Blood tests, results and understanding

[Lloreta]

I am not sure of my blood test readings or what type of the named Thyroid problem I have. Also how and what to use as a supplement, my bloods read: TPO Anitbodies 107 (0-33 U/ml), Anti-Thyroglobulin Abs 108 (-0114 U/ml), Rheumatiod factor 1<10 (0-139 IU/ML).Could this be why my hair is falling out badly, please can you advise? I can't see my GP due to the CoronaVirus outbreak and they will not give me a telephone appointment because they are too busy with emergencies! I am feeling depressed with my hair thinning at a fast rate and have no idea how to deal with this or get help. Hospital consultant not getting back to me either Help!!

[SeasideSusie Remembering]

Lloreta

TPO Anitbodies 107 (0-33 U/ml), Anti-Thyroglobulin Abs 108 (-0114 U/ml)

Those are positive antibody results which means that the cause of your hypothyroidism is autoimmune, known by patients as Hashimoto's, the most common cause.

Hashimoto's which is where the thyroid is attacked and gradually destroyed.

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

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

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.

Rheumatiod factor 1<10 (0-139 IU/ML)

Very low and this would be a good result.

Could this be why my hair is falling out badly, please can you advise?

Not in itself. What you need to do is post current results, including reference ranges (ranges are important as they vary from lab to lab), for:

TSH

FT4

FT3

Vit D - also include unit of measurement

B12 - also include unit of measurement

Folate

Ferritin

We need to see if you are optimally treated for your hypothyroidism and the TSH/FT4/FT3 results will tell us that.

For thyroid hormone to be able to work properly, optimal nutrient levels are essential, hence the reason for the other tests.

Your hair falling out may be due to hypothyroidism undertreated, but it also may be due to low ferritin or other vitamins. So first step is to post those results and we can hopefully go forward from there.

[Lloreta in reply to SeasideSusie]

Hi thank you for replying so soon.

My iron levels are: Iron level 23.4 (11.0-29.0 umol/L)

Total Iron capacity 51 (41-77 umol/L)

Transferrin Saturation (%) 46 (9-47%)

Ferritin 53 (22-275 ug/l)

B12 (Holo TC) .128 (25-108 pmol/L)

<25 pmol/L - Vit B12 insufficient/deficient

25-70 pmol - samples are referred for confirma\tory MMA analysis

>70 pmo/L Vit B12 replete

Vit D

25 Hydroxy Vit D 67 (nmol/L

<30 NMOL/l Vit D deficiency

30-50 nmol/L Vit D insufficiency

>50 nmol Vit D Sufficiency

Serum Folate

6.2 (3. 1-20.5 ug/l)

Gonadotrophins -(LH/FSH level)

Follicale stimulating 112.1 (IUL)

Hormone Level -Lutenising Hormone level 36.1 (IUL)

Testosterone Level <0.5 (0.0-1.8 nmol)

Sex Hormone Binding Globulin Level 91 (14-69 nmol) it states on the form that Due to reformation of SHBG assay by the manufactuer, results will be up to 18% lower than previous. Reference ranges are NOT affected.

Prolactin Level 318 (102-496 mlU/L

Thyroid stimulating level 0.56 (0.27-4.20 mIU/L)

Commons Auto-antibodies

Smooth Muscle Antibody Negative

Gastric Parietal Cell AB. POSITIVE

GPC antibodies may occur in pernicious anaemia and other autoimmune disorder

Does this help?

[SeasideSusie Remembering in reply to Lloreta]

Lloreta

Optimal levels for an iron panel are:

Serum iron: 55 to 70% of the range, higher end for men - yours is 23.4 (11.0-29.0 umol/L) and is 68.89% through range which is OK for a male but high for a female.

Saturation: optimal is 35 to 45%, higher end for men - yours is 46 (9-47%) so at the top end of it's range.

TIBC (total iron binding capacity) Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is 51 (41-77 umol/L) which is 27.78% through range which is low in range.

Ferritin: Low level virtually always indicates need for iron supplementation - yours is just 12.25% through range.

Low serum iron and low saturation can suggest iron deficiency, but yours are both at the high end of range. Low ferritin can suggest iron deficiency but your serum iron and saturation do not. Iron is complicated and this needs discussing with your GP or other doctor who understands how you can raise your ferritin level without raising your iron level.

According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth, so whoever said optimal ferritin should be >70 is correct. The optimal ferritin level for thyroid function is between 90-110 ng/ml.

**

B12 (Holo TC) .128 (25-108 pmol/L)

I take it this is the Active B12 test and your result is over range. Do you supplement or are you on B12 injections?

