latest private blood results...please help - Thyroid UK

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latest private blood results...please help

Sleepy101
Sleepy101

Inflammation

CRP HS X 7.3 mg/L (Range: < 5)

Iron Status Ferritin 80.4 ug/L (Range: 13 - 150)

Vitamins

Folate - Serum X 3.31 ug/L (Range: > 3.89)

Vitamin B12 - Active 73.900 pmol/L (Range: > 37.5)

Vitamin D X 32.6 nmol/L Deficient <30 Insufficient 30 - 50Consider reducing dose >175 (Range: 50 - 175)

Thyroid Hormones

TSH 3.27 mIU/L (Range: 0.27 - 4.2)

Free T3 4.6 pmol/L (Range: 3.1 - 6.8) Free Thyroxine X 11.700 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies X 402.000 kIU/L (Range: < 115)

Thyroid Peroxidase Antibodies X 265 kIU/L (Range: < 34)

12 Replies
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SeasideSusie
SeasideSusieAdministrator

Sleepy101

CRP HS X 7.3 mg/L (Range: < 5)

This is slightly raised and can indicate inflammation, but as it's non-specific it can't tell you where the inflammation is.

**

Ferritin 80.4 ug/L (Range: 13 - 150)

This is a good result. Ferritin is recommended to be half way through range, which is 81.5 with that range.

**

Folate - Serum X 3.31 ug/L (Range: > 3.89)

This is a problem, as you can see it's below range. Folate should be at least half way through range and Medicheck's range is 3.89-19.45 so with that range you'd want it to be at least 12.

cks.nice.org.uk/anaemia-b12... says

Folate level

◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.

◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.

So your result puts you in the "indeterminate zone", I doubt your GP would do anything about it but it's possibly worth mentioning.

**

Vitamin B12 - Active 73.900 pmol/L (Range: > 37.5)

This result isn't bad but with Active B12 the range is 37.5-188 and I prefer mine to be over 100 (below 70 suggests testing for B12 deficiency).

A good quality, bioavailable B Complex such as Thorne Basic B or Igennus Super B will help raise your 12 level and also your folate level.

**

Vitamin D X 32.6 nmol/L Deficient <30 Insufficient 30 - 50Consider reducing dose >175 (Range: 50 - 175)

This is dire and only just above the Deficiency level.

The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L.

To reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 5,000iu D3 daily

Retest after 3 months.

Once you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3 as recommended by the Vit D Council.

D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.

**

TSH 3.27 mIU/L (Range: 0.27 - 4.2)

Too high for a normal healthy person, you are on your way to hypothyroidism which I think has been mentioned in reply to previous posts.

Free Thyroxine X 11.700 pmol/L (Range: 12 - 22)

Below range. One would hope that your GP would take this into consideration and start you on Levo but with an in-range TSH this could be unlikely.

Free T3 4.6 pmol/L (Range: 3.1 - 6.8)

Not too bad at the moment, your body is doing it's best to produce T3 which is the active hormone that every cell in our bodies need.

**

Thyroglobulin Antibodies X 402.000 kIU/L (Range: < 115)

Thyroid Peroxidase Antibodies X 265 kIU/L (Range: < 34)

This is where you have a problem. Your raised antibodies suggest that you are positive for autoimmune thyroid disease aka Hashimoto's which is where the thyroid is attacked and gradually destroyed.

Fluctuations in symptoms and test results are common with Hashi's.

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.

Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.

If you can get a TSH result over range at the same time as thyroid antibodies over range, then an enlightened doctor should start you on Levo, see article by Dr Toft, past president of the British Thyroid Association and leading endocrinologist, who states in Pulse Magazine (the magazine for doctors) in answer to Question 2:

Question 2 asks:

I often see patients who have an elevated TSH but normal T4. How should I be managing them?

Answer:

The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat thyroid function tests in 2 or 3 months in case the abnormality represents a resolving thyroiditis.

But if it persists then antibodies to thyroid peroxidase should be measured. If these are positive - indicative of underlying autoimmune thyroid disease - the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms, some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow up.

Treatment should be started with levothyroxine in a dose sufficient to restored serum TSH to the lower part of it's reference range. Levothyroxine in a dose of 75-100mcg daily will usually be enough.

You can obtain a copy of the article by emailing Dionne at

tukadmin@thyroiduk.org

print it and highlight question 2 to show your doctor.

