Further bloods advice please?

[Bambini83]

Have already had some great advice here - just a couple of points I’m struggling with and thought I’d post in case anyone can help.

Brief background - no official diagnosis or meds. Symptoms ongoing roughly 1 year. Two thyroid nodules classified as non suspicious, cytology normal. Saw private endo in the summer. July medichecks bloods showed what she said was normal thyroid function but slightly elevated TPO antibodies. She advised thyroid profile every 3 months, female hormones to be tested by GP also 9 am cortisol. Also advised to check receptor antibodies to rule out potential for Graves. Her overall summary was that I fit the profile for ME. She felt I had adrenal fatigue, possible thyroiditis or it could be Hashimotos ‘trying to get hold’. I’ve just been referred to a persistent physical symptoms team and I suspect they’ll diagnose ME. Awaiting appointment with neurologist but endo felt this would come up with nothing.

GP bloods taken Sept - morning cortisol was elevated but I think that result is invalidated by adrenaline surge being in surgery. Have ordered regenerous saliva test based on advice here. Afraid I can’t attach second photo of these results but they are on a previous post or I can type results out if needed.

What has confused me is that my TPO antibodies on NHS bloods are negative - shows Se thyroid peroxidase Ab conc - Normal - Anti TPO Ab negative (25 IU/ml - no reference range). Based on what I believe is equivalent unit measurement these are almost half what they were in July. Repeat medichecks bloods last week (results below) show that these are still elevated at similar level to summer. My question here is do I have reason to doubt the medichecks result? Is it likely the anti bodies halfed and then doubled again in such a short time frame? My receptor antibody test was negative.

Medichecks Oct bloods:

CRP 0.3 mg/l (<5)

Ferritin 29.9ug/L (13-150)

Vit B12 active >150 (>37.5)

Thyroid hormones - attached as photo

Antibodies THYROGLOBULIN ANTIBODIES 18 kIU/l (<115)

Thyroid Peroxidase Antibodies 52.5 kIU/l (<34)

I’ve cut gluten and dairy in an attempt to address the TPO antibodies - is it likely that at a low level they are inconsequential or could I be very early stage/‘pre’ Hashimotos? It may be worth me seeing the private endo again to discuss this?

My vitamin D levels are now ok so I’ve dropped to maintenance dose. My ferritin has dropped - I did receive good advice on here from Seasidesusie about getting this to optimal level and admittedly I haven’t properly addressed yet so that’s my plan now. I was taking spatone sachets until late summer then stopped after I saw the endo as she suggested Centrum A-Z performance which contains my RDA of iron. This has obviously impacted my absorption. I wonder if it would be safe to take the spatone sachet as well as the multi vit? I will start with chicken livers weekly. I might feel safer with an iron panel done first - would the Medichecks full blood count be adequate for this or can anyone suggest other test for iron panel?

Apologies for length of post and thank you for reading!

[SeasideSusie Remembering]

Bambini83

What has confused me is that my TPO antibodies on NHS bloods are negative - shows Se thyroid peroxidase Ab conc - Normal - Anti TPO Ab negative (25 IU/ml - no reference range).

Medichecks Oct bloods:

Thyroid Peroxidase Antibodies 52.5 kIU/l (<34)

is it likely that at a low level they are inconsequential or could I be very early stage/‘pre’ Hashimotos?

Antibodies fluctuate, that's their nature. Raised antibodies suggest Hashimoto's. You've had an over range result so that would suggest Hashi's, you've had an under range results of 25 (range is probably <34) so it's quite high in range anyway. Fluctuation is expected. I would say there is no doubt you have Hashi's but it's not yet impacted your thyroid enough to send your TSH over range whichy ou need for a diagnosis.

I might feel safer with an iron panel done first - would the Medichecks full blood count be adequate for this or can anyone suggest other test for iron panel?

A full blood count doesn't include an iron panel. Medichecks do an Iron Deficiency Check (which is the iron panel) which can be done by fingerprick.

I saw the endo as she suggested Centrum A-Z performance which contains my RDA of iron

Not the best brand and multis aren't recommended. They contain too little of anything to help low levels, often contain things we should test for first before supplementing, and the iron will affect absorption of everything else in the supplement.

[Bambini83 in reply to SeasideSusie]

Thanks Susie - I genuinely appreciate your responses they’re so helpful to me.

I know I wasn’t mad keen on the multi vit tbh but she said this specific one is one she recommends for thyroid supporting components like iodine, zinc, selenium - it’s the centrum performance so not a full A-Z as such. I might need to think again with that. Do you recommend supplementing things like iodine?

[SeasideSusie Remembering in reply to Bambini83]

Bambini83

she said this specific one is one she recommends for thyroid supporting components like iodine, zinc, selenium - it’s the centrum performance so not a full A-Z as such. I might need to think again with that. Do you recommend supplementing things like iodine?

So that one contains

Vitamin A: 800 µg

Vitamin D: 5 µg = 200iu which is less than a child's maintenance dose

Vitamin E: 26.8 mg

Vitamin C: 120 mg = 1000mg would be better, recommended for Hypos and also supports adrenals

Vitamin K: 25 µg = doesn't say which form - K1 or K2 and this is important. K1 is the blood clotting form, K2 directs calcium to bones and teeth and away from arteries and soft tissues

The next 7 are all B vitamins which you'd get in any B Complex

Thiamine: 4.2 mg

Riboflavin: 4.8 mg

Niacin: 36 mg 225%

Vitamin B6: 6 mg

Vitamin B12: 18 µg = not enough if you are low in B12

Biotin: 40 µg

Pantothenic acid: 10 mg

Iron: 14 mg = will affect absorption of everything else

Zinc: 7.5 mg = should really be tested

Copper: 700 µg = should be balanced with copper so should really be tested

Manganese: 4 mg

Selenium: 70 µg = doesn't say which form, should be selenium l-selenomethionine or a yeast bound selenium and not selenite or selenate

Chromium: 120 µg

Molybdenum: 75 µg

Iodine: 150 µg = this is the RDA and we can easily get iodine from a normal UK diet, eg milk, yoghurt, cod, haddock, scampi, etc. Iodine should be tested and only supplemented if deficient.

Ginkgo biloba extract 60 mg

Ginseng extract: 50 mg = doesn't tell us which Ginseng, there are many forms and some are included in adrenal supplements which are known to lower cortisol levels.

Best thing to do is test - Vit D, B12, Folate, Ferritin, then if necessary test selenium, zinc, copper, iodine.