Over recent times I’ve consulted this forum and got a real education with my Hashimoto’s. More recently you helped my daughter who you established is borderline hypo. This got me thinking about my son who has always been “lazy” but skinny. Lately though he has been putting on weight that is shifting only very slowly. He’s reduced his carb intake, skips daily and does 20 mins of high intensity daily. He’s changing shape gradually and looks a lot better but I’m suspicious of why he’s suddenly started to gain weight when nothing about his lifestyle has changed. He’s 28
We come from a long line of skinnies and particularly on the maternal female side of my family, a long line of thyroid sufferers so it was no surprise that my daughter and I started to have problems
I’ve been reading Dr Broda Barnes’ book - admittedly old and possibly out of date - and was shocked to find how many children have thyroid problems. It got me thinking about my own childhood and how hyper-active and unhealthily thin I was. It seems I could’ve been suffering with thyroid issues for a long time. So, could my son’s laziness be caused by his thyroid and therefore be lethargy rather than laziness? Who knows but here are his results. I would so appreciate your input because I don’t want him to suffer the way I have. He may not be hypo yet but it would be good to know where this might by headed
B12 379.0 (211.0 - 911.0) Folate 5.93 (>5.38) which means what exactly?!! Is 5.93 satisfactorily higher?!! Ferritin <4 (0.0 - 6.0) again, what does this mean
Now I know that liver and thyroid problems can be connected (an issue I have myself) but my GP or endo have never mentioned a connection. This is something I’ve read on this site and subsequently elsewhere. It’s possibly the same for him or the result of too much red wine at weekends!
With regard to Dr Broda Barnes’ book, it’s been such a revelation and it seems that’s today’s so-called endocrinologists have no knowledge or choose to ignore the simplicity of his methods. I appreciate that much of it could be obsolete but the basal temperature test seems to me to be genius. It’s a reliable indicator of hypo status and I’d never heard of it before Dr P talked about it. Amazing. I’ve been taking mine ever since and will get my son to re-take his once he’s back
Thank you for reading
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A normal healthy person would have a TSH level no higher than 2, often around 1, with FT4 around mid-range-ish.
His TSH is about right, his FT4 is 40.95% through range. Because we aren't tested for a baseline when we are well, we don't know where our personal "normal" is so these results could be your son's normal levels.
His TPO antibody result isn't really low enough to say there's not a problem so personally I'd keep an eye on that to see if fluctuates. I would also be tempted to do a private thyroid panel to include Thyroglobulin (Tg) antibodies as well as TPO. It's possible to have Hashi's when TPO are negative but Tg positive.
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B12 379.0 (211.0 - 911.0)
This is low in range, but is it pmol/L or ng/L or pg/ml (the latter two are the same).
If it's pmol/L then that's equal to 513.54pg/ml.
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
If he has any then he should list them to discuss with his GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
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Folate 5.93 (>5.38) which means what exactly?!! Is 5.93 satisfactorily higher?!!
I find this type of range extremely frustrating. Obviously he's not deficient but it's not much over the range so it's not satisfactorily higher. When there is no proper range I would want my folate level in double figures.
He could take a good quality B Complex such as Thorne Basic B or Igennus Super B, this will raise his folate level (also eat folate rich foods) and will also raise his B12 level. BUT do not start a B Complex if he has signs of B12 deficiency, further investigation into that and B12 injections or supplements started first, then the B Complex a week or two later.
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Ferritin <4 (0.0 - 6.0) again, what does this mean
That is not a range I have ever seen before. For males the range is often shown as 30-400 with both the private and NHS labs.
I would guess that what the result of <4 means is that the testing equipment isn't calibrated to measure any lower than 4, that his ferritin result is lower than that but can't be accurately measured.
Is it actually shown on the print out as "Ferritin".
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Liver function Bilirubin 29 (0.0 - 20.0)
Serum alanine aminotransferase 57 (10.0 - 49.0)
I can't comment on these as it's not something I have experience of. As they are over range and you have liver issues yourself, maybe he should discuss this with his GP, mentioning your issues.
Thank you, that’s very detailed and makes sense. His B12 is measured 379.0 ng/L with the range being (211.0 - 911.0) which to me seems very low. I’ll read the links you sent
So as his B12 is ng/L then the quote above is relevant. Some people with B12 in the 300s have been found to need B12 injections so get him to check the list of signs/symptoms and if necessary take it from there. If he has none, then it would be worth buying some sublingual methylcobalamin 1000mcg, take those along with the B Complex. When the bottle of methylcobalamin has been used, just continue with the B Complex. That should be enough to raise his level and by continuing with the B Complex it should be maintained.
As for the ferritin, I really don't know what to say, I've never seen a range like that before, it doesn't really tell you anything. Just by saying <4 all you know for certain is that it's not high, but how low it is is anyone's guess, a totally nonsensical result in my opinion. If he's willing he can do an iron panel with Medichecks, called an Iron Deficiency Check, it can be done by fingerprick (or venous blood draw if he prefers). That will give a complete picture of his iron status and the range for ferritin is a proper range.