**

Folate 6.2 (3. 1-20.5 ug/l)

This is quite low. Folate is recommended to be at least half way through range and it's OK for folate to be high if B12 is high. A good quality, bioavailable B Complex will help raise your ferritin, and eating folate rich foods should help. If you already take a B12 supplement you wont need this but you do really need a B Complex.

**

Vit D 67 (nmol/L)

This is in the sufficiency category but it's not optimal. The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L. If you want to supplement to raise your level then the Vit D Council suggests taking about 3,500iu D3 daily.

As you have Hashi's you may wish to consider an oral spray such as BetterYou, this is absorbed through the mucous membranes in the mouth so bypasses the stomach. Some Hashi's patients have also got on well with oil based softgels such as Doctor's Best.

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.

**

Here is an article about vitamin deficiencies and hair loss:

hubpages.com/health/16-Vita...

**

In the consultants letter he wrote that I have a positive anti-TPO antibody test suggesting tendency to autoimmune thyroid disease. Are the blood results not sufficient for a proper diagnoses?

The raised antibodies - Hashimoto's - is the cause of hypothyroidism, Hashi's isn't treated, it's the resulting hypothyroidism that is treated. Do you have a diagnosis of hypothyroidism, and are you on Levothyroxine? If on Levo, how much do you take?

Thyroid stimulating level 0.56 (0.27-4.20 mIU/L)

Do you have FT4 and FT3 results as well?

[Lloreta in reply to SeasideSusie]

Hi SeasideSusie, I do not take any supplements at the moment because the results have only just been sent to me. I would like to self medicate, but have no idea what to take or how much on a daily basis. I have not been able to get a telephone appointment with my doctor and desperate for my hair to stop falling out. Any suggestions would be greatly appreciated so I can make a start to self help. I'm afraid I do not have FT4 or 3 results. Maybe I wasn't tested for those, there is nothing on the letter stating that I was.

[SeasideSusie Remembering in reply to Lloreta]

Lloreta

I would like to self medicate, but have no idea what to take or how much on a daily basis.

Do you mean you don't have a diagnosis of hypothyroidism at the moment so you aren't on Levo? Are you considering self medicating for hypothyroidism?

If so then your TSH result of 0.56 (0.27-4.20 mIU/L) suggests that your thyroid is not yet struggling. What you would need for a diagnosis, with raised antibodies, is a TSH over range so above 4.2. But it's also essential to see FT4 and if possible FT3 results as these are the thyroid hormones. TSH isn't a thyroid hormone, it's a signal from the pituitary that detects if there is enough thyroid hormone. A low TSH is saying there's enough thyroid hormone, a high TSH is saying there's not enough thyroid hormone. There is one exception to this and this is when the feedback loop between the thyroid and pituitary isn't working and the TSH remains low, we would need to see FT4/FT3 results as well as the TSH to know this.

Or do you mean supplements for the low nutrient levels? If so then I've already made suggestions for low Vit D in my previous reply. As for B12, that is high for someone not supplementing and is uncommon and it may be best to discuss this with your GP when possible, before supplementing with a B Complex, all B Complex supplements contain some B12 and you don't want to push your B12 any higher.

I can't make any suggestions for ferritin, iron is complicated as you can see from the interpretation of your results. If you took iron tablets for your low ferritin then you are in danger of pushing your serum iron and saturation even higher than they are now, and too much iron is as bad as too little, so again this is something that needs to be discussed with your doctor. Who was it that said "target ferritin>70mcg/L" because you should be discussing with that person how you can achieve that ferritin level without raising your iron levels.

[Lloreta in reply to SeasideSusie]

Hi , its a mine field and I have to thank you because you are the only person who has given me so much information regarding this. I felt that I had just been left on the scrap heap to deal with it! I have only just had the results sent back and unable to get a GP appointment to discuss this therefore not taking any vitamin supplements at the moment but very grateful for the info that you sent me.

Not sure if you can buy medication from a decent health store for thyroid problems. I would like to try and self heal myself without prescription drugs. If not, I will have to take the advice of the doctor.. The iron and ferritin is complicated as you mentioned. The target ferritin >70mcg/L was typed on the results by the lab. The hair loss consultant sent me the results but has signed me off to my doctor to deal with. I will email the surgery and once again ask for the doctor to call me regarding this and get further testing for FT4, FT3 and TSH.

[SeasideSusie Remembering in reply to Lloreta]

Lloreta

Not sure if you can buy medication from a decent health store for thyroid problems.

Are you in the UK? You most certainly cannot buy a prescription medication over the counter in the UK and most definitely you can't buy thyroid medication from a health store. Please don't be tempted by "thyroid support" supplements, they are not what you need and contain ingredients that can be harmful to the thyroid, eg iodine/kelp.

If you have hypothyroidism, the prescription is for Levothyroxine (first line prescription medication), it's actually a thyroid hormone replacement.

I would like to try and self heal myself without prescription drugs.

