Results are in...: Hi all, Got results back from... - Thyroid UK

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distractonaught profile image
21 Replies

Hi all,

Got results back from my Medicheck Ultravit blood test this morning.

I'd really appreciate your input on what these numbers suggest, and in particular why I should be getting a 'low' TSH reading when I'm actually taking a lower levo dose than my doctor recommended. Also, why my antibodies might be so high.

Background: I'm prescribed 100mcg with 125 mcg on alternate days, following an indication from my GP that I needed to be on a higher dose than 100mcg (after my TSH spiked to 50). But I felt overmedicated on this dose and decided to drop it back to 100mcg only. I then went for the private test.

Anyway, these are my readings along with vitamin levels (which both need increasing a lot as well) from last week's test. I was most surprised to learn that my TSH is currently low, even though I'm taking less than I've been told to. However the T3 and T4 levels look fine.

Also, what do you make of that antibody result? The dr's report didn't go into a lot of detail on that, but is that a normal level for autoimmune thyroid diseases? It appears to be almost off the scale.

WWYD with these results? Continue on same dose or start dropping it a bit lower?

(Reference ranges and more info in the image)

TSH: 0.105 mIU/L

Free T3: 4.46 pmol/L

Free Thyroxine: 19.3 pmol/L

Thyroglobulin Antibodies: > 4,000

Thyroid Peroxidase antibodies: 20.9

Ferritin: 32.6 ug/L

Vitamin B12: 33.3 pmol/L

Vitamin D: 47.5 nmol/L

Many thanks.

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distractonaught
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21 Replies
SeasideSusie profile image
SeasideSusieRemembering

distractonaught

Can you please add the reference ranges for all the tests. As they vary from lab to lab, members will need the ranges that came with these results.

Or you could add a picture of the results in your first post, click on MORE V to edit your post. Ensure you don't include any personal details that would identify you.

distractonaught profile image
distractonaught in reply to SeasideSusie

Will do, sorry! In fact I'll add it as an image, thanks

SlowDragon profile image
SlowDragonAdministrator

Ferritin too low. Ask GP for full iron panel test for anaemia

B12 is EXTREMELY low. Any active B12 under 70 is considered suspicious. Obviously this is well under 70

No folate result?

Vitamin D far too low

GP will only prescribe to bring levels to 50nmol. But improving to around 80nmol or 100nmol may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

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

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Local CCG guidelines

clinox.info/clinical-suppor...

Government recommends everyone supplement October to April

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

Magnesium

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Bone pain

easy-immune-health.com/pain...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

Your TG antibodies are EXTREMELY high

Ask for ultrasound scan of your thyroid

distractonaught profile image
distractonaught in reply to SlowDragon

Hi there, thanks for the response.

I did get folate results as well sorry - they are 8.4 ug/L which looks to be well into the healthy range. As for the other results:

B12 level may be related to me being vegetarian and not paying enough attention to my diet, although it's not terrible. I will get some supplements today however and start taking them regularly.

Vit D result was disappointing as I have been taking a supplement (a mouth spray like you suggest - it's H&B 25ug). The Dr's report suggested I up that to a 800-2000 iu supplement for 12 weeks. I get confused with all the units so does that line up with what you recommend?

I'm also taking a magnesium supplement (fairly recent addition) if that makes any odds.

As for the TG antibodies, what could that mean why do you suggest a scan?

Many thanks

SlowDragon profile image
SlowDragonAdministrator in reply to distractonaught

Is that and H& B own brand?

Or the recommended vitamin D by Better You

As a vegetarian with hashimoto’s you will need to work very very hard all the time to maintain optimal vitamin levels

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

Igennus Super B complex are nice small tablets. 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 Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

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...

If you have Low B12 symptoms you mayneed sublingual B12 as well

b12deficiency.info/signs-an...

Eating iron rich foods like pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

dailyiron.net

Links about iron and ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

drhedberg.com/ferritin-hypo...

restartmed.com/hypothyroidi...

As you have hashimoto’s an ultrasound scan should be done to check levels of damage

distractonaught profile image
distractonaught in reply to SlowDragon

Thanks for the info - I find this all a bit complicated (and it seems most doctors do too) so it's refreshing to have such practical advice. Good also to confirm Hashis, as my GP has never done this in 20 years of having the condition.

Yes, the vitamin D spray I've been using is H&B's own brand, this one: hollandandbarrett.com/shop/...

