Thyroid panel blood results, help please. - Thyroid UK

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Thyroid panel blood results, help please.

SummerJessica profile image

Hi

I just received my results from Thriva. Unfortunately some of my tests couldn't be performed due to blood cells bursting but I did get my thyroid panel results. Can someone please help me interpret them? I have had ongoing symptoms for several years. I initially posted here 2 years ago when a lump was found on my thyroid (benign) and then my GP was only willing to test the bare minimum (TSH at that point was 4.2). Last year I was diagnosed with Raynauds Syndrome as I was suffering very cold fee with my toes turning white and even blue, even in the house! I have PCOS (diagnosed in 2001) but I have always struggled with weight gain, I have very fragile hair, nails peel including on my toes, I get a lot of muscle cramps all over my body, tired all the time and have been having awful anxiety this last year. I could go on! I meant to do a private thyroid test last year but just didn't get round to it :(

So here are my results from Thriva, bloods taken 2 daya ago first thing in the morning, fasted.

Ferritin 47 ug/L (normal)

Vitamin D 28 nmol/L (abnormal)

TSH 6.01 mIU/L (abnormal)

FT3 4.7 pmol/L (optimal)

TgAB 56.5 kU/L (normal)

TPOAB 15.9 klU/L (normal)

T4 118 nmol/L (normal)

FT4 14.9 pmol/L (optimal)

B12 326 pmol/L (normal)

My TSH is higher than it was last year :(

If anyone can help I would be grateful.

21 Replies
SlowDragon profile image
SlowDragonAdministrator

Your vitamins are all low BECAUSE you are hypothyroid.

Improving all four vitamins will help get improve symptoms

Vitamin D is insufficient and just short of deficient

GP should prescribe 1600iu everyday for 6 months, but you may want to supplement at higher dose

Vitamin D

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Taking too much vitamin D is not a good idea

chriskresser.com/vitamin-d-...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

2 good videos on magnesium

healthunlocked.com/thyroidu...

Thanks for that! I don't have a diagnosis of hypothyroid. My GP has always said my results are normal. My next step was to go back to my GP with these results and see where we go from here. I have a feeling they will want to repeat bloods before doing anything :(

SlowDragon profile image
SlowDragonAdministrator in reply to SummerJessica

Yes they typically will want to retest themselves

Insist all these tests are done....plus folate

Don’t start any any supplements until after testing

Great I will ask for these to be done. Do you think they will do them based on these results now? No matter how hard I tried before, I couldn't get them to run a full thyroid panel etc. I had bloods from the GP last July and they were as follows. This included folate.

B12 was 194 ng/L [147 - 840]

Ferritin 32 ng/ml [11 - 307]

Folate 5.7 ng/ml [3.1 - 19.9]

Magnesium 0.84mmol/l [0.7 - 1]

Calcium 2.16 mmol/L [2.2 - 2.6]

Vitamin D 69 nmol/L

TSH 4.52 miu/L [0.38 - 5.33]

T4 11 pmol/L [8 - 16]

SlowDragon profile image
SlowDragonAdministrator in reply to SummerJessica

Are you vegetarian or vegan?

B12 extremely low

Likely to have Low B12 symptoms b12deficiency.info/signs-an...

Low enough certainly that GP should have done more investigations

The rest are low but not low enough for GP to consider an issue

But low enough that you need to self improve

No I'm not vegetarian/vegan, in fact I eat a pretty varied diet. Meat and chicken usually every day with plenty of vegetables. I always said to my GP that I felt these results were low even though they are considered to be normal range. Why would my B12 be so low then?

I've just had a look at the signs and symptoms of B12 deficiency and I have an awful lot of them. Tinnitus, restless legs are the most annoying ones right now, but I also had a DVT in the past with no real explanation. My GP has never once mentioned my B12 being low or any cause for concern.

