Update on 15 yo daughter's results

[sbadd]

Can anyone advise on daughters results, after twisting doct arm he did thyroid but no antibodies, her iron has dropped further, what are thoughts on thyroid test.

[SlowDragon Administrator]

Obviously needs full private testing

Ft3 is rock bottom and ferritin

Has she had vitamin D, folate and B12 tested

[sbadd in reply to SlowDragon]

Just had b12 done aswell this has dropped so pretty sure injections need to be reistated as positive to parietal antibodies, her real doct has just ordered thyroid antibodies and more gastric tests and crp, told her to start back on iron and considering infusion next week, was mainly the thyroid i wanted advice on, her thyroid test was done around 4.30pm in arvo no fasting.

[SlowDragon Administrator in reply to sbadd]

ALWAYS get thyroid testing as early as possible in morning before eating or drinking anything other than water

TSH daily variation

healthunlocked.com/thyroidu...

So important what time of day you test TSH ....

researchgate.net/publicatio...

“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”

“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”

ncbi.nlm.nih.gov/pubmed/252...

TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.

Her low TSH and low Ft4 and low Ft3...either shows central hypothyroidism or TSH given up reacting to rapid changes of Hashimoto’s

With low Ft4 and Ft3, TSH should be high

[sbadd in reply to SlowDragon]

Her b12 261 under 150 is deficient

B12 3 months back was 415

Folate is good 41.6 above 10 normal

I think b12 needs to be reistated and iron then thyroid should improve

[SlowDragon Administrator in reply to sbadd]

If she has positive parietal antibodies I think she should be on B12 injections for life

shaws or Marz might add more info on that

[sbadd in reply to SlowDragon]

Yes im thinking the same and i think her doct 2 so hopefully fingers crossed

[helvella Administrator Thyroid UK]

I suggest even a brief read of:

Autoimmune gastritis involves an autoimmune attack against the stomach lining’s parietal cell antibodies. As a result, parietal cells become casualties, resulting in the long-term consequences of autoimmune gastritis: hypochlorhydria, iron deficiency, and vitamin B12 deficiency. Iron deficiency results because stomach acid is required to extract iron from food, while B12 deficiency develops because the parietal cells no longer produce the so-called “intrinsic factor” necessary for B12 absorption when it reaches the ileum further down the intestinal tract. If uncorrected, iron deficiency can lead to a form of anemia, microcytic (meaning small red blood cells), while B12 deficiency can lead to a macrocytic (large red blood cells) anemia. In advanced stages, the stomach lining becomes atrophied (“atrophic gastritis”) and stops producing stomach acid altogether.

blog.undoctored.com/lets-de...

I see you have posted on the Pernicious Anaemia Society forum - I suggest you go back there (as well as staying here). Several members do things like take lime juice in order better to digest food.

The usual advice to take vitamin C along with iron supplements seems reasonable but might not be sufficient.

You might get a tiny bit of help from my iron document:

dropbox.com/s/4d885frbic4z8...

[sbadd in reply to helvella]

thankyou for response i have read up on the gastritis, can this be reversed or not?

[helvella Administrator Thyroid UK in reply to sbadd]

I don't want to answer that because I simply do not know enough.

(Better to say nothing than to mislead.)

Some on the PAS forum know far, far more than do I - including personal experience.

[sbadd in reply to helvella]

Ok thanks ill post this on there aswell, i just want it sorted and a diagnosis once and for all, my doct has given whole list of extra bloods to do Tomorrow related to gastric so hopefully will get somewhere next week, shes also considering iron infusion

[helvella Administrator Thyroid UK in reply to sbadd]

Of course you do!

I hope the doctor has thought through properly and requested the appropriate tests.

[sbadd in reply to helvella]

Hope so 2