.677 Range .358 - 3.740
T3 Free 3.4 pg/mL Range 1.5 - 3.5
T4 Free .69 ng/dL Range .76 - 1.46
Anti-TPO MICROSOMAL 383.80 Range 0 - 28. First time tested
Thyroglobulin AB - 103.40 Range 0. - 15.00
Folate (Folic Acid)- Greater than 24 ng/mL Range 5.9 - 24.8
Zinc - Plasma or serum 73 ug/dL Range 56 - 134
Vit B1 (Thiamine), Whole Blood 152.2 nmol/L Range 66.5 - 200
I started taking a product that repairs at the cellular level 5 weeks before the November blood tests. My antibodies came down 48 points in that time and my energy and stamina have improved slightly and not hitting the brick wall as often.
I had also been diagnosed with CKD, I have been on a renal diet and managed to lose 4 lbs in 4 months. Awfully slow wight loss. My last blood work showed I no longer have that. However I put 4 lbs back on when I couldn't exercise due to excessive heat in September where I live. I had very low heat tolerance during that time. However, I just found out I lost 2 lbs in 1 week, so that's better than before. Nothing has changed except taking this product.
Thanks for your help with this.
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Susiegood
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The idea is that we leave between 12 hours between our last dose of NDT and the blood draw. You don't give exact timings so it's difficult to know if you leave the correct gap.
However, if you do take your last dose closer to the blood draw than that, what will happen is that you get a false 'high' FT4 and FT3. (Don't know about the Triiodothyronine Uptake (T3U), because I've never understood what that tells you.) If you want to know the normal circulating levels of FT4 and FT3, you need to respect that gap.
The TSH is affected by the time of day the blood is taken. TSH is highest early morning, and drops throughout the day, and after eating. So, if you want to know what the TSH is at its highest, have the blood draw before 9 am and fast over-night.
I take the Armour thyroid as soon as I wake up, which could be anywhere from 6.30 am to 9 am depending on my night.
When I have the blood draw it is usually about an hour and a half later.
If I wait to take it after the blood draw, my results will probably be quite different and I will have to explain that to my doctor. I realize I will have a more accurate result which is good, but trying to explain to my Puerto Rican doctor will be interesting. I don't see the endocrinologist until Feb.
Hi, not sure whether I can just jump in there, but always wondering about the 12 hour gap people talk about. So, if you take once daily NDT first thing in the morning, I always assumed you just take it after the blood draw. That gives you a 24 hour gap though. So, would you suggest taking your NDT the evening before instead of in the morning on the day leading up to the blood draw? So, you would have one day with a very long gap since last dose (36 hours since last dose) and then have blood drawn in the morning and take the next dose roughly 12 hours since the last dose?? Thanks for your thoughts.
You could do that. Or, just for that one day, you could cut your dose in half and take half in the morning, and half in the evening, 8 - 12 hours before the blood draw.
Thanks of course, had't thought about that. So, the idea is, that my current method (bloods after 24 hr gap) underestimates the FT3 that my body has available, because it has been used up. Presumably it would be a different reading though, if you are doing half a dose or a full dose? Feels a bit like we are just measuring what we have just put into the body though? Sorry not questioning you, but trying to understand what gives the most accurate picture what is going on in my body! Thanks!
* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (many labs use Biotin in the testing procedure).
These are patient to patient tips which we don't discuss with doctors or phlebotomists.
Hopefully the above explains why the time gap is necessary. We want to measure the normal amount of circulating hormone so that we can take the appropriate dose of thyroid hormone replacement that we need, we don't want a false high result nor a false low result.
Taking your latest results, and taking into account that you took your Armour just before the test:
November 2019
TSH 3rd Generation - 1.677 Range .358 - 3.740
Your TSH will not be affected by taking your Armour. If you did this test early morning, no later than 9am, and didn't eat breakfast or have coffee, nor take a B Complex or Biotin supplement in the 7 days before the test, then this result is a pretty accurate reflection of your normal TSH level and this is high for someone taking Armour so suggests you are undermedicated. Taking any NDT tends to lower, even suppress TSH.
T3 Free 3.4 pg/mL Range 1.5 - 3.5
Taking into account that you took your Armour just before the test, you have a false high FT3 result. It's not possible to say what your normal circulating level is, and it's not possible to give an accurate estimation.
T4 Free .69 ng/dL Range .76 - 1.46
Taking into account that you took your Armour just before the test, you have a false high FT4 result. However, taking Armour can lower FT4. It is below range so your normal circulating hormone level could well be even lower. We are all different as to where we need FT4 when we take a combination hormone replacement, some of us need it higher in range, some of us are fine with it lower in range. It is very individual and up to each of us to find our own level.
