Help with understanding test results

[Behappy88]

Hi, I'm new on here. I was wondering if someone could please help me read my recent test results from Thriva. I'm not on any thyroid medications. I have some symptoms of an underactive thyroid like feeling cold all the time, scalloped tongue and hair loss. I was wondering what I need to look out for in terms of hashimotos? I would be grateful for any help. Thanks.

Vitamin D 75 (75-175 nmol/L)

Ferritin 61 (13-150 ug/L)

Active B12 89 (37.5-188 pmol/L)

Folate (serum) 29.0 (8.83-60.8 nmol/L)

TSH 1.27 (0.270-4.2 mIU/L)

Free T3 4.8 (3.1-6.8 pmol/L)

Free Thyroxine FT4 16.1 (12-22 pmol/L)

Thyroglobulin antibodies 14.2 (0-115 kU/L)

Thyroid Peroxidase antibodies 6.1 (0-34 kIU/L)

Total Thyroxine T4 101.0 (59-154 nmol/L)

[SeasideSusie Remembering]

Behappy88

To confirm Hashi's your thyroid antibodies would be raised. Hashi's is where the immune system gradually attacks the thyroid and destroys it, resulting in hypothyroidism. There can be swings from hyper type symptoms to hypo and fluctuations in test results. Your results don't suggest Hashi's.

TSH 1.27 (0.270-4.2 mIU/L)

Free T3 4.8 (3.1-6.8 pmol/L)

Free Thyroxine FT4 16.1 (12-22 pmol/L)

Your results are euthyroid (normal). A normal healthy person will have a TSH of no more than 2 (often around 1) with FT4 around mid-range.

Vitamin D 75 (75-175 nmol/L)

Recommended level, according to the Vit D Council/Vit D Society is 100-150nmol/L

Ferritin 61 (13-150 ug/L)

Recommended level is half way through range - 82 with that range.

Active B12 89 (37.5-188 pmol/L)

Active B12 should be over 70 (below 70 suggests testing for B12 deficiency), I like mine 100+

Folate (serum) 29.0 (8.83-60.8 nmol/L)

Recommended level is at least half way through range (35+ with that range)

Your levels aren't too bad, you might want to improve your Vit D and maybe eat liver, black pudding or liver pate every couple of weeks to lift your ferritin a bit and maintain it.

[Behappy88 in reply to SeasideSusie]

Thank you so much for replying. That makes things a lot clearer. Could I also ask.. my last tsh level was 3.24 (Jan 2020) and GP said it was normal range and wouldn't test for anything else, that's why I decided to pay for a finger prick test. Is it normal for tsh levels to rise/fluctuate? Thank you so much for your advice

[SeasideSusie Remembering in reply to Behappy88]

Behappy

To be able to compare results, tests have to be done under exactly the same conditions.

Do you remember what time you did your GP test?

What time did you do your Thriva test?

TSH is highest early morning and lowers throughout the day.

Eating can lower TSH.

Coffee can affect TSH.

For a diagnosis of hypothyroidism we need the highest possible TSH, at least over range and most doctors wait until it reaches 10.

When doing thyroid tests, we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

[* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.]

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

[Behappy88 in reply to SeasideSusie]

Theres so much to consider before taking blood tests, thank you for the information. The blood test in Jan 2020 was some time between 9-9.30am and the home prick test was 9.40am. Next time I'll know to do it even earlier. I did fast both times but I can't remember if I took any biotin before the test in Jan. Id recently read about biotin affecting blood tests so stopped taking any the week before I did the Thriva test. Its very worrying that gps tend to wait until tsh is over 10 to do anything! By then surely you would be feeling pretty ill and thyroid could be quite damaged?

[SeasideSusie Remembering in reply to Behappy88]

Behappy88

By then surely you would be feeling pretty ill and thyroid could be quite damaged?