The key to getting the highest possible TSH for diagnosis is to have a test no later than 9am with nothing to eat or drink before the test except water.

Thank you very much! I have read and reread so many times and I am doing research into how to help myself and be aware of things to advocate for myself with the Dr. Do you think seeing a private specialist might help? I have low cortisol too so my GP ( who normally ignores my symptoms and tells me I'm fine) wants to see me and possibly refer on because of the low cortisol, I guess the specialistmight know about the other issues too like thyroid?. I only asked and pushed for the cortisol test and the private thyroid teat because of the site and you supportive lovely people so thank you.

SeasideSusie
SeasideSusieAdministrator in reply to Sleepy101

Sleepy101

Do you think seeing a private specialist might help?

Possibly but choose very carefully. Your below range FT4 should hopefully help but it would be better if your TSH crept over range.

You can send for the list of thyroid friendly endos from Dionne at ThyroidUK then ask on the forum for feedback by private message on any that you can travel to:

tukadmin@thyroiduk.org

hi,

I have been prescribed vitamin D3 now. I bought the super B complex too.

I have also been referred to an endo. I mentioned to my GP trialling me on Levo and he said antibodys don't mean anything and only a quack would prescribe for it. He said everyone would want it because it gives energy and makes people lose weight. I wanted to say.....those people already have normal energy and metabolism and are people that don't need it based on the symptoms and antibodys but i thought I would wait and just hope to have a sympathetic clued up endo.

Thanks again

SeasideSusie
SeasideSusieAdministrator in reply to Sleepy101

Sleepy101

How much Vit D have you been prescribed?

Don't forget you'll need magnesium and Vit K2-MK7 mentioned above, your GP wont know about those so you'll need to buy them yourself.

Not surprised your GP dismissed your antibodies, they know nothing about them. Did you show your GP the article by Dr Toft about antibodies?

At least you've got a referral to an endo, hopefully the endo will accept the referral.

Been prescribed booster of 20,000 iu...oh yes I will order those too.

I havent received the artice yet (I emailed) but I tried to show him the question and I mentioned it to him and he was just...only quacks would prescribe for antibodys.

I think the referral is for my low cortisol and also my symptoms and not because of thyroid so hopefully it will be accepted and maybe I can get help from there. With private endo appointments do they see people without a referral or still need one? I want to trial levo and not wait to get worse.

SlowDragon
SlowDragonAdministrator

As you have raised thyroid antibodies and below range Ft4 your GP should start you on levothyroxine

Essential to improve vitamin levels too as outlined by SeasideSusie

Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Sleepy101
Sleepy101 in reply to SlowDragon

thank you so much! You are so helpful and its really reallt useful information. I am reading and rereading and trying to make a plan of what to do and also build up my knowledge. X

SlowDragon
SlowDragonAdministrator in reply to Sleepy101

Cortisol and thyroid issues often go together

Adrenal glands try to compensate for low thyroid hormones...as result, initially cortisol is often high. But after trying to compensate for long time cortisol levels can drop

Usually cortisol levels improve as thyroid hormones are improved, but endocrinologist may wish to double check adrenal function first

Improving low vitamin levels as detailed by SeasideSusie while waiting to get started on levothyroxine, will help improve symptoms

Sleepy101
Sleepy101 in reply to SlowDragon

its all starting to link together. I am going to try to get started on levo through my endo but its an NHS referral so I have heard it can be quite hit and miss with how good they are.

Latest results!

Values and Investigations (Latest Value)

28-Jul-2020! Full blood count - FBC - (IB3321) - within acceptable limits

Haemoglobin estimation142g/L120.00 - 150.00g/L

Total white cell count7.310*9/L4.00 - 11.0010*9/L

! Platelet count41210*9/L150.00 - 400.0010*9/L

Neutrophil count3.810*9/L2.00 - 7.5010*9/L

Lymphocyte count310*9/L1.50 - 4.0010*9/L

Monocyte count0.410*9/L0.20 - 1.0010*9/L

Eosinophil count0.110*9/L0.00 - 0.5010*9/L

Basophil count0.110*9/L0.00 - 0.1010*9/L

! Red blood cell (RBC) count4.8810*12/L3.80 - 4.8010*12/L

Haematocrit0.407L/L0.36 - 0.46L/L

Mean corpuscular volume (MCV)83.4fL80.00 - 100.00fL

Mean corpusc. haemoglobin(MCH)29.1pg27.00 - 32.00pg

Mean corpusc. Hb. conc. (MCHC)349g/L320.00 - 360.00g/L

Nucleated red blood cell

28-Jul-2020Free androgen index - (IB3321) - -3.6%0.60 - 6.10%

28-Jul-2020Serum sex hormne binding glob - (IB3321) - -45nmol/L30.00 - 90.00nmol/L

28-Jul-2020Serum vitamin B12 - (IB3321) - -273ng/L>160.00ng/L

Vitamin B12 reference range

B12 >160 ng/L: B12 deficiency excluded.

