Looking for opinions on recent bloods? Many thanks in advance

[MrsButler]

I’ve just had some tests done (early morning), as I’m monitoring my thyroid situation.

TSH – 2.88 range 0.27 – 4.2

Free t3 – 4.27 range 3.01 – 6.8

Free t4 – 12.6 range 12-22

TGA – 11.8 range 0-115

TPO under 9 range 0-34

Symptoms wise, mainly tiredness, feeling cold, some weight gain, hair loss and spotty face.

Previous tests showed up vitamin and ferritin issues – I’ve worked on these and improvements have been shown, but couldn’t afford to re-test this time.

Obviously, my antibody situation doesn’t support Hashis – but I’m sure I had a swing earlier this year. I was having a lot of pain in my lower throat and back of neck, palpitations and I lost half a stone without even trying. I’ve swung back to above symptoms that were present from last year at least.

I’m due to see the neck lump clinic in August ( I have a thyroglossal duct cyst that will likely need removing), so I’m going to ask that my thyroid be scanned again ( last ultrasound showed 2 nodules) and really push them as to if they can see any sign of Hashis.

Not diagnosed or on any medication for my thyroid.

But what I’m asking tonight is, what do you think of those results – to me it looks like a move towards being hypo?

[SlowDragon Administrator]

Yes ..

Suggest you put all test results together on spreadsheet

Levels look like they are dropping at each test

How’s your ferritin...can see it was very low

healthunlocked.com/thyroidu......

[MrsButler in reply to SlowDragon]

Last test I had my ferritin was 25, that was a couple of months ago so I'm assuming it's risen further since then. Probably should re test it shouldn't I.

Gp did a full iron panel thing since my last post and didn't raise any concerns.

[SlowDragon Administrator in reply to MrsButler]

Can you add the iron panel results?

[MrsButler in reply to SlowDragon]

Added below

[Zazbag]

Could this be heading towards secondary hypothyroidism?

[MrsButler]

Looking at what I have, she did a FBC. That's not the same is it? I asked for iron...can you advise what tests I actually need. I seem to fail with every trip to gp.

Hb 137. R 115-165

Haematocrit 0.409 r 0.37 - 0.47

RBC 4.75. R 3.8. R 3.8-5.8

MCV 84.8 r 82-98

MCH 28.6. R 27-32

Ferritin 25 r 13- 150

Folate 7.2. R 3.9 - 19.8

[SlowDragon Administrator in reply to MrsButler]

Ferritin is very low...eating iron rich foods like liver or liver pate once a week, red meat, pumpkin seeds, dark chocolate etc can help improve

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

[SlowDragon Administrator in reply to MrsButler]

Folate in low side

No B12

No vitamin D

NHS postal kit test

vitamindtest.org.uk

[MrsButler in reply to SlowDragon]

Last vit d was 96 r 50-175

Total b12 465 r200-900

Active b12 64.8 r 50-175

All a couple of months old but continue to take better you sprays for both

[SlowDragon Administrator in reply to MrsButler]

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

B12 and folate on the low side. Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

This would help improve low folate and keep all B vitamins in balance

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Igennus Super B complex are nice small tablets. Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[MrsButler in reply to SlowDragon]

Thank u. I will order those and then re test everything in around 6 weeks before I go to my neck lump clinic.

[SlowDragon Administrator in reply to MrsButler]

20% of Hashimoto's patients never have raised antibodies

Ask for ultrasound scan of thyroid

healthunlocked.com/thyroidu...

[MrsButler in reply to SlowDragon]

Thanks for all the info

[Hidden]

"Obviously, my antibody situation doesn’t support Hashis"

Not necessarily true. Antibodies come and go, and sometimes one test doesn't show high antibodies even if you do have that condition.

"I’m going to ask that my thyroid be scanned again ( last ultrasound showed 2 nodules) and really push them as to if they can see any sign of Hashis."

I don't know much about scans. If you have nodules they would be wanting to keep an eye on them, but don't know if a scan would show up an autoimmune condition (not necessarily Hashis). Lymphocyte (immune cells) infiltration of the gland would prove immune system attack but not sure if a scan would show it.

Your TSH is probably too high. Most of us need a TSH under 1. I still felt very hypo when my TSH was just under 3.

