Hi all, I am very new to all this and don’t know much about the thyroid. I had a thyroid test and got 3 abnormal results and am not sure what they mean, if I have a thyroid problem, or whether I should be worried. If someone could answer these questions it would be very much appreciated. My results are below:
1. T4 (Thyroxine): HIGH: 178 nmol/L. Normal range: 59-154.
2. T3 (Free Triiodothyronine): HIGH: 7.7 pmol/L. Normal range: 3.1-6.8.
Your raised TPO antibodies suggest autoimmune thyroid disease aka Hashimoto's which is where the thyroid is attacked and gradually destroyed, resulting in hypothyroidism. Hashi's is the most common cause of hypothyroidism.
In a normal healthy person with no thyroid problem, the TSH would be no higher than 2, FT4 would be around mid-range and FT3 within range.
Your FT4 is within range but your FT3 is over range.
Fluctuations in symptoms and test results are common with Hashi's.
Presumably you don't have a diagnosis and haven't been prescribed Levothyroxine.
Normally, when positive antibodies are present, TSH will need to be over range before diagnosis is given and Levo prescribed. Without positive antibodies, TSH would have to be over 10.
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.
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
As your TSH and FT4 are within the normal range, all that you can do at the moment is keep an eye on them, maybe retest in 3 months to see if there is any change.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. It's essential to test Vit D, B12, Folate and Ferritin and address any problems so it would be an idea to ask your GP to test these. You are welcome to post these results, including reference ranges (plus units of measurement for Vit D and B12), for comment and suggestions for supplementing where necessary.
Feel free to ask questions about anything to help you understand more.
Thank you so much for your thorough reply, it is much appreciated. I will definitely look into the links you have provided and potentially going gluten-free.
So do you think it is likely that I have Hashimoto’s then?
I suspected I had a thyroid problem after looking into a few health problems I have. I went to my GP who did the FT4 and TSH test, and as you can see, they both come out normal. Therefore, my doctor concluded that I have no thyroid problem and I was dismissed.
After reading a little more about it, I discovered that GPs don’t do the more in-depth tests, so I had these done via a private company. As you can see, they seem to suggest something isn’t right. Of course I would hate to have a thyroid problem, however it would answer a LOT in terms of health problems I have.
I did have some further health tests done which assessed the Vitamin C etc you mentioned. I will look for those results and report back.
I have booked another GP appointment for a few weeks time, but I’m sure they will do the same test as last time and say I’m fine again.
Regarding the test results you mentioned, I privately got some tests done in a bid to understand my chorionic tiredness and almost daily headaches. They are from last August so a bit out of date, but understanding them would still be helpful. Here are the results:
I notice that the Ferritin result is abnormal, do you know what this means? If you wouldn’t mind giving me a quick run down of what each vitamin does/what it means I would greatly appreciate it.
If taking iron supplements they should be left off for 7 days before testing. This result could be high due to supplements.
If not taking iron supplements then ferritin can be high due to infection/inflammation. It can also be high if you had eaten iron rich food in the week before the test, eg liver, liver pate, black pudding, etc. If it was iron overload it would be higher than that, ie over 200 for pre-menopause or over 300 for post-menopause and males (from what I have read). However, iron is complicated so there could be other reasons.
Barely into the sufficient category. The Vit D Council recommends a level of 125nmol and the Vit D Society recommends 100-150nmol. Supplementation was necessary. If supplementing, dose was not high enough.
Were these done at the same time and without any supplementation? I'll comment when I know the answer to that because I'm quite intrigued by those results.
Folate is recommended to be at least half way through range. This result suggests either supplementing or eating lots of Folate rich foods or just a naturally high level.
Yes, the results, including both B12, were done at the same time. Why does that result intrigue you out of interest?
I do and always have taken supplements. I took them at the time of the test, as I didn’t realise they would affect results unfortunately. I admittedly don’t eat very healthily due to a combination of food allergies and being a fussy eater. The supplements I take are:
Ultra Maximum Acidophilus tablet 1 a day (20 billion friendly bacteria) which provides Lactobacillus acidophilus and Bifidobacterium bifidum (hollandandbarrett.com/shop/....
I also take Berocca Energy Supplement effervescent drink 1 a day, which provides Vitamin B1, Vitamin B2, Niacin, Vitamin B6, Folic Acid, Vitamin B12, Biotin, Pantothenic Acid, Vitamin C, Magnesium and Zinc (superdrug.com/b/Berocca).
