Can you comment on Full Thyroid Function test, please?

[natmcvit]

Hello!

I got Ultimate Performance blood test from Medichecks and the results for Thyroid hormones for my daughter (17 years old) are the following:

03.08.20

TSH, mU/ L - 2.31 (range 0.27 - 4.2

)

Free T4, pmol /L - 16.1 (range 12 - 22)

Free T3, pmol / L - 3.36 (range 3.1 - 6.8)

Cortisol level came back as 319 nmol / L

2 months ago it was 251 nmol / L

Can you comment and de-code the results for me please?

Does it look like she has thyroid dysfunction?

According to Medichecks her results are fine but I noticed that their range of "normal" are lower even than official NHS's ones!

[SlowDragon Administrator]

Was this test done as early as possible in morning before eating or drinking anything other than water

EXACTLY What vitamin supplements is she taking (can see on previous post she’s on vitamin D and B12?)

When were vitamin levels last tested

Please add results and ranges on vitamin D, folate B12 and ferritin

Has she had TPO and TG thyroid antibodies tested previously or had ultrasound scan of thyroid

[natmcvit in reply to SlowDragon]

1. The test was done at 9.30 am. 10 hours fasting before the test.

2. She has been OFF B12, folate and iron for a 4 weeks before the test. OFF D for about 10 days.

3. Vitamin levels were tested at the same time as the Thyroid and the latest results came as:

Vitamin D - 118 nmol / L

Serum Folate - 8.1 ug / L

ACTIVE B12 - 101 pmol / L

T'ferrin Saturation - 21%

Iron - 13.89 umol / L

4. She did not have TPO and TG thyroid antibodies tested and never had ultrasound scan of thyroid.

[humanbean in reply to natmcvit]

Do you have a ferritin result?

[natmcvit in reply to humanbean]

Ferritin result is 48.3 ug / L

[SlowDragon Administrator in reply to natmcvit]

Can you add ranges on vitamin results

Is she taking folate, folic acid or vitamin B complex

How much vitamin D

How low was vitamin D before supplementing

Taking magnesium and vitamin K2 mk7 as well?

So next step test thyroid antibodies and look at ultrasound scan of thyroid if antibodies come back negative

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

[SlowDragon Administrator]

Just read first post in full

The fact gluten free diet has been beneficial suggests possible Hashimoto’s

Her vitamin levels weren’t dire...but improving levels obviously helping

Mental issues including Bi-polar and link to Hashimoto's

drknews.com/when-hashimotos...

holtorfmed.com/mental-illne...

thyroidpharmacist.com/artic...

hypothyroidmom.com/miss-dia...

ncbi.nlm.nih.gov/pmc/articl...

ncbi.nlm.nih.gov/pmc/articl...

[natmcvit in reply to SlowDragon]

<Has she had TPO and TG thyroid antibodies tested>

I am not sure if this is the right antibodies but she was tested by Medichecks for:

THYROGLOBULIN ANTIBODIES - 10.2 kIU / L (range 0 - 115)

THYROID PEROXIDASE ANTIBODIES - 11.6 kIU / L (range 0 - 34)

<How low was vitamin D before supplementing>

Before supplementing D level was 58 nmol / L - now after 2 months on D protocol (D3 + K2 + magnesium) the level is 118 nmol / L

<Is she taking folate, folic acid or vitamin B complex?>

She was on all these supplements for a few months, stopped about a months ago to re-test them as I suspect she has issues with absorbing B12, folate and iron from supplements and I needed to check it. And I was right - after a months of no supplements her folate, B12 and iron dropped.

[SlowDragon Administrator in reply to natmcvit]

So she doesn’t appear to have Hashimoto’s as both TPO and TG thyroid antibodies are negative

However 20% of Hashimoto's patients never have raised antibodies

An ultrasound scan of thyroid can be helpful. You may need to do so privately if GP won’t agree

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

[natmcvit in reply to SlowDragon]

Can I just double-check: so the results for Thyroid function (TSH, FT3 and FT4) look OK?

[SlowDragon Administrator in reply to natmcvit]

Her TSH is very slightly above average

Ft4 mid range

Ft3 low in range

Improving low vitamin levels can help improve conversion of Ft4 to Ft3. So might some regular not too excessive exercise (assuming not too exhausted)

Ferritin is on low side

humanbean will probably comment on this

[SlowDragon Administrator in reply to natmcvit]

For low folate, it’s often better to supplement a good quality daily vitamin B complex, one with folate in (not folic acid)

She doesn’t need folic acid as well as folate

Just folate or just vitamin B complex...not both

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

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

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

endocrinenews.endocrine.org...

[humanbean]

Iron and iron-related results :

T'ferrin Saturation - 21%

Iron - 13.89 umol / L

Ferritin result is 48.3 ug / L

It's difficult to say much about your results without the reference ranges but the above three results look low to me.

Haemoglobin - levels below 120 g/L or 12.0 g/dL or below range indicate anaemia.

CRP or CRP-hs - These are a measure of inflammation or infection. Optimal results are low in range. If CRP is high this often leads to people having a high ferritin because ferritin is an "acute phase protein" or an "acute phase reactant".

en.wikipedia.org/wiki/Acute...

Optimal results for iron and iron-related results are :

Ferritin [iron stores] - mid-range

For other optimal values see this link :

rt3-adrenals.org/Iron_test_...