Results back - now need real deal advice (that ... - Thyroid UK

Thyroid UK

137,828 members • 161,652 posts

Results back - now need real deal advice (that I can then feed back to the doc)

Hello all well I’ve had my blue Horizon blood panel and got the results back tonight. I would really appreciate some advice on interpretation.

Written by

Charlie-Farley

To view profiles and participate in discussions please or .

The ability to reply to this post has been turned off.

19 Replies

•

Steni3 years ago

I looking forward to seeing what people say on this , hopefully by liking it I will get to see ( thinking ‘liking’ is the same as following ?)

SlowDragonAdministrator3 years ago

See in previous post you have recently gone strictly gluten free and seen great benefits

Your high thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Hashimoto’s frequently causes gluten intolerance

Your above range TSH and BELOW RANGE FT4 confirms clinical hypothyroidism

GP may want to do NHS tests to confirm. And often they want 2 tests 6-8 weeks apart ....before starting what will almost certainly be lifelong treatment

Once GP has done test they should start you on levothyroxine. Standard starter dose of levothyroxine is 50mcg. Bloods should be retested 6-8 weeks after each dose or brand change in levothyroxine. Dose is increased slowly upwards in 25mcg steps until TSH is definitely under 2.

Most people on levothyroxine when adequately treated will have TSH well under one.

Most important results are always Ft3 followed by Ft4.

Aiming for Ft3 at least 50-60% through range and usually Ft4 will be higher

Low vitamin levels extremely common when hypothyroid due to low stomach acid and poor gut function

Optimal vitamin levels

Vitamin D at least around 80nmol and around 100nmol maybe better

Folate and ferritin at least half way through range

B12 at least over 500

So folate, B12 and vitamin D need improvement

High ferritin common with Hashimoto’s due to inflammation

Iron may not necessarily be high. GP should do full iron panel test to see if iron is low

High cortisol common when hypothyroid as adrenals try to compensate for lack of thyroid hormones. You should see this improves as you start on levothyroxine

SlowDragonAdministrator3 years ago

See both flow charts on here

Clear that you should be starting on levothyroxine

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

Low vitamin D obviously needs improving and GP should prescribe 1600iu everyday for 6 months

NHS Guidelines on dose vitamin D required

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

But you may find you need higher dose than this with Hashimoto’s- see below

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...

But with Hashimoto’s, 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, with hashimoto’s we frequently need higher dose than average

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...

Charlie-Farley in reply to SlowDragon3 years ago

Thank you so much for all the info- lots to read! I’m going to ‘old school’ it. Print it out and highlight draw arrows and open links on screen. This is an amazing resource. The most important thing is the advice is geared towards feeling well not just being in range. Sadly as past experience has taught me when advocating for my mum it was all about the numbers, her well-being was incidental.

I’ll keep you posted how I get on with the doc.

SlowDragonAdministrator3 years ago

Only add one supplement at a time and then wait at least 10 days to assess before adding another

Starting with vitamin D, followed by magnesium

Then look at B12 and folate

Low folate

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-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

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 B12 result below 500, recommended to be 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

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

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

healthunlocked.com/thyroidu...

healthline.com/nutrition/me...

Charlie-Farley in reply to SlowDragon3 years ago

Lots to read! Thank you 😊

Hashihouseman3 years ago

Looks like Hashimoto’s thyroiditis that needs treating before it gets worse.... some say you can cure it by diet and voodoo at this stage but....? You’re obviously low on t4 which is raising your tsh which is keeping your t3 ok but that may not last, at least it indicates you may convert t4 to t3 well and/or your suffering thyroid gland is spitting out more t3 in response to the tsh, which is what it should do. Before treating it and with the benefit of hindsight I would take ft3 ft4 and tsh blood tests at midday and midnight in the same 24 hr period to see what your natural circadian rythym is before it gets corrrupted by replacement thyroid hormones... then you can emulate it it later with treatment regime if you need to.

Charlie-Farley in reply to Hashihouseman3 years ago

I’m hoping GP will refer 😊🤞

SlowDragonAdministrator in reply to Charlie-Farley3 years ago

Very unlikely

There’s almost 2 million people in U.K. on levothyroxine...99% managed (or mismanaged) by GP’s

Your results show you are clinically hypothyroid

GP is obligated to repeat the tests via NHS rather than just accept private blood tests

And usually we need two consecutive tests with out of range results before starting on levothyroxine

Meanwhile working on improving low vitamin levels will help improve symptoms

Hashihouseman3 years ago

PS your total t4 report is also worth noting in terms of your absolute insufficiency - it should be around 100-110 (the lab range, as ever with these things, is way way too wide to be really meaningful)

Charlie-Farley in reply to Hashihouseman3 years ago

Thank you for this, truly

tattybogle3 years ago

well those results explain why you are struggling . They are clinically hypothyroid results , meaning the TSH (thyroid stimulating hormone) is over range, (asking for more thyroid hormone) AND the fT4 (free T4) is under range ( not enough thyroid hormone)

the TPOab (thyroid peroxidase antibodies) are over range , showing that the cause of the hypothyroidism is 'autoimmune', which is the most common cause in UK.

