I hope everyone is getting on okay during these uncertain times.
I apologise in advance for the length of this post! And I'm sorry for putting the full names of everything - I haven't heard of half of them myself so think it's about time I get used to reading and writing them!
I've just received the results of my advanced Thryoid panel from Thriva - when I do my 'general' bloods I can't fault them, but unfortunately the annotations on this test are particularly sparse and I don't really understand what some of the results mean.
Could someone please help me interpret what they mean?
Should mention that when I've done the more generic tests in the past, my TSH and FT4 have been virtually the same as they are below. I tended to take those tests when working a night shift - waking up in the afternoon, taking the test, and waiting until after the test to take my meds. This time (for this set of results) I fasted from around 6pm the previous night, took the test at 9am sharp and didn't take my meds until afterwards. It was 24 hours since my last dose of Thyroxine, so I'm unsure as to why the TSH and T4 didn't change at all, despite doing the test under such different conditions?
Here's the latest results and ranges:
Vitamin D - 46nmol/L
(normal range 50-75nmol/L, optimal range 75-120nmol/L)
B12 (active) - 103pmol/L
(normal range 37.5-188pmol/L)
Triiodothyronine (FT3) - 4.8pmol/L
(normal range 5-6.8pmol/L, optimal range 3.1-5pmol/L)
Thyroid-stimulating hormone (TSH) - 0.11mlU/L
(normal range 0.27-1mlU/L, optimal range 1-2.5mlU/L)
Thyroglobulin antibodies (TgAB) - 262.5kU/L
(normal range 0-115kU/L)
Thyroid peroxidase antibodies (TPOAb) - 45.9kIU/L
(normal range 0-34kIU/L)
Thyroxine (T4) - 137nmol/L
(normal range 66-181nmol/L)
Free thyroxine (FT4) - 19.4pmol/L
(normal range 17-22pmol/L, optimal range 12-17pmol/L)
Thank you in advance!
Written by
Addams11
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This is low. The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L.
If you aren't already supplementing then to reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 4,000-5,000iu D3 daily
Retest after 3 months.
Once you have 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:
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.
This result is good. Below 70 would suggest testing for B12 deficiency, I would want mine over 100.
**
(TSH) - 0.11mlU/L (normal range 0.27-1mlU/L, optimal range 1-2.5mlU/L)
There is something wrong with the "normal range". I think you will find that it is 0.27 to possibly 4.20.
Free thyroxine (FT4) - 19.4pmol/L (normal range 17-22pmol/L, optimal range 12-17pmol/L)
Again, there is something wrong, the normal range is actually 12-22.
Triiodothyronine (FT3) - 4.8pmol/L (normal range 5-6.8pmol/L, optimal range 3.1-5pmol/L)
Again - normal range is 3.1-6.8.
I think the way that Thriva display there results can be confusing. From what I understand they have a graphic which has a green bar, and the green bar has a light green section and a darker green section. One of those sections says "optimal".
As for the reference range - the "normal" range - you take the figure from the left hand end of the green bar through to the right hand end and include both the light green and dark green sections. So FT4 range is 12-22 and FT3 range is 3.1-6.8.
I wouldn't put much store by Thriva's "optimal range", optimal for who? And to have an optimal FT4 range of 12-17 is ridiculous because that is between 0 and 50% through range. Again with FT3 their optimal range of 3.1-5 is between 0 and 51% through range.
The aim of a treated Hypo patient on Levo, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their ranges, often over 70% is where most people feel best.
So your results are actually:
TSH: 0.11 (0.27-4.2) - This is below range which a doctor will not like, but TSH is not a thyroid hormone, it's a signal from the pituitary to tell the thyroid to make hormone if it detects there's not enough. Yours is low because the pituitary knows you have a good FT4 level so doesn't need to tell the thyroid to make any more hormone.
FT4: 19.4 (12-22) - this is a good result, it's 74% through range.
FT3: 4.8 (3.1-6.8) - this is 45.95% through range so is not in balance with your FT4, it is rather low in range suggesting that you don't convert T4 to T3 particularly well.
Good conversion requires optimal nutrient levels. We can see that your Active B12 is OK but that your Vit D is poor. What about Folate and Ferritin?
Your antibodies are raised and this suggests autoimmune thyroid disease, aka Hashimoto's, which is where the immune system attacks and gradually destroys the thyroid.
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.
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. This is possibly why your Vit D is low. If you can post your folate and ferritin results as well then further comment can be made.
Apologies regarding the ranges, I didn't mean for it to be confusing, I've just written exactly what Thriva have sent back to me. What you have said makes much more sense and I'll bear that in mind when posting the Thriva ranges in future.
Unfortunately I was unable to take my Vitamin D supplements for about a week or so prior to the test (they were out of stock) my new pack are arriving this week, so I'll be back on that again. I'll monitor the levels in future against the numbers you've published above - thank you again!
It's interesting that you mention a gluten-free diet. This is something I have considered for some time. I'll take a look at the links you've provided.
My ferritin is 24/ug/L - the range on Thriva is shown as 13-150ug/L.
My folate is 20.3nmol/L - the range on Thriva is shown as 8.83-60.8nmol/L
Thank you so much for your help - I really do appreciate it.
My ferritin is 24/ug/L - the range on Thriva is shown as 13-150ug/L.
This is very low. Ferritin is recommended to be half way through it's range (82-ish with that range). Low ferritin can suggest iron deficiency anaemia.It's not a good idea to self supplement with iron tablets. I would ask your GP to do an iron panel (will tell you if you have iron deficiency) and a full blood count (will tell you if you have anaemia).
If you don't have iron deficiency or anaemia then you can help raise ferritin 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
My folate is 20.3nmol/L - the range on Thriva is shown as 8.83-60.8nmol/L
Folate is recommended to be at least half way through range, so with that range you'd be looking for at least 35. If that was my result I'd be supplementing with a good, bioavailable B complex such as Thorne Basic B or Igennus Super B. If you take a B Complex then leave it off for 7 days before any blood tests in future (thyroid or otherwise) because it contains Biotin and most testing equipment uses Biotin and will result in false readings.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
and I'll bear that in mind when posting the Thriva ranges in future.
Looking for any help interpreting latest test results please. 
Help interpreting results please
Help interpreting test results 
Can you please help me interpret my test results
New Results: Please Help Interpret!
