Blood test results from Hospital

[Ladybex]

Hi there

Can anyone help me with these results please

Best wishes

[SeasideSusie Remembering]

Ladybex

Unfortunately there are no ranges so there's no way of interpreting them other than to say you have Hashi's (confirmed positive TPO antibodies) and your TSH is high so you have hypothyroidism caused by Hashi's.

Ferritin appears to be low, the normal range we see is about 13-150 or 15-300 and it's recommended to be half way through range.

Whenever my CRP has been done the range comes back as <5, it's an inflammation marker so it looks as though yours is elevated slightly but that could be due to the Hashi's.

[sbadd]

Pending result looks like a lupus test of some sort, some of others tests relate to b12 deficiency Pernicious anemia (gastric parietal cell)

Smooth muscle rheumatoid test

Your Tsh still high but no T4 reading but you have the antibodies?

Combo of tests listed here but others may have more info for you

[SlowDragon Administrator]

TSH 4.90

High thyroid antibodies confirms you have autoimmune thyroid disease also called Hashimoto’s

See GP for 25mcg dose increase in levothyroxine

TSH is far far too high

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially as you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels and coeliac blood test if not been tested yet

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

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 strictly gluten free diet for 3-6 months

If no noticeable improvement, reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

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

thyroidpharmacist.com/artic...

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

restartmed.com/hashimotos-g...

Guidelines on dose that you are eventually going to need to increase slowly up to is worked out by your weight in kilo x 1.6

So if you weight for example 9st 8lb that’s 60.8kg

60 x 1.6 = 96....so would likely need 100mcg levothyroxine daily

New NICE guidelines

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

Post getting dose increase

healthunlocked.com/thyroidu....

[Ladybex]

Thank you for all that info ... I’m 11 stone and just started on 50mcg

Another blood test in 2 weeks ...

do you know what C1q test is ? I’m waiting results .... 😊

[SlowDragon Administrator in reply to Ladybex]

Make sure to get bloods retested after 6-8 weeks on 50mcg Levothyroxine

50mcg is only a standard starter dose of levothyroxine

Which brand of levothyroxine do you prefer?

Also getting vitamin D, folate, ferritin and B12 tested

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

[Tina_Maria]

C1q is measuring the complement level antibody - it is an immunological assay.

kappa and lamda light chains are also immunological assessments to see if your plasma cells are okay (they are elevated in certain plasma cell disorders). They are part of the family of immunoglobulins, some of which are responsible for our antibody production.

[Ladybex in reply to Tina_Maria]

Thanks Tina but can’t understand that... is it serious ... I thought it was to do with lupus ?

[Tina_Maria in reply to Ladybex]

the complement level antibody is a marker for an autoimmune disease, such as lupus. I think they will just check the levels to see ,if they are elevated and then make a further decision.

Likewise the immunoglobulin assessment is just to check out anything else. The normal kappa to lamda light chains are 0.26 - 1.56, so you would fall within that.

[Ladybex in reply to Tina_Maria]

Thanks Tina 😊

[Tina_Maria in reply to Ladybex]

No worries! Hope you get it all sorted! x

[Ladybex]

Think you ... all blood test came back good .. I’m on Levothyroxine 50mcg Mercury Pharma and feeling so much better 😊

[SlowDragon Administrator in reply to Ladybex]

Bloods should be retested 6-8 weeks after each dose increase in levothyroxine

Essential to regularly retest vitamin D, folate, B12 and ferritin

Improving nutrients improves conversion

healthunlocked.com/thyroidu...

Even if we don’t start on full replacement dose of levothyroxine vast majority of patients need to increase dose up slowly until on full replacement dose

NICE guidelines

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

Post re how to push for dose increase in levothyroxine

healthunlocked.com/thyroidu....