I am a member of the board and you have helped me in the past, thank you and hugs!
But today, I am writing on behalf of my dear brother-in-law Shawn. Shawn went to a more naturopathic doctor in Toronto, Canada because the family doctor is well, not to helpful. This doctor did quality bloodwork and bingo, very interesting results.
Shawn is 60, has weight issues, has only partial lung capacity (so is very careful of the virus), has been on a statin for many years, has recently taken antibiotics for Lyme, has in the past been on prednisone for many years, leads a sedentary life, eats ok but many carbs, low alcohol use - AND is the most dearest, wonderful, responsible human!
I and Shawn would appreciate your analysis of what is going on so he can approach his doctors from a position of strength.....
Thank you in advance for helping Shawn, and you are also helping me!
May blessings flow to each of you and your families and may we all remain well in these challenging times.
C-Reactive Protein High Sensitivity (<=3.0) - Result 1.9
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Calculating percentage through the range
To calculate percentages through the range for any test result (not just thyroid test results) which has a top and bottom of the range this link is helpful :
Note that if the reference range is of the form "< X", you can consider the bottom of the range to be 0, and still calculate a percentage through the range.
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ALT - Outside top of normal range - (High)
ALT = Alanine aminotransferase= one of the tests done in a Liver Function Test
High levels ( but not dramatically over the range) of this often indicate that someone has a fatty liver. But if your brother's level is very high (i.e. multiples of the top of the range) it could indicate there are other diseases going on. The link I gave above gives pointers to what should be considered / researched.
Fatty liver is usually found in people who eat high levels of carbs and sugars. It is not caused by eating fat. Fatty liver can lead to fibrosis and scarring in the liver, and may end up causing cirrhosis.
The above calculator from grassrootshealth can be used to calculate the dose required to raise vitamin D to optimal. This is important in trying to ward off Covid-19.
Vitamin D supplements taken should always contain vitamin D3 not vitamin D2.
The best vitamin D supplements are capsules containing only oil and vitamin D3. An alternative is mouth sprays.
Vitamin D raises the amount of calcium absorbed from the diet. In order for that calcium to end up in bones and teeth, rather than lining the arteries, there are two other supplements recommended. They are magnesium and vitamin K2. If you search the forum for references to vitamin K2 and magnesium you'll find they have been referenced hundreds of times.
Ferritin (15-517) - Result 322 61% of the way through the range
Ferritin is a measure of one's iron stores.
Your brother's result is very good. However, ferritin can look "falsely good" in cases of ill health, infection, or where inflammation is present.
B12 (>220) - Result 255 (High)
There are two types of vitamin B12 test. One is the Serum Vitamin B12 test and the other is the Active Vitamin B12 test. For future reference, the Active test is the better test. Based on the reference range given this result is from a serum Vitamin B12 test. Knowing the units of measurement would confirm it one way or the other, so please let us know.
Your brother's test result is not high, it is in the reference range. The reference range suggests that a good level is over 220, and your brother's result is over 220.
However, for a serum Vitamin B12 test a level of 255 is not good. I would suggest a better level would be about 1000 ng/L.
If your brother decides to supplement B12 the best supplement is methylcobalamin which is an active form of B12 that the body can readily make use of. I would suggest taking 1000mcg per day for 2 - 3 months, then re-testing after the first bottle is finished. Once 1000ng/L has been reached, reduce the number of days a week the supplement is taken to try and maintain the level.
Folate - No result given
For the body to make use of the B12 it has it needs good levels of folate. Optimal for folate is upper half of the reference range, but don't go over the range. If it needs to be supplemented then the best form of supplement is methylfolate. Dose should be 1000mcg per day until optimal is reached, then reduce the number of days per week the supplement is taken to maintain it at optimal. A useful link, well worth reading :
CRP is a measure of inflammation in the body. Your brother's result is within the reference range which is good. Optimal is less than 1, but there is no way to influence it directly. Optimising nutrients and healthy diet with sufficient fat and protein and limited carbs and sugars would help.
I'll post this and then start on some of the other results.
TSH (0.35-5.0) - Result 2.86 54% of the way through the range
Free T4 (12-22) - Result 14 20% of the way through the reference range
Free T3 (3.4-5.9) - Result 6.3 (High) 116% of the way through the reference range
Thyroid Peroxidase Antibodies (<35) - Result 106 (High) - Positive result
Thyroglobulin Antibodies (<41) - Result <20 - Negative result
Thyroglobulin (1.6-60) - Result 20.8 I don't know anything about this result - it rarely gets measured in the UK.
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TSH is well within range, suggesting that your brother is not (currently) hypothyroid. The TSH level at which doctors will diagnose hypothyroidism varies from country to country. In countries where the medical profession has some compassion they will treat for hypothyroidism when TSH is 3 or more. In countries like the UK where sadism is the rule we have to wait for TSH to be 10 or more.
What the results do show is that your brother's thyroid is struggling a bit. An early sign of this is often low Free T4 and high Free T3. The body recognises the thyroid is failing and starts to convert more Free T4 into Free T3, so people end up with results a bit like your brother's.