Total B12 measures the total of B12 both bound to proteins and unbound (free/active). Active B12 measures just the free/active B12. It's the active B12 which is available for the cells to use. We can have a good level of Total B12 but a poor level of Active B12.
Both your Total and Active B12 levels are high in range. I would have been surprised to have seen those results if you didn't supplement and I imagine these high levels are due to the Berocca. I am actually surprised because Berocca isn't a particularly good supplement. Does it actually give the amounts of each of the active ingredients, it's not easy to find this information on the Internet.
Hello, yes I had also heard Berocca isn’t a very good supplement. But I was taking it more as it is supposed to really boost your energy as I struggle badly with fatigue. I haven’t noticed it make any difference, even with continued use.
The amount of each vitamin are: Vitamin B1=10.4mg, Vitamin B2=13.6mg, Niacin=45.3mg Niacin Equivalent, Vitamin B6=7.1mg, Folic Acid=366ug, Vitamin B12=8.6ug, Biotin=130ug, Pantothenic Acid=22.7mg, Vitamin C=476mg, Magnesium=95mg and Zinc=9mg.
The u in the ug is a strange symbol I don’t have on my keyboard.
Thank you for that information. I am debating stopping the Berocca and starting a supplement if you could recommend any good ones? It would be much appreciated.
Just thought I’d also mention I did get two more abnormal results. You didn’t ask for these, but thought I’d mention it to give you a fuller picture and incase it is relevant:
CRP is an inflammation marker, it will be high if there is infection/inflammation at the time of the test. Every test I've had has a range of <5 so the upper limit of your range is quite low. Yours could be raised due to your Hashi's.
There is no multivitamin that can be recommended, they generally contain too little of anything to help raise low levels, tend to use the cheapest, least absorbable and wrong form of ingredients, and often include things we should test first and only supplement if deficient, eg iron, calcium, Vit D, iodine.
Always advised here is to test the core nutrients :
Vit D
B12
Folate
Ferritin
and supplement where necessary.
Your only low level was Vit D and you should be supplementing that. As your test was done in August I would do a new test and post the result for guidance on how much D3 you should take and information about the cofactors needed when taking D3.
It's a dried blood spot test so should be fine to do even with the current delays with the post. Standard first class seems to be taking 5 working days at the moment but that may change.
Thank you for your response. I have been busy trying to sort a doctors appointment out. They have agreed to do some more tests due to my abnormal private test results. I have a long list of things they are testing me for - is there a way I can attach a photo to my reply? I can type it out if not but it will take a while as the names of the tests are complicated!
You can add one photo to the opening post of a thread only, so you could put it there. Click on MORE below your first post then choose EDIT, add the picture then click on SUBMIT. Please make sure that there are no personal details showing, eg name, date of birth, National Health number, and that there's not so much information to make it unreadable.
Hello, sorry for the delay in response. I have typed the tests I have been sent for by the doctor below. If you wouldn’t mind letting me know what they mean if possible, if not I can look them up individually as I know there are quite a few, just thought it might help my understanding if explained by a real person! And if you have any initial thoughts what the doctor may be suspecting is wrong with me judging by the tests ordered it would be interesting to know your opinion.
It’s a 12 hour fasting blood test. Thank you and let me know if any other info is needed.
Anti-Thyroid Peroxidase Abs, - thyroid antibody test. You've already had this done and your antibodies were elevated suggesting autoimmune thyroid disease aka Hashimoto's. Once you've had a positive result there's no need to retest. Antibodies fluctuate and even if you subsequently have a low result you will still have Hashi's.
Vitamin B12 and Folate, - B12 and folate work together so it's good that both are being done. You already know that you have good levels of these.
Bone (Ca, CCa, Alb, Phos, ALP) - bone profile, checking strength of bones, looking for osteoporosis, etc.
Blood Picture (includes FBC and Diff) - full blood count and differential, looks and red and white blood count, will show up any anaemia or infection
eGFR (Creatinine only), - kidney function
CRP, - inflammation marker, can be raised if inflammation or infection is present
Erythrocyte Sedimentation Rate, - another inflammation marker
Ferritin, - Ferritin is a blood protein that contains iron, this is your iron store. Low level can suggest iron deficiency or iron deficiency anaemia. You know yours is high.
Fasting Glucose, - checking for diabetes
HbA1c - Suspected Diabetes Diagnosis, - checks average blood sugar for previous 2-3 months
Lipid Screen (Chlo HDL)(=Fasting), - tests cholesterol and other fats in the blood
Liver (ALT, T Bil, Alb, ALP), - looking at liver function
TFT (for monitoring)(=) - thyroid function test, this could be TSH alone, it could be TSH plus FT4, it could be TSH, FT4 and FT3.
