Low but in range test results?

[katerina1004]

hello dear wise people

I have been 'lurking' for a while here trying to learn, but I still can't make any sense of my results, so decided to post here, hoping for some help.

My symptoms are mostly fatigue and brainfog - I'm still functioning, working etc but I feel like a shadow of my former self. I don't have weight issues, but then my diet is very good (all homecooked, lots of veg, occasional meat & fish, no sugar or refined anything) so something else is going on. I don't see the point of going to the GP (I'm not on the floor yet) so trying to figure this out myself...

Recent results via Thriva look like this (pasted below):

All within range but Thyroid numbers look all very low to me (shouldn't there be in imbalance rather than depression throughout?), vitamins are mostly good but I'm supplementing. Cholesterol is high which just can't be explained by my diet, though I understand high cholesterol can be a symptom of hypothyroidism?

Would be so grateful for any advice or suggestions!

TSH 1.15 (0.27 - 4.20 mIU/L)

T4 Total 71.7 (66 - 181 nmol/L)

Free T4 13.7 (12.0 - 22.0 pmol/L)

Free T3 4.04 (3.1 - 6.8 pmol/L)

Anti-Thyroidperoxidase 21 (<34 kIU/L)

Anti-Thyroglobulin 12 (<115 kIU/L)

B12-Active 99.2 (>37.5 pmol/L)

Serum Folate 27.60 (8.83 - 60.8 nmol/L)

Vitamin D (25 OH) 113.00 (<30 nmol/L)

Ferritin 101.0 (13 - 150 ug/L)

Cholesterol 6.25 (0 - 5.0 mmol/L)

HDL 2.38 (>1.3 mmol/L)

Triglycerides 0.94 (<1.7(Fasting) mmol/L)

LDL 3.44 (<3.0 mmol/L)

Chol:HDL ratio 2.63 (<4.0 ratio)

Thank you so much!

[fuchsia-pink]

The easiest thing to remember is that you want your TSH nice and low and your frees nice and high and your nutrients at least in the middle

Total T4 and T3 don't mean much - it's the frees that matter - and your antibodies are what they are - they only need testing once to see if you have eg Hashi's - if so then they will bob up and down as they want - you'll never get rid of them.

In your case, TSH is ok - bit lower wouldn't hurt. Free T4 is only 17% through range. Free T3 is a bit better at 25% but both are basically rubbish and why you are feeling dreadful. If you're on levo, a bit more would be good

greygoose is excellent on cholesterol issues, so hopefully she will pop up in a bit x

[SlowDragon Administrator]

Welcome to the forum

Yes high cholesterol is often linked to being hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

TSH is not raised, so is not responding to low Ft4 and Ft3

Was test done as early as possible in morning before eating or drinking

What vitamin supplements are you currently taking?

How low were vitamin levels before you started supplements?

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

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

endocrinenews.endocrine.org...

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Getting ultrasound scan of thyroid might be worth considering.

[katerina1004]

Thanks for the welcome, and your replies!

Test was done first thing in the morning in a completely fasted state.

Thanks for pointing out the Biotin intereference, and issue I wasn't aware of that could have played a role as I take a B complex (Nutri-Advanced) with 50ug of Biotin.

I also take vitamin C (3000mg) and vitD (2000iu) due to the virus situation.

"THS not responding to low Ft4 and Ft3" as pointed out by SlowDragon seems to be the key here.

Is it worth trying to get the suggested ultrasound scan from the GP given that all tests are 'in range'?

I did another test last October, with similar results. Same first thing in the morning test, and no biotin back then.

That's when I first dicovred the forum, and decided to come off gluten just to be sure in case there was a Hashimotos issue. Hasn't made any difference to how I feel or the new test results, though I'm happy to continue that way.

Back then I understood from reading other posts that my results where lowish even though in range, so I tried boosting with glandulars (Metavive) but it seems from the latest results that didn't have an effect at all. Maybe I didn't take enough (I kind of talked myself into 'but I'm still in range and not feeling as bad as some people do').

While my Bs were not terribly low then, the reason for taking a (methylated) B complex since, is that I also found out I carry one copy of the MTFHR gene, and also hoping more Bvits would help me have better energy. Again, not much use it seems.

TSH 1.33 (0.27 - 4.20 mIU/L)

T4 Total 71.6 (66 - 181 nmol/L)

Free T4 14.9 (12.0 - 22.0 pmol/L)

Free T3 4.68 (3.1 - 6.8 pmol/L)

Anti-Thyroidperoxidase abs 22 (<34 kIU/L)

Anti-Thyroglobulin Abs <10 (<115 kIU/L)

B12-Active 150.0 (37.5 - 188 pmol/L)

Serum Folate 44.10 (8.83 - 60.8 nmol/L)

Vitamin D (25 OH) 76.30 (<30 nmol/L)

Ferritin 82.0 (13 - 150 ug/L)

Cholesterol 5.63 (0 - 5.0 mmol/L)

HDL 2.66 (>1.3 mmol/L)

Triglycerides 0.80 (<1.7(Fasting) mmol/L)

LDL 2.61 (<3.0 mmol/L)

Chol:HDL ratio 2.12 (<4.0 ratio)

[SlowDragon Administrator in reply to katerina1004]

So looking at the two folate results, folate has actually dropped since taking vitamin B complex ...

Suggests you need increase in folate

How long were you taking Metavive and how long since you stopped taking it before getting this test?

You would need to be not taking any Metavive at all for minimum of 10-12 weeks (perhaps longer)

[greygoose]

Cholesterol levels have nothing to do with your diet. Cholesterol is made in the liver, and the more you eat, the less the liver makes. The less you eat, the more the liver makes. However, if your T3 is low, the body cannot process the cholesterol correctly, and it builds up in the blood. As the FT3 levels rise, the cholesterol level should drop. You can see when comparing your two sets of results, your FT3 has gone down, and your cholesterol has risen.

But, it's nothing to worry about. Cholesterol doesn't cause heart attacks or strokes.

[katerina1004]

Yes I note that too, trend is downward overall despite trying to change things...

I stopped Metavive for 2 weeks or so before the latest test. I would have thought stopping for the same time as widely suggested for Levo before a test would be comparable? Why would Metavive need so much longer stopping?

Does that suggest that the result would be even lower if I had stopped Metavive for longer?