But I'll give the one you've suggested a try, along with a good B complex. Small tablets sounds good and I'll look into the sublingual ones too.

Just had a look at the list of B12 deficiency symptoms and I have a LOT of these so am hopeful that this will improve some of them. Especially tinnitus which I suffer from very badly and am willing to try anything for.

There is also the persistent unexplained weight loss, which I am still trying to get to the bottom of, but I guess improving all of these levels is a good first step.

Am seeing the GP tomorrow about another issue so will ask him about a scan - are these usually hard to obtain on the NHS?

SlowDragon profile image
SlowDragonAdministrator in reply to distractonaught

Show him the results of your tests. In fact give him a copy and request it’s put on your medical record

Point out very high antibodies and request ultrasound scan of thyroid

The B12 result is so low GP should test for pernicious anaemia .....though it’s more likely linked to being vegetarian ...as is low iron

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

distractonaught profile image
distractonaught in reply to SlowDragon

Thank you. I'm not vegan though - and I eat plenty of dairy products. Also a decent amount of seeds and grains so shouldn't that help with B12?

SlowDragon profile image
SlowDragonAdministrator in reply to distractonaught

B12 is only available in animal products.....limited amount in dairy

ods.od.nih.gov/factsheets/V...

How long have you been vegetarian?

Vegetarians are recommended that they should supplement B12 and regularly monitor iron levels

With hashimoto’s our ability to absorb nutrients is compromised due to low stomach acid and poor gut function

distractonaught profile image
distractonaught in reply to SlowDragon

Hiya - appreciate it's probably not going to have the same B12 levels as meat, but I often see dairy listed as a source so thought it was worth mentioning. I've been vegetarian most of my life, about 30 years.

SlowDragon profile image
SlowDragonAdministrator in reply to distractonaught

As a long term vegetarian with hashimoto’s B12 probably should be supplemented

Obviously with hashimoto’s poor gut function means we have much lower vitamin levels than is typical

Hashimoto’s is as much a gut issue as it is thyroid

webmd.com/food-recipes/news...

medicalnewstoday.com/articl...

forksoverknives.com/every-v...

SlowDragon profile image
SlowDragonAdministrator in reply to distractonaught

Noticed last link wasn’t working ....here it is again

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

Obviously this is significant issue when on Levothyroxine as we always need OPTIMAL Vitamin levels

SeasideSusie profile image
SeasideSusieRemembering

distractonaught

From labtestsonline.org.uk

Mild to moderately elevated levels of thyroid antibodies may be found in a variety of diseases.

Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto’s thyroiditis, primary myxoedema, and Graves’ disease. In general, the higher the level, the more likely autoimmune thyroid disease is present.

You can have Hashi's with just raised Tg antibodies (and no raised TPO antibodies).

You obviously don't have Graves disease so I would say that your raised Tg antibodies confirm Hashi's.

As antibody levels fluctuate, there is no normal.

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 is said to help reduce the antibodies, as can keeping TSH suppressed.

**

I wouldn't worry to much about your TSH. It becomes less relevant when we are on replacement thyroid hormone. It's your FT4 and FT3 that are important. You levels are likely to fluctuate due to the Hashi's and some people find they need to adjust their dose of Levo when these fluctuations occur, readjusting when things get back to normal.

Your current results show a good level of FT4 at 73% through it's range but your FT3 is only 36.76% through range

Calculator here: chorobytarczycy.eu/kalkulator

This shows poor conversion of T4 to T3.

Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies and optimal levels are needed for thyroid hormone to work properly and good conversion to take place and you have some problems there which need addressing; however you haven't given the ranges for these:

Ferritin: 32.6 ug/L

This range is likely to be 13-150 so you are low in range.

Symptoms of low ferritin include:

◾Weakness

◾Fatigue

◾Difficulty concentrating

◾Poor work productivity

◾Cold hands and feet

◾Poor short-term memory

◾Difficulty remembering names

◾Dizziness

◾Pounding in the ears

◾Shortness of breath

◾Brittle nails

◾Headaches

◾Restless legs

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

apjcn.nhri.org.tw/server/in...

Don't take iron supplements. Before doing that you would need to do an iron panel and a full blood count to see if you had iron deficiency or iron deficiency anaemia.

*

Vitamin B12: 33.3 pmol/L

As this is a Medichecks test I believe this is an Active B12 test with a range of 37.5 - 188 or similar. So you are below range.

Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:

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

Reference range:>70. *Between 25-70 referred for MMA

Do you have any signs of B12 deficiency – check here:

b12deficiency.info/signs-an...

If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.

** Where is your Folate result? B12 and Folate work together.

*

Vitamin D: 47.5 nmol/L

The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L.

To reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 5,000iu D3 daily

Retest after 3 months.

Once you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3 as recommended by the Vit D Council

D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

*

Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.

distractonaught profile image
distractonaught in reply to SeasideSusie

Hi there, thanks for such a comprehensive reply.

Sorry - my folate was 8.4 ug/L (reference range 3.8 to 19.45) so not great but within range. And that 13-150 is indeed the range they used for ferritin.

I do have a lot of the symptoms associated with B12 deficiency (some I did not know were related like tinnitus are really bad), so I will ask the GP about pernicious anemia if you think that's likely.

I'm currently taking Solgar magnesium citrate twice a day, but only started a couple of weeks ago.

As I may have mentioned earlier, the main symptom I have that I can't explain is persistent weight loss without trying. Part of the reason for doing this test was to see if I could get some answers on this - so do you think anything here suggests a cause?

SeasideSusie profile image
SeasideSusieRemembering in reply to distractonaught

distractonaught

I do have a lot of the symptoms associated with B12 deficiency (some I did not know were related like tinnitus are really bad), so I will ask the GP about pernicious anemia if you think that's likely.

As mentioned before, your Active B12 is very low and below 70 suggests testing for B12 deficiency (pernicious anaemia is one cause of B12 deficiency). So as you have a lot of those symptoms, list them and ask your doctor for further testing for B12 deficiency and pernicious anaemia. Doctors are supposed to take more notice of symptoms than numbers where B12 is concerned. Do not take any supplement to raise folate level (eg B complex, methylfolate, folic acid) nor a B12 supplement before further testing has been carried out as this will mask signs of B12 deficiency and skew results.

*

As I may have mentioned earlier, the main symptom I have that I can't explain is persistent weight loss without trying. Part of the reason for doing this test was to see if I could get some answers on this - so do you think anything here suggests a cause?

Hashi's can cause symptoms of both hyper and hypo, weight loss can be a symptom of hyper so this could be connected.

distractonaught profile image
distractonaught in reply to SeasideSusie

Thank you. Hashis seems like a complicated condition - but it's at least good to (finally) know that this is the type I've got.

Lora7again profile image
Lora7again

Mine are 4000 and have been like that for a few years. I also use medichecks what a coincidence. My Thyroid Peroxidase antibodies used to be 600 but have dropped slightly now. I think it means your thyroid is under attack and I have no idea how to lower them. I have tried selenium tablets and a gluten free diet but nothing has worked so far. I do have a multinodular goitre btw.

distractonaught profile image
distractonaught in reply to Lora7again

Thanks Lora, have you ever had any advice from your doctor on what to do to improve these levels? Also, have you ever had unexplained weight loss? This is my main symptom and I've never been able to get to the bottom of it. Was hoping these tests might shed some light on that. Thanks.

Lora7again profile image
Lora7again in reply to distractonaught

I don't have a Doctor who treats me for thyroid disease. This is because I have been badly let down by my GP and the NHS. You can read my story on my profile page. I have lost about 1 1/2 stones without trying because my thyroid seems to be working at the moment. Last time it worked for 4 years then I had an underactive thyroid for about 2 1/2 years. I tried to get my GP to give me levothyroxine because I had taken it in the past but he refused because my TSH was 0.80. I sat infront of him with a balding head and nails lifting off their beds and he didn't want to help. So I purchased Thyroid S from Thailand and self medicated because I had no choice. My TSH is 0.37 and I feel well at the moment but I know it won't last. I am not on any drugs I just take Selenium, Vitamin D and Methyl Folate.

distractonaught profile image
distractonaught in reply to Lora7again

Yikes, sorry to hear that. I've never had much help from GPs either, but they do keep prescribing at least. I am constantly wondering if my weight loss means I shouldn't be taking levo at all, but whenever my results come back they suggest my T3 and T4 is within range, even though TSH goes up and down like a yoyo.

Lora7again profile image
Lora7again in reply to distractonaught

My TSH is 0.37 now and last July it was 0.54 and then days later 0.79 after my thyroid storm. I did think my TSH would have been lower after my thyroid storm but I had just eaten a large cooked breakfast and a couple of cups of coffee before at a wedding I was stopping over night at.

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