Whilst this is not really Thyroid related I hope you knowledgeable people will take a look at my Granddaughter's blood tests results and see if there is anything we can tackle.
My Granddaughter has been struggling since last summer with tics and vocal outbursts. She gets so frustrated that she ends up punching her head which is very distressing for her parents and sister. She has been diagnosed as having Tourettes syndrome and has been waiting on a consultation with CAHMS since last August. Prior to this consultation they requested blood tests. the results of which all appear normal. I encouraged them to add in Thyroid function tests, Ferritin, Folate, Vit D, and Vit B12 as I have Hashimoto's She has Type 1 Diabetes and will be 14 next month. She has only recently started menstruating (December). The blood test was taken at 3.30 pm.
Yes, that low ferritin almost certainly is causing some problems—or is about to! Has her doctor done a full iron panel? That’s a very low number and I’d suspect iron deficiency anaemia, which is going to leave her feeling terrible, especially now she’s started her periods.
Those are tests for immunoglobulins - tests for allergies and intolerances (for example gluten intolerance) and signs of infection. All are normal, so that’s good. Nothing to do with iron though.
Her doctor should really do a full set of iron tests to see how anaemic she is.
Total T3 Serum total T3 level 1.6 mmol/L ( 0.9 - 2.5)
Her TSH would have been higher at 8 to 9 am. And, frankly, should be higher, given her low FT4. 33.33% is probably not euthyroid. That would be more like 50% - although, that might be her own personal setting, but who can tell, given that she didn't get it tested when she was well. But, I think that's worrying enough to continue to survey her levels by testing from time to time.
Unfortunately, they tested the wrong T3. Total T3 doesn't give you very much useful information, and what you need is the Free T3. That will tell you a lot more.
Pity they didn't test her antibodies - especially as you have Hashi's. Maybe next time?
Thank you Greygoose. I encouraged them to get tested early morning, but they had to accept the appointment that was available. They did test the Thyroid peroxidase antibody level which was <0.1 U/mL (normal range <6.0.. I didn't include as I thought it was not relavent.
Well, one negative result does not prove she doesn't have Hashi's. Antibodies fluctuate all the time, and that range is so narrow that they could very well be over-range in a future test. Plus there are two Hashi's antibodies: TPOab AND TgAB. Plus, you don't even have to have high antibodies to have Hash's. 20% of Hashi's people never have over-range antibodies, but they still have Hashi's.
My opinion is that it's better to refuse an appointment than get tested at the wrong time. Because the difference in the TSH could make all the difference to the diagnosis.
Low iron and/or low ferritin frequently linked to hair loss
Look at increasing iron rich foods in diet
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
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
Thank you SlowDragon for so much information for us to absorb. Her diet could be described as bland. White and spinach pastas, noodles, breads, fortified cereals, milk and cheese. The GP has prescribed Stexerol (D3 25000u 625 mcg tablets one every 2 weeks for 6 weeks. Should the GP be able to deal with the low ferritin problem or will she need to be referred on to more in depth treatment? I will try to get the further blood test results requested by Jazzw. Thanks again for all the help.
Recommend reading her many posts and replies on iron and ferritin
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
Having low iron also often results in heavy periods (bit of a design error )
Look at increasing iron rich foods in diet
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
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
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