Help understanding blood results

[Saintrockz]

Biochemistry

hs-CRP 1.85 <5.0 mg/L

Ferritin 42.5

Magnesium 0.94

Cortisol (Random) 217.0

Thyroid Function

TSH H 5.43

T4 Total 106

Free T4 12.9

Free T3 4.92

Anti-Thyroidperoxidase abs 12

Anti-Thyroglobulin Abs 68

Vitamin D (25 OH) 73

Vitamin B12 451

I have always had low BP cold feet n hands and fluid retention and thought nothing of it. Dry hair hair loss, constipation even though I go twice a day drink lot of water eat a lot of fibre, strong smelling urine even though it's clear, tiredness depression anxiety severe care tunnel on both hands n cubital tunnel in my elbows stiff calf muscles n trapped nerve in my foot...not in relation to my exercise....n this year when going on keto and going to gym in Jan 6 times a week my weight wouldn't drop. Keto should have made my hair shiny n thick instead I lost hair n it's like a dry bush. My fluid retention went crazy those summer n my legs arms all swelled. I have been to the gp about all of these things but no dot to dot was done ...my cholesterol was also raised but ascertained as I'm Asian so predisposed and a huge swollen belly not in line with wat I eat. I am intermittent fasting managing16 hours without eating but nothing shows. It's my circulation that worries me the most but having low BP was always seen as good by the gp. Anyway I had a blood test in Jan with a change in thyroid function....very basic test was told wait three months I did have another then cOvid happened so gp couldnt see me but again it was raised. I again requested and the earliest appointment given was the 13th of November at 8. In the mean time reading on this wonderful forum I realised I should private test my bloods to get an accurate result. But my anxiety is flaring up when reading my results wat do they indicate what should I be pushing my gp to do, refer to a specialist or ask for a private prescription or simply order privately myself online. I understand people may need to p.m. me but I am struggling,my mind fog and constant feeling tired us impacting negatively on my family life hugely n I am spiralling with my depression. Many thanks all thesuperkind people who read, decifer suggest and help in a selfless manner....

[SlowDragon Administrator]

Please add ranges (figures in brackets after each result)

Every lab has different ranges

[Saintrockz in reply to SlowDragon]

est Patient Result Normal Range Units Comment

Biochemistry

hs-CRP 1.85 <5.0 mg/L

Ferritin 42.5 13 - 150 ug/L

Magnesium 0.94 0.7 - 1.0 mmol/L

Hormones

Cortisol (Random) 217.0 6am - 10am 113 - 456 nmol/L

4pm - 8pm 58 - 278

Midnight <64

Thyroid Function

TSH H 5.43 0.27 - 4.20 mIU/L

T4 Total 106.0 66 - 181 nmol/L

Free T4 12.9 12.0 - 22.0 pmol/L

Free T3 4.92 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs 12 <34 kIU/L

Anti-Thyroglobulin Abs 68 <115 kIU/L

Vitamins

Vitamin D (25 OH) 73 50 - 175 nmol/L

Vitamin B12 451 Deficient <145 pmol/L

Insufficient 145 - 300

Consider reducing dose >569

Serum Folate 40.50 8.83 - 60.8 nmol/L

[SlowDragon Administrator in reply to Saintrockz]

So this is second thyroid test

What were results of first test?

TSH is over top of range and Ft4 rock bottom

Thyroid antibodies are negative for autoimmune thyroid disease

So GP could/should offer trial of levothyroxine, especially if first test was abnormal

See flow chart on top of page 2

gp-update.co.uk/Latest-Upda...

Folate, ferritin and B12 ok, but could be better

Vitamin D want to keep over 75nmol

Do you supplement?

Cortisol is quite low for early morning test

Standard starter dose of levothyroxine is 50mcg

Perhaps ask for ultrasound scan of thyroid

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...

High cholesterol levels linked to being hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

[Saintrockz in reply to SlowDragon]

I had two tests with the gp, and this is my first with blue medical. Usually I take a good multivitamin but as per the forum I stopped for a week.

May I ask what does the low cortisol mean? My mother did not respond well to levo and was eventually prescribed armour but this was years ago, sadly she died 7 years ago. But I am not hung up on ndt being the only way forward I just want to know my options with the gp. I don't have the mental strength to do months of trials n tests and then end up asking for a private prescription. If can order online then I will try that, my gp was so dismissive with my symptoms, and the worse is I have sent years with a useless index finger n numbness due to care tunnel n no help just told have an operation which I did and it came back worse.

[SlowDragon Administrator in reply to Saintrockz]

would strongly recommend getting GP on board and getting levothyroxine prescribed

Important to tell GP your mother also had hypothyroidism (presumably autoimmune) - it’s extremely genetic

If GP remains unhelpful

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private

[e-mail]

Far better to get official diagnosis rather than self medicating

Carpel tunnel is common hypothyroid symptom

Any operation can significantly decrease B12, making hypothyroidism worse

Generally we don’t recommend multivitamins

Better to supplement Vitamin D

Perhaps consider adding a daily vitamin B complex too

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

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 is another option that contain folate, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

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

endocrinenews.endocrine.org...

Low B12 symptoms

b12deficiency.info/signs-an...

[SlowDragon Administrator in reply to Saintrockz]

When we are hypothyroid, adrenal glands try to compensate for lack of thyroid hormones, initially this often causes high cortisol. Eventually adrenals can’t keep up and cortisol levels start to drop

You might want to consider getting adrenal cortisol and dhea testing (not available on nhs )

regeneruslabs.com/products/...

cdn.shopify.com/s/files/1/0...

This can help identify if diurnal variation is out of sync, or if levels are low all day

[Saintrockz in reply to SlowDragon]

Thank you so much slow dragon, I'm going to get my tests printed this afternoon and will post the results, they were not taken early in the morning though ....let's see wat the gp says....I need something to change desperately as my depression is really bad

[SlowDragon Administrator in reply to Saintrockz]

Obviously depression is something that is extremely common hypothyroid symptom

List of hypothyroid symptoms

thyroiduk.org/signs-symptom...

[Hidden]

What time of day was your blood cortisol test done? This is relevant as cortisol should be at it's highest point first thing in the morning & then drops during the day.

[Saintrockz in reply to Hidden]

My tests were done 830 am. I'm close to a breakdown, all my symptoms scream thyroid but gp is so reluctant. Could anyone p.m. me an endo or private gp who might prescribe armour privately

[Hidden in reply to Saintrockz]

if you cortisol test was done at 8.30am then it is low & you need further investigations, it might be your thyroid but it could be that your adrenal glands aren't working as well as they should be. Show your GO these results & ask that he tests your cortisol levels. Cortisol first thing in the morning should be more than 350nmol/Ls preferably nearer to 500nmol/Ls. If you need to see an Endo then it needs to be one who is conversant with pituitary/adrenal issues as not all of them do. Where about in the country are you?

[Saintrockz in reply to Hidden]

I'm in Harrow border of Hertfordshire. I know I need to see a specialist endo but not sure how to find one. I'm assuming going private would mean going anywhere to someone who understood the pathology of both adrenal n thyroid issues?

Thank you so much for your help, it means so much

[Hidden in reply to Saintrockz]

I'll message you.

[Saintrockz in reply to Hidden]

Thank u so much Pauline....u r such a superstar

[SlowDragon Administrator]

Have you had list of recommended thyroid specialist endocrinologists

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private

[e-mail]

You need Adrenal and thyroid specialist

Probably an ultrasound scan of thyroid too

I have details of private scan options in London, pm me if you want details

£150 approx