Hello everyone. I wonder if anyone could help me understand my NHS test results, please.
I have multinodular goiter (benign U2 nodules) and I do not take thyroid medicine because the doctor says I am euthyroid, but I have many symptoms, such as feeling cold all the time, without energy, tired all the time, hair loss, weak nails and thin as a paper. Five years ago I had a total hysterectomy, but the nodules were diagnosed before surgery.
I would be very grateful for any help. Thanks!
Serum B12: 280 ng / L (191-663 ng/L)
Folate serum: 5.7 ug / L (3.3-19.3 ug/L)
LH Serum: 52 IU / L
TSH: 2.48 Mu / Lr ( 0.27 - 4.2 Mu/Lr)
FSH: 73 IU / L
Free T4: 13.6 pmol / L (9-26 pmol/L)
Free T3: 5.2 pmol / L
Thyroid peroxidase antibodies: 76 KiU / L
(Above are all laboratory ranges I have found)
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This is low. 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."
Some people with B12 in the 300s have been found to need B12 injections. Do you have any signs of B12 deficiency? |Check here:
If you do then list them to discuss with your 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.
Folate serum: 5.7 ug / L
Is there a range? Always include reference ranges with results as these vary from lab to lab. Ranges we see here are:
>3.89 - in which case a result in double figures would be good
8.83-60.8 - at least half way through range is recommended so 35+ with that range
3.89-19.45 at least half way through range is recommended so 12+ with that range
So your result is low and eating folate rich foods should help raise it, also supplementing with a good quality, bioavailable B Complex such as Thorne Basic B or Igennus Super B. This should not be taken until after further testing of B12 if it is necessary. B Complex contains Biotin which needs to be left off for 7 days before any blood test as it can give false results.
LH Serum: 52 IU / L - can't help with this
FSH: 73 IU / L - can't help with this
TSH: 2.48 Mu / L
A normal healthy person will have a TSH level no more than 2, often nearer 1.
Free T4: 13.6 pmol / L - need reference range
Free T3: 5.2 pmol / L - need reference range
Thyroid peroxidase antibodies: 76 KiU / L - need reference range but this is very likely over range suggesting autoimmune thyroid disease aka Hashimoto's, which is where the immune system attacks and gradually destroys the thyroid resulting in hypothyroidism.
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 you are 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
With such low B12 result taking a B12 supplement and a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
Assuming range on TPO tests is 34 .......you have high TPO antibodies this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
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
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
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
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.
Nature provides 2400mcg Bioactive B12 Pure and vegan containing Methylcobalamin plus Adenosylcobalamin taken sublingually under tongue raised my B12 from 266 to over 700 and that wasn't with suggested dose (10 drops daily under tongue), I started with 3 drops and worked up to 6 drops daily.....
66.6% Methylcobalamin and 33.3% Adenosylcobalamin other ingredients:- reverse osmosis water
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