Yep! Doctors are sadists! I honestly have no idea why there is a reference range of, approx, 0.2-4.2 (or similar) then it's totally ignored and you can't be diagnosed until it's over double the top end of range. Symptoms are ignored, doctors can't "doctor" any more, they don't know how to, they can only read blood tests and if it doesn't say "abnormal" then you are perfectly healthy, and in some instances even when it does say "abnormal" you are still perfectly healthy.

Oh, and once diagnosed they become slaves to TSH, which isn't even a thyroid hormone. TSH is useful for diagnosis but after that it's not a lot of help. TSH is a signal from the pituitary to tell the thyroid to make hormone when it detects there's not enough (TSH will be high in those circumstances). FT4 and FT3 are thyroid hormones and that's what tells us if we're optimally medicated, but many doctors only test TSH and even if FT4/FT3 are tested they ignore the result and only use the TSH to decide the dose of Levo.

I'm afraid I'm on my soapbox tonight 😠

[Behappy88 in reply to SeasideSusie]

Thats crazy! Its very worrying! On reading the list of symptoms, I was convinced I had an underactive thyroid and then read symptoms of Hashimoto and that kind of fitted too. Sorry if my questions upset or got you annoyed, its an awful, frustrating and confusing situation! Thanks again for your help x

[SeasideSusie Remembering in reply to Behappy88]

Behappy88

Sorry if my questions upset or got you annoyed, its an awful, frustrating and confusing situation!

Oh gosh, no, your post hasn't upset me, we see so many dreadful tales of doctor ignorance and patient suffering daily on here that just occasionally it bubbles over and has to come out, better out than in they say, does me good to have a rant occasionally 😂

[Behappy88 in reply to SeasideSusie]

I can imagine! lol yes definitely better out! I'll have another set of tests done in 3 months time and hopefully the results will be similar. I just don't know why I have cold hands all the time and hair loss but it'll be good if I can rule out thyroid/hashimoto.

[SlowDragon Administrator in reply to Behappy88]

Do you have any sensation of swelling in neck...pain or difficulty swallowing?

Any history of thyroid disease in your family

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

[Behappy88 in reply to SlowDragon]

Hi slowdragon, no I dont have any problems with swallowing or pain. Last year I did feel like I had something stuck in my throat for about a day or 2 but haven't experienced that again. Ive been trying to check my thyroid at home and to me it looks a little enlarged but my husband says he can't see anything so I'm not sure if I'm being paranoid. Once lockdown is eased/lifted then I will go and see gp to have it checked. No one in my family has been diagnosed with any thyroid disease. Thanks for replying x

[Behappy88 in reply to SlowDragon]

Hi slowdragon, just wondering if I am someone who doesn't show antibodies with hashimoto, would you be able to advise me how would I rule it out please? Would it be an ultrasound of the thyroid? Or some further blood tests possible blood counts or cortisol/inflammation levels? Thanks

[SlowDragon Administrator in reply to Behappy88]

Yes an ultrasound.

[Behappy88 in reply to SlowDragon]

Thank you

[Behappy88 in reply to Behappy88]

Hi again,

Would you be able to advise/help me please. Before I did the thriva blood test I had another blood test done. Due to miscommunication I only just received the results back. This test was taken around 11.15am (I didn't know then that the best time to take blood is before 9am).

Tsh 1.110 mIU/L (0.465-4.68)

Free T3 5.56 pmol/L (4.3-8.1)

Free T4 16.2 pmol/L (10.0-28.2)

Thyroglobulin antibodies 11.6 (0-115 kU/L)

Thyroid Peroxidase antibodies <9.0 (0-34 kIU/L)

All gp said was its all normal. Would you be able to look at the results please? Are they a waste of money because I had the test done a bit later in the day? Thanks

[Behappy88 in reply to Behappy88]

Sorry measurement for antibodies should be IU/ml, the ranges are correct

[SlowDragon Administrator in reply to Behappy88]

Sorry never saw this as you replied to yourself (easily done)