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I can't thank you enough for the link and other information. He's had a fine tremor since time immemorial and now I feel guilt that I never got it investigation. How stupid can one be
I've sent him the link because he may have other symptoms that I'm unaware of. I have several of them myself and now I'm wondering ... There's a significant overlap of Hashi and B12 deficiency symptoms which I've attributed to Hashi because I didn't know any better
Once again, my heartfelt thanks for drawing my attention to this and apologies if I've already sent you this reply. I typed it once then "lost"it. I'm just not getting on very well with this app!
If he has symptoms and discusses them with his GP, don't let him be fobbed off with "your result is in range", too many doctors do this. With B12 it's symptoms that matter, not numbers, so if necessary he should push for further testing.
Are there specific tests for it? Isn't it enough that his blood test suggests he's low? I suppose what I'm saying is: suppose the B12 test he's just had revealed he was below the normal range, wouldn't that in itself be a diagnosis of B12 deficiency?
This is possibly a silly question but as he's low in the range why not just supplement with B12 or is it much more complicated than that?
Please don't answer till tomorrow, it's late but I just wanted to send this whilst it's on my mind
This is possibly a silly question but as he's low in the range why not just supplement with B12 or is it much more complicated than that?
No, as I said some people with B12 in the 300s have been found to need B12 injections. One cause of B12 deficiency is pernicious anaemia so that would need to be ruled out (or in).
This is all so helpful, thank you. I misinformed you about one of his test results. It’s like you said, if the numbers are too close together it’s unhelpful
The case in point is ferritin, the result I gave you was: serum c reactive protein level! His ferritin is:
48.5 ug/L (22.0 - 322.0). A case for supplemtation? His full blood count is:
Total white blood count 6.7 10*9/L (3.9 - 10.2)
Red blood cell count 5.20 10* 12/L (4.3 - 5.75)
Haemoglobin concentration 151 g/L (135.0 - 172.0)
Haematocrit 0.462 L/L (0.395 - 0.505)
Mean cell volume 88.1 fL (80.0 -99.0)
Mean cell Haemoglobin 28.87 pg (27.0 - 33.5)
Red cell distribution width 13.2% (11.0 - 16.0)
Platelet 229 10*9/L (150.0 - 370.0)
Plateletcrit 0.230
Mean platelet volume 10.1 fL
Platelet distribution width 50%
Neutrophil count 4.43 10*9/L (1.5 -7.7)
Lymphocyte 1.57 10*9/L )1.1 - 4.5)
Monocyte 0.44 10*9/L (0.1 - 0.9)
Eosinophil 0.09 10*9/L (0.02 - 0.5)
Basophil 0.05 10*9/L 0.0 - 0.2)
I don’t expect you to know what these results mean but I’ve included them in case you do. If so, based on what you see, is there enough information there to be able to advise on whether or not to supplement with ferritin? It seems awfully low. Someone explained once before that ferritin is stored. Does his level mean that he’s using up his stores too much or that his store is just deficient? There’s a lot to learn and understand
His haemoglobin doesn’t seem too bad, should it be higher and if so, does that mean his ferritin store would be used less?
The case in point is ferritin, the result I gave you was: serum c reactive protein level!
That makes a lot more sense.
His ferritin is:
48.5 ug/L (22.0 - 322.0).
Yes it's low, recommended is half way through range which would be 172 although I have seen it said that 150 is a good level for males.
A case for supplemtation?
There is nothing in his FBC to suggest anaemia. What I would do is an iron panel to check his Serum Iron, Transferrin Saturation % and Total Iron Bindin Capacity as well as ferritin. This will show if he has iron deficiency and if so his GP should prescribe iron tablets and monitor him regularly.
If he doesn't have iron deficiency, just low ferritin, then he can help raise his level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
If he doesn't have iron deficiency and has a good level of serum iron, then taking iron tablets could push his serum iron too high and too much iron is as bad as too little.
Thank you. That makes a lot of sense, I’ll get the tests ordered. I thought I saw someone mention - possibly you - some companies that have discounts currently, would you mind repeating them. During the week is absolutely fine
Thank you also for the link to the list of foods. Surprising but helpful
No hurry to reply, it’s the weekend. Just wanted to get it posted and done with
Medichecks have one test on offer every Thursday (different one every Thursday) which is posted on the forum with a link, otherwise you can use code THYROIDUK for 10% on any test not on offer.
Ok, thank you. We've re-read, in preparation for our GP call on Wednesday, the B12 link you sent. It's very informative and interesting and sheds some light on certain "things" about him (and me for that matter). He's away studying for the next 18 months or so, so I have authorisation to speak with his doctor. I wonder how open she'll be to all the suggestions I'll be bombarding her with? Though to be fair, I've never met her and she may well be absolutely fine
Thank you once again for you time and patience and for imparting your knowledge. This site is a god-send and although these days it takes a long time for me to remember and learn, the help here has been invaluable
Just playing 'devil's advocate' . but don't underestimate the effect's of this lovely global pandemic on every ones habit's /weight/motivation..... both my grown up kids have put weight on, and become somewhat demotivated in the last few months.
Yes t, I agree that it could be a possibility if it weren’t for the fact that nothing in his lifestyle has changed. He’s always had the appetite of a horse, my entire family does. The only person who wasn’t able to eat like our children and I, was my husband. We come from a long line of skinnies and he a long line of overweight people. To his credit though, he’s managed to stay at a healthy weight through hard work
It’s a difficult time for so many of us and I hope your children’s mojo soon returns. Thank you for you input
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