Serum U&E (Na, K, Urea, Creatinine) - looking at kidney function
Your GP is being very thorough. He's probably not suspecting anything is wrong but is checking everything to rule them out.
If you don't have any symptoms there's nothing to worry about. Patients with elevated antibodies are more likely to eventually develop hypothyroidism. This risk is about 2% per year.
However, you had a comprehensive thyroid blood test which suggests you do have symptoms. In this case the elevated antibodies could lead to erratic hormone secretion for a while and perhaps eventual failure of the thyroid gland.
I suspected I had a thyroid problem after looking into a few health problems I have. I went to my GP who did the FT4 and TSH test, and as you can see, they both come out normal. Therefore, my doctor concluded that I have no thyroid problem and I was dismissed. However, when this more in-depth testing was undertaken privately, it seems to suggest something is not right.
In your opinion, do you think I have a thyroid problem, and if so what problem? (I won’t hold you to it, just interested in people’s opinions as I am still learning about it all!)
It's more important to go by signs and symptoms than blood hormone levels. In that respect what are the symptoms that concern you? Your blood results are abnormal but people can be OK or quite ill with these sort of abnormal results.
What started my research and going privately for blood tests is desperation due to extreme and constant tiredness and almost daily headaches. I’m getting to the point where I can barely function, but my GP just says that my bloods have come back fine so he doesn’t know what’s wrong. So I’m trying to figure it out myself, which is both draining and stressful.
I assume you have been tested for diabetes, just to rule it out. I don’t think you extreme symptoms would be due to a failing thyroid gland or one that is intermittently putting out too much hormone. The minor deviations in the hormone levels wouldn’t explain this. However, I was severely hypothyroid with excellent blood test results. Thyroid hormone action is extremely complex and doctors (and endocrinologists) fail to acknowledge this. The only way to find out is by a trial of thyroid hormone.
What other symptoms do you have other than tiredness and headaches? It would also be useful to know your resting pulse. Your fT3 figure would suggest hyperthyroidism which also causes fatigue, so it’s important to know all signs and symptoms.
If you don’t mind me asking, how did you get diagnosed with a thyroid problem with excellent blood test results?
I have been tested to see if I am diabetic and it come back negative.
My resting pulse is 80-90 usually. It’s 93 at present. Sometimes it is 100-120 when I am resting and I am alerted to this as I have palpitations. I have had a heart test regarding my palpitations but nothing was picked up.
What triggered me to do these tests is because lately a LOT of my hair is falling out which is panicking me. I have also gained a lot of weight recently which was another reason. After researching these problems, I read a little about thyroid problems and after looking at the symptoms, it would explain quite a few of my health problems where the cause has never been discovered. As well as the fatigue, headaches, hair loss, weight gain, I cannot stand being cold, am incredibly pale, suffer with dry skin, brittle nails, enlarged tongue, very weak muscles, excessive and prolonged menstrual bleeding, constipation, dry eyes, anxiety, depression and very bad memory lapses.
The difficulty is that the above symptoms could all have other causes, eg I could just be prone to heavy bleeding or have undiagnosed PCOS. My fast heartbeat could be because I don’t exercise much because of extreme fatigue. Etc.
My profile gives a little detail. I was severely hypothyroid with excellent hormone levels. A lot of research pointed to hypothyroidism. I saw a very nice endocrinologist who felt unable to diagnose due to my excellent blood test results. I read this ncbi.nlm.nih.gov/pmc/articl... in the BMJ and was referred to Dr Skinner who said he thought I might be hypothyroid and prescribed levothyroxine. Dr Skinner was hounded by some endocrinologists and the GMC because of his support for patients. This led to his early death from a stroke. This action against Dr Skinner was the most evil behaviour I have ever witnessed from the medical profession.
Given all your signs and symptoms, some of which are specific,I think there is a strong chance you suffer from hypothyroidism. It’s possible you have a failing thyroid gland but given the extent of your symptoms with mildly abnormal bloods I suspect there is some other explanation for your hypothyroidism. However, in practical terms it will be far easier to get treatment on the basis of abnormal blood tests.
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Blue Horizons Blood Results for Thyroid - Please help
Interpreting results
Received my results today, any ideas/help? Thanks x
Re-posting - thyroid & vitamin test results