Once you are hypothyroid you can't. Your body will no longer be able to produce thyroid hormone naturally so it has to be replaced with thyroid hormone replacement (Levothyroxine).

However, as I said, your current TSH level doesn't show that your thyroid is struggling at the moment, you would need at least FT4 tested at the same time (preferably FT3 as well) to see how much thyroid hormone you are producing naturally. If you currently have good thyroid hormone levels (FT4 and FT3) with your low TSH then you are not in need of Levo. If you have very low or below range FT4/FT3 with your low TSH then this can suggest the breakdown of the feedback loop between the pituitary and the thyroid, as mentioned.

Autoimmune thyroid disease - Hashimoto's - is where the immune system attacks the thyroid and gradually destroys it. There's no saying how long it will take to reach the stage of full blown hypothyroidism, but there can be flutuations along the way as and when the attacks happen. You can have evidence of Hashi's - raised antibody levels - but not enough damage yet done to cause hypothyroidism. The hypothyroidism is generally shown by high TSH and low FT4.

If you are in the UK and your GP can't or wont test FT4/FT3 then you can get private tests, you will only need TSH, FT4 and FT3 and this can be done with a fingerprick test offered by an NHS lab in Exeter - check out MonitorMyHealth. Cost is £29 and the results should be accepted by your GP as the test is done in an NHS lab, it's a test that is promoted by the NHS. Any thyroid test should be done no later than 9am before having anything to eat or drink other than water.

In the meantime, some information about Hashi's:

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

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.

You can also check out ThyroidUK's main website (this is their forum), work down the purple menu on the left hand side, and there is a section on autoimmune thyroid disease:

thyroiduk.org/tuk/about_the...

[Lloreta in reply to SeasideSusie]

Wow! so much information I am overwhelmed and so grateful to you. I am in the UK and will sort out tomorrow about futher testing. I will keep you updated with the results once I have them. I will log onto the sites you have sent and check them out for as much information as I can so I can understand Hashi's. I have heard about the gluten free diet and anything is worth a try. Will also try the selenium, glad you mentioned you can't but thyroid meds over the counter. I would never buy that type of medication on the net you never know what's in them. I normally buy my supplements from John Bell and Croyden which is next to Harley Street they are a reptable pharmacy. A big "Thank you" Seaside Susie you have been my saviour.

[SeasideSusie Remembering in reply to Lloreta]

You're welcome

Sorry there's so much information and it's a lot to take in, just keep re-reading, break it down into sections, and eventually it sinks in.

Do come back with further results and hopefully we may be able to suggest something further for you.

[Lloreta in reply to SeasideSusie]

Will do. Thank you

[Lloreta in reply to SeasideSusie]

Hi Seaside Susie, I just received my blood test results that you recommended me to have from monitormyhealth and here are the results. FT3 4.4pmol/L (normal range 3.1 - 6.8 pmol/L), FT4 15.8 pmol/L (normal range 22-22 pmol/L), TSH 0.94 mu/L (normal range 0.27 - 42 mU/L). It seems I am within range or am I missing something? Your take on this would be greatly appereciated. Thank you

[SeasideSusie Remembering in reply to Lloreta]

Hi Lloreta

So new results are:

TSH: 0.94 (0.27-4.2)

FT4: 15.8 (12-22)

FT3: 4.4 (3.1-6.8)

All within range, FT4 is lowish at just 38% through range and FT3 is lowish at 35.14% through range. At least they are well balanced and you seem to be converting T4 (the storage hormone) to T3 (the active hormone which every cell in our bodies need) well enough.

So again, your thyroid hormone results aren't bad enough for a diagnosis and to be started on Levo.

So to reiterate what we discussed before:

1) You have Hashimoto's which is where the immune system attacks and gradually destroys the thyroid. Supplementing with Selenium l-selenomethionine (or a yeast bound selenium) 200mcg daily is said to help reduce the antibodies. Avoid Selenite and Selenate forms of selenium.

2) Your thyroid function test results are all within range so your thyroid has not yet been affected enough to give a diagnosis and start you on Levo. You will need FT4 to go to the bottom of range or below, or TSH to go over range, for diagnosis.

If you have over range TSH with raised antibodies your GP should start you on Levo.

3) Your iron panel doesn't show iron deficiency but does show low ferritin. If you can't get to discuss this with your GP then it's not a good idea to self supplement with iron, you could send your serum iron too high and that wouldn't be good.

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...

You need a ferritin level of over 70ng/ml or mcg/L for hair regrowth but the recommended level is half way through range.

4) Folate is low, a good B Complex will help, eg Thorne Basic B or Igennus Super B.

5) Vit D needs improving to 100-150nmol/L and I suggested supplementing with 3,500iu D3 daily along with important cofactors Vit K2-MK7 and magnesium.

