Positive TG Ab, normal TSH

[Theatrigal]

Is there a reason a doctor would order only TSH and TG Ab tests?

All I’m finding indicates that TG Ab is usually assessed with TPO Ab, if not also TSI Ab.

My doctor only ordered the two, with my TSH at 2.33 mcIU/mL and my TG Ab at 20.8 u/mL

My vitamin d is borderline and ferritin is low, despite supplementing for last ten months. Iron is normal and always has been whenever tested. 10 months ago was the first I was tested for ferritin that I know. I had been tested regularly for vitamin d deficiency between 2009 and 2018 , and 2019 was the first time I ever displayed deficiency.

My primary symptoms on and off over the the last 4 years are fatigue, brain fog, neuropathy especially on one side of face and same side arm), irregular menstrual cycle, hair loss, facial puffiness, extreme weight loss and then more recently, weight gain. I also have koilonychia/Beau’s lines in my nails (some worse than others)- a minor but embarrassing symptom.

I’m at a loss and would appreciate any guidance. I will be talking to the doctor an want to be prepared as she has told me “I don’t know” about most symptoms. Should I ask her to do the other thyroid labs as well, or do those values not merit that?

I get the impression she thinks I am making it up.

I’m desperate to feel better: I have a family and profession I feel like I cannot keep up with.

Thank you

[PurpleNails Administrator]

Usually a GP would order TSH and hopefully FT4 & FT3. It’s usually a specialist which looks at antibodies. It does seem strange that TPO was not ordered as well, and not obtaining FT4&3 just demonstrates how little the doctor understands.

Please include the ranges on your results as the vary between labs, TSH at 2.33 looks high. Definitely need FT4 and FT3 to access your full thyroid function.

As well as vitamin d & ferritin also test folate and B12. These cause symptoms and need to be optional for thyroid health.

[Theatrigal in reply to PurpleNails]

Thank you.

Folate tested 11.8 ng/mL and B12 at 188 pg/mL. I have been supplementing B12 for about a year before this test. I was told these values are normal. (Folate ref range 5.9-22.3, B12 range 145-670).

Doctor told me that these TSH were normal. Do you mean the reference ranges (I apologize for my ignorance)?

In September 2019 TSH was 2.02 mcIU/L with a reference range 0.36-3.72. Now late June it is 2.33 mcIU/mL.

The back story is that I had been having mild/moderate neuropathy during my last pregnancy. I dismissed fatigue as life. In late 2018, I developed more severe neuropathy with facial paralysis and arm weakness, like Bell’s Palsy but was told the arm would not be involved then. Fatigue also became much more drastic and ongoing. When my care was turned to this doctor, she believed it was Bell’s Palsy with carpal tunnel, unrelated. She did none of the neurology follow up that had been recommended. I was told to eat better, exercise more (at that point, she knew nothing of my diet and my BMI was low side of normal- for the record, I have a fairly low grain, low sugar, low processed foods diet).

Thank you again for any help. Already, I feel I know better what to ask her for/ask another doctor for.

[greygoose in reply to Theatrigal]

Your B12 was very low. You should have been tested for Pernicious Anemia. Could be that your paralysis was due to low B12.

[SlowDragon Administrator]

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

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies - either High TPO or High TG antibodies

Your B12 is extremely low considering you have been supplementing

Ask GP to test for Pernicious Anaemia

More detailed B12 testing including MMA and homocysteine

nutris.viapath.co.uk/pages/...

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 .

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin (doesn’t include folate)

medichecks.com/products/thy...

Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

Obviously just testing TSH is completely inadequate

[Theatrigal in reply to SlowDragon]

Thank you so much. I feel like I know how to talk to this doctor better to get what I need.