The positive result for Thyroid Peroxidase Antibodies (TPO Ab) shows that your brother has Hashimoto's Thyroiditis. This suggests that his thyroid will gradually get less and less good at producing sufficient thyroid hormones. TSH will gradually get higher and Free T4 and Free T3 will gradually get lower.
Many people with Hashi's feel much better when eating a gluten-free diet. To have any effect though, it has to be adhered to ruthlessly.
Having Hashi's will often cause thyroid results to fluctuate quite dramatically. If TSH drops low and Free T4 and Free T3 becomes high this suggests that the thyroid is under attack from the immune system. But if the thyroid was tested again a month later the results could be entirely different and much more hypothyroid i.e. high TSH, low Free T4 and low Free T3.
Some people find that giving up gluten reduces their antibody levels. Some people feel better for this, some people don't. It's one of those things people have to try for themselves. If there is no benefit of any kind in giving up gluten then the patient may as well start eating it again.
One final point - your brother's TSH is very close to mid-range. Many doctors think this proves the result is wonderful and optimal. But it isn't. Healthy people with healthy thyroids don't have a TSH which is mid-range, they have a TSH which is much lower in range. See this thread for more info :
There aren't many of these I know anything about. I can give some links that might be helpful (but I'm not giving any guarantees). I suspect, but can't be sure, that exercise, a better diet and losing weight might improve many of these. But I know how hard that can be.
The only thing I know about this is that it decreases as we age, and the lower it is the more likely cortisol is too low as well. I doubt that it should ever be below range in a healthy person. I know that some people supplement DHEA but I can't help with whether that is a good or bad thing to do. DHEA is actually a controlled drug in the UK, because it is classed as an anabolic steroid. And yet in many countries it can be bought over the counter. I think it is the UK that is out of step with reality in this situation.
Estradiol (<159) - Result 185 (High)
Estradiol is the main form of estrogen found in the human body.
Why was your brother taking prednisone? Why does he no longer take it? I know it is essential in some conditions, but it does have unfortunate and serious side effects - it may suppress the function of the adrenal glands, and the body might not be able to restart production of cortisol if prednisone is withdrawn.
These both suggest that your brother may be suffering from insulin resistance or metabolic syndrome or pre-diabetes. I'd be surprised if he was suffering from type 2 diabetes (I don't think the results are high enough for that) but it may happen in the future. All of these conditions are reversible with the right diet.
If your brother is at high risk of suffering badly from Covid-19 then getting his vitamin D level up to optimal is essential and urgent. There has been evidence that those with good levels of vitamin D are less likely to catch Covid-19 and if they do catch it they have less severe symptoms.
Doctors in the UK prescribe ridiculously small doses of vitamin D e.g. 800 iU is common and wouldn't improve levels for a Vitamin D deficient flea.
I have good levels of vitamin D, but I still take 4000 iU per day. If I take less than 2000 iU per day my vitamin D level actually drops.
OMG, your response is simply outstanding and full of care and compassion. Shawn and I thank you so very much. Thanks for taking the time from your day to help another person, this is symbolic of the type of people on this board.
So many hugs sent to you from Shawn and I.
Your analysis mirrors my thoughts as well.
Fortunately the naturopathic nurse practitioner does have dispensing rights, so Synthroid might be in order, a low dose to start to help support the thyroid. Perhaps some DT as an alternative.
I am Hashi as well and contemplating gluten free going forward.
The blood sugar needs adjustment for sure - need to start with daily sugar monitoring to see what trends there are based on food.
I am getting Shawn some liquid D3 for sublingual usage to get his Vit D up.
One thing that concerns me is the liver ALT above the top of the range - this tells me that the liver needs support and that it is burdened with drug usage issues like the statin.
I like your comments on the UK health positions/perspective, in Canada we do not have a private system at all, so we have 0 choice in health and frankly very limited access to any family doctor let alone a specialist. In Ontario about 25% of taxpayers do not have a family doctor, there are none. It can take a year to get a specialist. We have a very poor health system for what we pay.
Fortunately we have excellent access to drugs because of proximity to the US and naturopathic drugs and there are 4 stores near me that sell every type of supplement known to humans - so that helps.
I agree, what I am thinking is for Shawn to get a prescription for 25 mg synthroid, to be halved. Keep it in his pocket.
I am also researching the low T, this is a big issue for men but I am also personally suffering from it due to exhausted Adrenals, so the low T applies to us ladies over 60!
Make the diet changes and supplements first. The reason to have the prescription in hand is that it is sooooooooooooooo hard to get a doctor appointment here, even with those practicing naturopathic medicine. The Ontario college of physicians and surgeons are a cabal of anti functional medicine awful people who are trying to rid the province of any medicine other than their by the book big pharma approach. I am working with the nurse practitioner to fight them and keep her business going and I am citing the fact that all G20 countries have a minimum of two health systems, one private and one public. Canada is the only G20 country with only a public system (even Russia has 2)!.
We have no private medicine health system in Canada. Often I access medical care in the US.
So I get your analysis of the national system in the UK!
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Need help please. 29 yr old male, feeling tired all the time.