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.

Optimising nutrients may make a difference, especially ferritin.

As for medication for the hypothyroidism, that's not yet possible because your thyroid function test results aren't yet showing that you are hypothyroid, just that you are likely on the way.

It would be worth reading through the thread again as I haven't gone into so much detail in this reply as it's all above.

[Lloreta in reply to SeasideSusie]

Thank you so much for your reply. I have taken on board the information you have given and will place an order for supplements. Wait 3 months then see if there are improvements to my hair and then do further blood tests. Now to shop for liver and investigate the iron rich foods too. Your expertise.

[Lloreta in reply to SeasideSusie]

Hi Seaside Susie

It’s now been over three months since supplementing and I have paid for some bloods to be taken also insisted I have NHS one’s and now have all the results. I would be grateful if you could shed some light on the results for me? My GP doesn’t seem to want to do anything apart from saying they are all normal! My hair is still falling out at a fast rate! I now have some patches at the back of my head. Also my TPO antibodies are still high, but all in all I feel great! Exercising every day and no aches or pains. I had hospital and Medicheck bloods done four days apart to check results were similar. Here goes…..

Vit D - 62 nmol

Zinc - 10.7!

TPO – 103! (down from 107 in February)

TGA – 108!

TSH – 1.2 miu/L

TF4 – 15.8

TF3 4.4

Ferritin – 65 ug/L

Iron – 15.93 umol/L

TIBC – 57.13 umol/L

UIBC – 41.2 umol/L

Transferrin Saturation – 27.88%

FSH

121- IU/L

25.8 - 134.8 R

LH

11 Jun 2020

38.4

IU/L

7.7 - 58.5 R

Oestradiol

42.9 pmol/L

< 100 R

Testosterone

1.09

nmol/L

0.101 - 1.42 R

Free Androgen Index ( I read this hormone could cause hair loss)

1.06

Ratio

0.2 - 7.1 R

Prolactin

419

mU/L

102 - 496 R

I have been supplementing with Selenium 200mg, Zinc, Iron, Vit D 3500 and K2, Omega 3,6 & 9 oils 3tbs, Biotin1000Ug, Methyl Active B Complex, Vit C with Bioflavonoids and a good Probiotic.

Additional to this, I have changed my diet big time, cut out diary and gluten. Eating Liver twice a week and lots of liver pate, steak , chicken, avocados, green leaf and oily fish to boost Ferritin

I have inflammation somewhere, it could be the gut. The hair could be alopecia or possibly thyroid. No idea what to do next any advice would be greatly appreciated.

[SeasideSusie Remembering in reply to Lloreta]

Hi Lloreta

Can you add the reference ranges please for those results that don't have them. And if you could edit your post and sort out those later results so that the results/reference range are all on one line for each test please, I can't easily read them as they've lost their formatting (presumably a copy and paste job).

[Lloreta in reply to SeasideSusie]

Will do just popping out to pharmacy will sort out later. Thank you

[Lloreta in reply to Lloreta]

Hi Seasie Susie, here goes.....

Vit D - 62 nmo/L range - >50 nmol/L sufficiency

Zinc - 10.7! range - 11.0-19.0 umol/l

TPO - 103! range - 0-33 U/ml

Anti Thyroglobulin Abs - 108 range 0-114 U/ml

TSH - 1.2 mu/L range 0.27 - 42 mu/L

TF4 - 15.8 pmol/L range - 12-22 pmol/L

TF3 - 4.4 pmol/L range - 3.1 - 6.8 pmol/L

Iron results

Ferritin - 65 ug/L range 13.00 - 150.00 ug/L

Iron - 15.93 umol/L range 5.8 - 34.5 umol/L

TIBC - 57.13 umol/L range 45-72 umol/L

UIBC - 41.2 umol/L range 24.2 - 70.1 umol/L

Transferrin Saturation - 27.88% - range 20-50%

Hormone results

FSH - 121 IU/L range 25.8 - 134.8 IU/L

LH - 38.4 IU/L range 7.7 - 58.5 IU/L

Oestradoil - 42.9 pmol/L range <100 pmol/L

Testosterone - 1.09 nmol/L range 0.101 - 1.42

Free Androgen Index - 1.06 ratio 0.2 - 7.1 (I read this hormone can cause hair loss)

Prolactin - 419 mU/L range 102-496 mU/L

Thank you for looking into this for me.

[Lloreta]

Hi Scrumbler, I have Zinc deficiency (target plasma concentraion: mid-range), sub-optimal iron (target ferritin>70mcg/L); The rest cam back ok. In the consultants letter he wrote that I have a positive anti-TPO antibody test suggesting tendency to autoimmune thyroid disease. Are the blood results not sufficient for a proper diagnoses?