SlowDragon profile image
SlowDragonAdministrator in reply to SummerJessica

Being hypothyroid causes low stomach acid and low stomach acid leads to low vitamin levels, especially low B12

Low stomach acid can be very common hypothyroid issue

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Web links re low stomach acid and reflux and hypothyroidism

nutritionjersey.com/high-or...

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

healthygut.com/articles/3-t...

naturalendocrinesolutions.c...

Protect your teeth if using ACV with mother

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator in reply to SummerJessica

NHS only obligated to treat deficiencies.....many CCG areas have bottom of B12 range at 210

147 is an especially low bottom range

Other countries have bottom of B12 range much higher at 300-400

So my recent result of 326pmol/L would fall within the normal range but still low?

Make sure you always have an early morning, fasting blood test - when TSH is highest - as so many doctors are obsessed with TSH regardless of your actual thyroid hormones :)

I took the blood at 9.20am and I fasted from 10pm the night before. I will make sure I schedule the bloods with the GP for first thing too.

SlowDragon profile image
SlowDragonAdministrator

Folate test unfortunately often fails

B12 is too low

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...

With such low B12 result taking a B12 supplement as well as 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.

B12 sublingual lozenges

cytoplan.co.uk/shop-by-prod...

amazon.co.uk/Jarrow-Methylc...

healthline.com/nutrition/me...

SlowDragon profile image
SlowDragonAdministrator

Ferritin is low, but not low enough for GP to treat

Low iron and/or low ferritin frequently linked to hair loss

Heavy periods are classic sign of being hypothyroid and will lead to low iron and ferritin ask for full iron panel testing for Anaemia

Never supplement iron without doing full iron panel test for anaemia first

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Post discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator

Only add one supplement at a time and wait at least 10-14 days before adding another

Retest thyroid in 2-3 months

Always do all thyroid tests as early as possible in morning before eating or drinking anything other than water

This gives highest TSH

Median TSH graph

healthunlocked.com/thyroidu...

TSH daily variation

healthunlocked.com/thyroidu...

Plus important when 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.

TSH is high enough now that you could/should be started on levothyroxine

See flow chart on top of page 2

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

Also request an 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...

PCOS and Hashimoto’s linked too

This is a useful piece of guidance for what docs should do re sub clinical hypothyroidism

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

That's my concern that as my T3 and T4 are in the normal range the GP won't do anything yet my TSH is the highest it has ever been and I have so many symptoms. Although some of that may be due to vitamin deficiency 😕

Bearo profile image
Bearo in reply to SummerJessica

Some GPs will prescribe for a TSH over 5 especially if you say you have symptoms. You can ask for a trial of thyroxine. Although your Ft3 and FT4 came back labelled optimal, there is a link often posted on this forum to find the percentage through the range; T4 should be in the top third, with T3 probably a little lower.

SummerJessica profile image
SummerJessica in reply to Bearo

Interesting then. I think I'm just going to ask for a trial as I've had ongoing symptoms for so long now. I am due to get bloods anyway (FBC etc) but I am going to call and ask them to do a full thyroid panel and ask them to make sure Vitamin D, B12, folate and ferritin is done. I hope they do these based on my recent results and also recent issues. GP diagnosed me with Gastritis in Dec and put me on Lansoprazole and last year was also diagnosed with Raynauds and they initially put me on Amlodopine, I took it for a month, but then I came off it as I didn't feel we got to the bottom of my issues. My restless legs have worsened this last year too :(

D9d9 profile image
D9d9 in reply to SummerJessica

Lansoprazole lowers stomach acid like PPIs. People then can have problems absorbing Vitamins as a result.

Hi SummerJessicaGPs are great, but they are not experts. I had/have most of your symptoms and was told by the GP ‘all is ok’. You need an Endocrinologist, either on the NHS or private (if you are in a position to afford that). For me it took one visit to the Endo and I had a diagnosis of hypothyroidism.

I hope all goes well for you

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