I was diagnosed with an under active thyroid aged 14 after 4 years of feeling ill and put on 125 mg of levothyroxine. Unfortunately at the same time I was diagnosed with glandular fever. I have spent years oscillating between feeling well and hardly being able to get out of bed . I practice yoga, rest as much as possible and only eat organic produce, no alcohol, dairy, gluten or sugar etc etc.
I have been virtually bed bound for the last 6 weeks, feeling exhausted all the time. I know I should go for more blood tests but don't want to enter a hospital at this time. Can anyone look at my results from Dec 2018 and see if they can spot a particular reason for this?
Se thyroid peroxidase Ab conc - (DRRI16590) - Normal - No action required <33 IU/ml 0 - 59 IU/ml
Negative
HbA1c levl - IFCC standardised - (JC16590) - Normal - No action required 31 mmol/mol 20 - 41 mmol/mol
In known diabetics a result <48mmol/mol indicates good glycaemic
control. For diagnosis, HbA1c <42mmol/mol is not consistent with DM
but patient may still be at high risk.Note that HbA1c measurement is
contraindicated in some patients. Contact the Duty
Biochemist if further information is required.
Erythrocyte sedimentation rate - (JC16590) - Normal - No action required 2 mm/hr 1 - 15 mm/hr
Serum folate - (JC16590) - Normal - No action required 13.9 ug/L 3.9 - 19.8 ug/L
Serum vitamin B12 - (JC16590) - Normal - No action required 563 ng/L 200 - 900 ng/L
Serum lipids - (JC16590) - Make Routine Appointment with HCA
Serum HDL cholesterol level 1.59 mmol/L >1 mmol/L
! Serum cholesterol 6.6 mmol/L <5.01 mmol/L
Note: the recommended level is 4.0 mmol/L or less for those at high
risk.
Serum cholesterol/HDL ratio 4.2
Serum total 25-OH vit D level - (JC16590) - Normal - No action required 60 nmol/L 50 - 150 nmol/L
Adequate vitamin D status
Liver function test - (JC16590) - Normal - No action required
Serum ALT level 16 U/L 0 - 41 U/L
Serum gamma GT level 8 U/L 0 - 42 U/L
Serum total bilirubin level 6 umol/L 0 - 21 umol/L
Serum total protein 78 g/L 60 - 80 g/L
Serum ferritin - (JC16590) - Normal - No action required 26 ug/L 12 - 300 ug/L
Thyroid function test - (JC16590) - Normal - No action required
Serum free T4 level 19.5 pmol/L 11 - 23 pmol/L
Serum TSH level 3.7 mU/L 0.35 - 5 mU/L
Serum C reactive protein level - (JC16590) - Normal - No action required <1 mg/L 0 - 5 mg/L
Urea and electrolytes - (ks2) - Normal - No action required
Serum potassium 4.1 mmol/L 3.5 - 5.3 mmol/L
Serum creatinine 74 umol/L 45 - 84 umol/L
GFR calculated abbreviatd MDRD >90 ml/min/1.73sqm
Estimated
GFR calculations are not valid if creatinine is changing in
acute disease.
Please note eGFR is now calculated using the CKD-EPI equation.
! Serum urea level 2.1 mmol/L 2.5 - 7.8 mmol/L
Serum sodium 139 mmol/L 133 - 146 mmol/L
Bone profile - (ks2) - Normal - No action required
Unfortunately at the same time I was diagnosed with glandular fever.
Epstein Barr Virus causes glandular fever which can cause hypothyroidism.
Can anyone look at my results from Dec 2018 and see if they can spot a particular reason for this?
Obviously 18 month old results are of no use now, everything could have changed. But what can be said is - at that time
* You were undermedicated to have a TSH of 3.7 (0.35 - 5) even though you had a reasonable FT4 level of 19.5 (11 - 23). You should have had an increase in your Levo. 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 reference ranges. When TSH is around 1 we look at both FT4 and FT3 to see how well we convert T4 (a storage hormone) to T3 (the active hormone which every cell in our bodies need). It's low T3 that causes symptoms.
* Your high cholesterol was probably due to being hypothyroid, it's very common, when optimally medicated cholesterol shouldn't be a problem.
* Even though your Ferrin was in range at 26 ug/L (12 - 300) which most doctors are happy with, this was very low and low ferritin can suggest iron deficiency. Your blood tests didn't suggest anaemia but you should have had an iron panel to see if you had iron deficiency and you should have had advice to raise your ferritin level.
* Adequate vitamin D status - it would be better to know the actual result because "adequate" isn't "optimal". Optimal is 100-150nmol/L according to the Vit D Council/Vit D Society, yet doctors are happy with 50nmol/L.
I know I should go for more blood tests but don't want to enter a hospital at this time.
That's understandable but I'm sure they're currently a lot safer than many people think. However, you can always do what hundreds of us here do and that is a private test at home with one of our recommended labs. Most popular are Medichecks and Blue Horizon - see details on ThyroidUK's main website here:
Thank you so so much for your detailed responses - they are extremely helpful and I can't tell you how much I appreciate it. This website is like a lifeline when you don't know where to turn to understand what's happening health wise.
I have ordered a test kit from Blue Horizon and will update here once I have the results.
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Absolutely essential to test Ft3
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Obviously you need to get new testing done
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
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