The gp will probably need to confirm these by doing their own testing , (and they may wish to do a repeat just to confirm it is not just a passing thing, but that seems unlikely given theTPOab 's)

And then they should start you on levothyroxine (which is synthetic T4)

And hopefully when you are on the correct dose , which unfortunately will take several months to get right, you will feel ore like yourself

Charlie-Farley in reply to tattybogle3 years ago

Thank you so much

tattybogle in reply to Charlie-Farley3 years ago

p.s it is quite possible that you have been struggling with low thyroid hormone levels for a few years for your results to have got to this level now. Your results are a bit worse than mine were when i was diagnosed , and i'd been really struggling for about 5 years before it was discovered to be hypothyroidism.I had TSH 6.8, so not shouting quite as loud for more as your 7.96 is (higher number = more please) and my Total T4 (TT4) was 91 [65-155], so i still had more T4 production than you do now at 75.6.

I never had a Free t4 (fT4) done back then . so don't know how much of the T4 was available.

Just thought i'd let u know this as your previous post mentions how much you've been struggling for so long.

Perhaps this graph

healthunlocked.com/thyroidu...

showing the most common levels of TSH in healthy people will be enlightening, you'll notice most are under 2, hardly anyone has 4 and the scale only goes up to 6. So if by some horrible . but sadly all to common, chance you get a GP who thinks 7.96 isn't too bad , and wants to wait until it gets to 10 before treating you.... bear this graph in mind and push hard to be heard.

Good luck at the Docs.

Charlie-Farley in reply to tattybogle3 years ago

I’m chewing over all the info given to me. BUT that graph! OMG, I’m agog that data like this can exist and yet medicine is so intransigent that treatment hasn’t modified in light of this.

Bearing in mind how much the medical profession like ‘ranges’ to measure against it is amazing they haven’t jumped on this - Except when you consider the medical egos behind much of the established protocols. (Thinking of those who have been hounded for daring to be lead by patient outcomes rather than prescribed protocols.)

Truly bad practice to not allow protocols to be modified in light of new evidence, just really bad science. I say this because I studied Environmental science to quite a high level. You get to think of things in a more system approach. I’m well out of my field of experience, but that graph is screaming at me 😱

So much of what I have experienced when advocating for my mother and father has been the worst kind of medical reductionism in action. I believe the systems in place are more to do with measuring performance and achieving ticks in boxes.

Example - my father was diagnosed with Alzheimer’s and 3 months later prostate cancer. Never was treatment for the cancer considered in light of my father’s Alzheimer’s diagnosis. Result? Aggressive radiotherapy for 7 and a half weeks that ultimately took his last good year off of him. Cured the cancer though- TICK!

I trusted we were getting good advice. Question everything - especially their underlying motivations. Conservative treatment with injections would have given better quality of life, but that is not a consideration for the medical profession in this country. It ALL about tick boxes. 🙄

Sorry! Rant over - bet you wish you hadn’t shown me that graph now 😂

tattybogle in reply to Charlie-Farley3 years ago

On the contrary , i'm very glad i did show it to you .... "a picture is worth a thousand words" and all that.And on the subject of words , i agree 100 % with every word of your rant.

I'm no scientist ,but i do like to be methodical, and i've been appalled to find out how little basic scientific good practice/observation / questioning goes on in the world of 'medicine as we see it practiced'

I'd settle for a bit more 'common sense ' to be honest, but it seems even that is too much to ask now that everything is a tick box mentality.

Looks like we'll just have to figure it out for ourselves , but then they do say 'if you want something doing properly , do it yourself'

Sorry to hear about your Dad's 'cure', i know exactly what you mean. They kept trying to 'cure' my mums high blood pressure, and if i knew then what i know now i'd have chucked the array of tablets with horrible side effects in the bin for her, and let her be happy for a couple of years with a high blood pressure, rather than miserable for 5.

Charlie-Farley in reply to tattybogle3 years ago

I’m so very sorry to hear you and yours have experienced this egregious treatment by ‘conventional medicine’. So many people are coming out of the woodwork with similar experiences to ours . The tide will change. There is a growing (if still mainly silent) band of people who will reach critical mass and hold a mirror up to these practices.

I think from conversations I have had with the medical profession they are aware of a growing tension and currently I would say 50% are on ‘our side’. The other 50% still hold sway and some of the key positions, that is the difficulty. I make no bones about what we as a family experienced and tell anyone who will hear to serve as a warning. If I can stop only one family being manipulated and coerced and made to suffer the way both my parents did ........

pennyannie3 years ago

Hey there again ;

So, there you have it, you have been very well looked after and have much to read and understand.

But yes, doctors do seem to be welded to guidelines, ranges and computer dogma : and do not seem to join up the dots -

This forum is excellent at dot to dot - so sharpen a pencil or two, as we have all had to do, and start turning things around for yourself, where you can.

You've already made progress and it's just a slow build and doable.

Charlie-Farley in reply to pennyannie3 years ago

Yes thank you to all who have helped me. The significant thing is GP was going to commission a blood test but that would not have included antibodies or cortisol. I used Covid and pressure on the NHS as the reason for getting the blue horizon test done😉and have now dropped off the results at the surgery. I was tempted to give her only the results that the NHS would have done then see what she could make of it then give the rest of the results- but she has been great so far so not going to ‘rag’ her. Hey, I may be one of the lucky ones.😊🤞

The ability to reply to this post has been turned off.