T3 and especially T4 are low, another indication that your thyroid isn't making enough hormone.

FT4 6 % through range

FT3 33.25% through range

If you are not yet medicated ask for a clinical trial of thyroxine.

I find it helpful to make a bullet list of symptoms and how they affect your life to show to the doctor. Only thing is that most consultations are by phone these days.

[MrsButler in reply to Hidden]

Thank you.

[HLAB35 in reply to MrsButler]

Great advice above from Jnetti and SlowDragon. I was looking at your TSH and thought, well, actually, it should probably be higher considering how low your T4 is..

Your T3 is less dire which may suggest that you recently had a flare up. If they tested you a couple of months ago, your results for thyroid could have been quite different ....

My 'guess' is that a month or two ago you had a flare with raised t4 and t3. The t4 would have dropped within a month in response to a suppressed tsh, but residual t3 is still circulating. I may predict that your t3 will slowly decline in line with low t4 and your tsh will continue to pick up and go higher... but it may not. Sometimes the hypothalamus takes a while to play catch up..

As you suspect - you should keep an eye on this. The iron panel wasn't complete, but if you're low in iron you could very easily be low in other minerals / vitamins which are hard to absorb when hypo. A proper iron panel would be good, plus vitamin d. For spots and hair loss you want to rule out PCOS with high levels of androgens? Possibly low vitamin D, C, A and B6 - but get p5p (which is in the Igennus tablets) plus zinc and magnesium - possibly selenium and chromium too. Also get checked for diabetic markers. PCOS is linked to insulin resistance and can occur in hypos.

[MrsButler in reply to HLAB35]

Thanks, I've responded below.

[MrsButler]

Thank you for your insight. It's all a bit puzzling to me so it's helps to have others views.

I've had the hbac1 test this year and that was fine. And last year I had my ovaries scanned (serious bloating is another of my symptoms) I had a cyst, but it reduced right down by 3 months later. I'm assuming pcos would've shown on that scan?

And I have ordered the ingennus tablets today.

[HLAB35 in reply to MrsButler]

Not all cysts are caused by pcos, but the likelihood of a cyst occurring is greater as a large number of follicles will be stimulated and then fail to produce eggs in pcos... and some of them may form cysts. If they were actively looking for multiple follicles on your ovaries they should have seen them with the scan, but it'd be worth asking the question.

Other symptoms, like weight gain, hirsuitism, missed periods, diabetic markers (yours are negative) etc would make a diagnosis of pcos reliable.

Endometriosis is another possibility and would tie in with low iron due to heavy periods, but you'd probably already suspect that if you had it.

Hashimoto's can mimic both conditions as short hyper phases can look like pcos with missed periods and the longer term hypo state can cause symptoms similar to endometriosis. Of course it is possible to have all three!

wrt Bloating - gluten and dairy may be exacerbating things.. they always did in me. Be careful with soya too - it can do weird things to hormone receptors. I avoid it mostly if I can. Marilyn Glenville has written lots on managing diets with hormonal issues including PMS, PCOS and menopause.

[MrsButler in reply to HLAB35]

Pretty sure I have endo, but consultant said lap was needed to confirm, but surgery is a bit risky down there for me due to scar tissue from a burst appendix and I don't want to risk it. Periods are all over the place but I'm also approaching peri menopausal time so... Who knows!

Thanks again

[HLAB35 in reply to MrsButler]

In that case (based on your age) it could be oestrogen dominance that's occurring which may also play havoc with the thyroid.... puberty, pregnancy and menopause are trigger times for Hashi's. Do lots of reading about it and consider a few dietary tweaks and additional supplements.

[MrsButler in reply to HLAB35]

The consultant has suggested an oestrogen pill for my possible endo, so I don't ovulate etc I really need to research if that's the right move for me.

Thanks again for replying

[HLAB35 in reply to MrsButler]

Given the thyroid issues you're already having, don't let them sweep those under the carpet.. In fact, high oestrogen means we need more (not less) thyroid hormone. (Look up Dr Marilyn Glenville and her books.) Also, if you start a new post here asking specifically about Oestrogen, Low Iron, Endometriosis and Hashi's you'll hopefully get some fresh information from admin members who missed this post.