B12 130-160 ng/L: indeterminate value.

Deficiency likely if macrocytosis +/- intrinsic factor

antibody.

>B12 <130 ng/L: consistent with B12 deficiency.

28-Jul-2020! Thyroid function test

The reference ranges for FT4 and TSH only apply to

non-pregnant females.

! Plasma free T4 level7.6pmol/L7.70 - 15.10pmol/L

Plasma TSH level2.21mu/L0.34 - 5.60mu/L

28-Jul-2020Plasma testosterone level - (IB3321) - -1.6nmol/L0.35 - 2.60nmol/L

28-Jul-2020Plasma oestradiol level - (IB3321) - -269pmol/L

Reference ranges for estradiol:

Males = <55 - 116 pmol/L

Post menopausal = <55 - 92 pmol/L

Days 2 - 4 = <55 - 158 pmol/L

Periovulatory = 318 - 1016 pmol/L

Mid-luteal = 166 - 525 pmol/L

28-Jul-2020Renal profile - (IB3321) - -

Plasma sodium level136mmol/L133.00 - 146.00mmol/L

Plasma potassium level4.4mmol/L3.50 - 5.30mmol/L

Plasma creatinine level55umol/L53.00 - 97.00umol/L

eGFRcreat (CKD-EPI)/1.73 m*2>90mL/min/1.73m2

28-Jul-2020Plasma LH level - (IB3321) - -2.9iu/L

Reference range for LH:

Pre puberty = <2iu/L,Mid follicular = 2.1-10.9iu/L

Mid Cycle = 19.2-103iu/L,Mid luteal = 1.2-12.9iu/L

Male = 1.2-8.6iu/L

28-Jul-2020Liver function test - (IB3321) - -

Plasma total protein68g/L60.00 - 80.00g/L

Plasma total bilirubin level6umol/L0.00 - 20.00umol/L

Plasma ALT level31U/L7.00 - 35.00U/L

28-Jul-2020Plasma FSH level - (IB3321) - -5.4iu/L

FSH Reference Range:

Pre puberty <2iu/L; Male = 1.3-19.3iu/L

Female: Days 2-4 =6.2-13.8iu/L

Mid-luteal(days 19-23 of 28day cycle) =2.0-9.6iu/L

Mid-cycle peak =7.2-20.3iu/L

28-Jul-2020Bone profile - (IB3321) - -

Plasma calcium level2.25mmol/L

Plasma adjusted calcium conc2.24mmol/L2.20 - 2.60mmol/L

Plasma albumin level40g/L35.00 - 50.00g/L

Plasma alk phosphatase level76U/L30.00 - 130.00U/L

28-Jul-2020Plasma prolactin level - (IB3321) - -195mu/L57.50 - 561.00mu/L

28-Jul-2020Serum total 25-OH vit D level - (IB3321) - seen and dealt with32nmol/L

25-OH vitamin D thresholds (National

Osteoporosis Society Guidelines 2013):

<30 nmol/L: consistent with deficiency,

30-50 nmol/L: May indicate deficiency;

consider treatment if raised PTH, fragility

fracture, osteoporosis, medication with

anticonvulsants/glucocorticoids/

antiresorptives, malabsorption or dark skin,

>50 nmol/L: Adequate level,

>374 nmol/L: Toxicity possible; consider

dose reduction,

>750 nmol/L: Toxicity; dose reduction

recommended.

28-Jul-2020Plasma folate level - (IB3321) - Normal no action10.2ug/L3.80 - 25.00ug/L

SlowDragon
SlowDragonAdministrator

Remember to stop taking Vitamin B complex a week before ANY Blood tests as biotin can falsely affect test results

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

endocrinenews.endocrine.org...

Have you had coeliac blood test done yet?

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