Anti-TPO MICROSOMAL 383.80 Range 0 - 28. First time tested
Thyroglobulin AB - 103.40 Range 0. - 15.00
Confirm 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.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
Folate (Folic Acid)- Greater than 24 ng/mL Range 5.9 - 24.8
Folate is recommended to be at least half way through range. Yours is obviously higher than the assay measures so it's probably over range. Are you supplementing with folic acid or methylfolate or a B Complex containing methylfolate?
Folate and B12 work together, your B12 was high in January and our store is supposed to be good for 2 years. I have read that a high folate level is apparently OK if B12 is also high.
Zinc - Plasma or serum 73 ug/dL Range 56 - 134
I have read that zinc should be half lway through it's range.
Vit B1 (Thiamine), Whole Blood 152.2 nmol/L Range 66.5 - 200
I have no idea of recommended levels of separate B vitamins so all I can say is that it is in range.
Vit D was within the recommended range of 40-60ng/ml in January, it might be worth retesting, it's a good idea to test vitamins once a year, if supplementing with D3 then twice a year.
Thanks so much Susie, would the 8 to 12 hours gap refer to the usual full dose of NDT for the day? So instead of taking it in the morning, I would leave it till the evening before testing blood? Feels like that would mess things up too somehow! It is just a scary thought, that by having different ways of doing it, I am influencing my all important FT3 measure! That I thought I could rely on!
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would the 8 to 12 hours gap refer to the usual full dose of NDT for the day?
No, split the dose into two the day before the test as Greygoose has suggested, last dose 8-12 hours before the test. Then on the day of the test leave your dose of NDT until after the test.
As explained in my reply to susiegood above:
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
You want to measure the normal circulating hormone level, you'll get this with the 8-12 hour gap.
Re: Biotin supplement in the 7 days before the test - I take a multi- vitamin with B vitamins in it including 150 mcg Biotin. I did not know about stopping the Biotin before the test. Therefore my TSH number is probably not accurate.
Fasting and no coffee of tea, just water.
When I do the next test, I will do as you suggest, however, I'm guessing that my numbers will therefore be quite different to what they have been before. I hope my doctor doesn't have a panic attack! At least it will give us a much more accurate result. I just worry that not sharing about Biotin and the timing of taking my med will make her worry that things have suddenly gone to hell in a hand basket. She is very open to my natural remedies and everything that I am doing, so I might share this with her anyway. I don't know about the Endocrinologist that I will be seeing in Feb. though.
Folate is 800 mcg in the multi.
I have been on a pretty gluten free diet for years, maybe that is why I am relatively (compared to others here), symptom free. I do not avoid it totally, but most of my eating is gluten free. I avoid most processed foods and what processed foods I do eat are organic, with only the main ingredients wherever possible. Eg. Canned tomatoes with just tomatoes and sea salt. As much organic everything else as I can get. I live in Puerto Rico, so not everything can be obtained here, but it's pretty good nonetheless.
My multi has 50 mcg of Selenium and I started to eat a couple of Brazil nuts several times a week. I don't eat them every day because I read that the amount of Selenium in them can vary greatly depending on the ground they are grown in and how long since they were picked.
Re: Biotin supplement in the 7 days before the test - I take a multi- vitamin with B vitamins in it including 150 mcg Biotin. I did not know about stopping the Biotin before the test. Therefore my TSH number is probably not accurate.
It's not just TSH, it can be any test. If biotin is used in the testing procedure it can give false results, we don't know which way they will be - false low or false high, we are just told it can be false.
My multi has 50 mcg of Selenium and I started to eat a couple of Brazil nuts several times a week. I don't eat them every day because I read that the amount of Selenium in them can vary greatly depending on the ground they are grown in and how long since they were picked.
Brazil nuts aren't the best way to get selenium, you may not be getting any at all. The nuts have to be grown in selenium rich soil to contain any selenium. Selenium content varies depending on where the nuts are grown. The package needs to say "Grown in selenium rich soil" and even then if it doesn't give the area where they're grown it can be very low amount of selenium. Best places are Eastern Amazon and Central Brazil but I've never seen the area mentioned on any packaging. See chart here:
I can't answer that. I've taken 200mcg, I currently take 100mcg, but I can't take the responsibility of saying that's OK for anyone else. Some people test, some don't, it has to be your decision. Do some reading
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