Help with bloods please

[Bubba28]

Good afternoon

I wondered if someone could help me interpret my blood results.

On 25th March I was tested looking for arthritis but they did a thyroid test and it came back abnormal so a week later I tested again, still abnormal but this time T3 was in range. I was referred to Endo who prescribed 5mg Carbimazole. I had to stop this last week as I got a rash and bruises but bloods were ok yesterday so I can resume. I stopped taking meds for about a week as I was away. Looking at the results it seems that TSH has marginally improved so hopefully will continue to do so, T3 has improved but T4 is slightly lower?

First results 25th March

Urate 355 (140.0 to 360.0)

TSH <0.01 (0.35 to 3.5)

T4 14.2 (7.5 to 21.1)

T3 6.3 (3.8 to 6.0)

Anti CCP <0.5 (0.0 to 5.0)

ESR 2 (0.0 to 30.0)

Antinuclear antibody 0.1 (0.0 to 1.0)

2nd results 30th March

TSH <0.01 (0.35 to 3.5)

T4 13.7 (7.5 to 21.1)

T3 5.8 (3.8 to 6.0)

Thyroid peroxidase 11.2 (0.0 to 34.0)

3rd results 9 June

Sodium 141 (133.0 to 146.0)

Potassium 4.0 (3.5 to 5.3)

Urea 5.5 (1.7 to 7.1)

Creative 59 (45.0 to 84.0)

Bilirubin 9 (<20.0)

Total protein 65 (63.0 to 82.0)

Albumin 41 (35.0 to 50.0)

Globulin 24 (21.0 to 35.0)

Alkaline phosphatase 49 (38.0 to 126.0)

Alanine aminotransferase 11 (0.0 to 50.0)

Gamma glutamyl 21 (9.0 to 36.0)

TSH 0.02 (0.35 to 3.5)

T3 4.2 (3.8 to 6.0)

T4 11.5 (7.5 to 21.1)

Full blood count was normal

I had a medichecks blood test done recently and blood count and clotting were fine so were kidneys, liver, proteins, Diabetes, gout, crp, and iron. These were the other results

Magnesium 0.86 (0.6 to 1.0)

Folate 7.6 (>2.9)

Vitamin B12 113 (25.1 to 165)

Vitamin D 61 (50.0 to 200.0)

So I have started a vitamin D supplement

Total cholesterol 5.4( <5)

LDL cholesterol 2.6 (<3)

Non HDL cholesterol 3.9 (< 3.8

HDL cholesterol 1.5 (>1.2)

Total cholesterol 3.6 (<4)

Fasting triglycerides 2.8 (<2.3)

Dr said to try to get the cholesterol down but was not very concerned and said overall my health looks good. I am starting some Personal Training sessions and starting a healthy eating plan so hopefully I can resolve that.

Does this mean Carbimazole is slowly correcting the issue? I have an endo app at the end of the month. What can I expect from the appointment? At the moment I am so tired, losing hair, anxious, had hand shakes, can’t tolerate heat well, sweating a lot. I am also at that age for a woman too where I could be going through menopause 😩. Also get raised pulse from little activity, tinnitus and ear pressure.Any advice very much appreciated xx

[SlowDragon Administrator]

Your results never suggested hyperthyroid (Graves disease)

Before being prescribed Carbimazole patient should ALWAYS have TSI or Trab antibodies tested to confirm Graves’ disease

High cholesterol is linked to being HYPOthyroid

Request ultrasound scan of thyroid

Medichecks….did you get TPO and TG antibodies tested for Hashimoto’s (autoimmune HYPOTHYROID)

Significant minority of Hashimoto’s patients only have high TG antibodies and NHS won’t test TG antibodies unless TPO antibodies are high

Hashimoto’s frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid

We regularly see early stage Hashimoto’s misdiagnosed as Graves’ disease if correct antibodies aren’t tested

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s.

Low vitamin levels are particularly common with Hashimoto’s and Graves’ disease

Gluten intolerance is often a hidden issue too

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Link about Graves’ disease

thyroiduk.org/hyperthyroid-...

Graves Disease antibodies test

medichecks.com/products/tsh...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

Have you had ferritin tested

[Bubba28 in reply to SlowDragon]

Hi Thanks for the reply.

I had a test for Thyroid Peroxidase and that was in range but did have TSI and that is raised. Cortisol was also lower than expected but I will discuss that with the consultant at the end of the month. Another support group suggested I was sub clinical hyperthyroid. Really confused by it all to be honest

[SlowDragon Administrator in reply to Bubba28]

Well your results are odd

Not obviously hyperthyroid….but if TSI was tested and high that does confirm Graves’ disease despite very ambiguous results

You likely need to very fine tune Carbimazole or can do block (with Carbimazole) and replace (with levothyroxine) to prevent going hypothyroid

You need ferritin tested.

Also Coeliac blood test done too

Both Hashimoto’s and Graves patients frequently find strictly gluten free diet helps reduce symptoms

But rule out coeliac first by testing before trialing strictly gluten free diet 3-6 months

healthcheckshop.co.uk/store...?

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

[Bubba28]

Gluten test done and I am not coeliac. Ferritin also checked and fine. I know it is a bit weird isn’t it?? Results contradict themselves a bit. I have all hyperthyroidism symptoms apart from losing weight but I was told that is because I have antibodies blocking it? I am so confused. On a very low dose Carbimazole but it does appear to be increasing my TSH very slowly but it is going up

[SlowDragon Administrator in reply to Bubba28]

More important that TSH (which often lags behind) are Ft4 and Ft3. They are dropping at each test. Don’t really want them much under 50% through range

Currently Ft4 is 30% through range

Ft3 only 19% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

High cholesterol linked to low Ft3, so it’s hardly surprising your cholesterol has gone up

So as had coeliac blood test done, you can now trial strictly gluten free diet. Only 5% are coeliac, over 80% see reduced symptoms gluten free

What was actual ferritin result and ranges?

Want ferritin at least half way through range

[Bubba28]

Ferritin was 71 (range 13-150). This is why I am confused as they were concerned that T3 was raised and then near top of range but now it has dropped

[Th-cat]

Hi I take 10mg of carbimazole a day to stop my thyroid going into over drive. I had a sore throat at first was tested I can still take them. It takes about 2 months before you will feel the benefit!

[Bubba28]

Thank you for the info x

[indiesnow]

Hi Bubba, Tyroid issues are so personal and so frustratining it is difficult to answer, my TSH at the moment is 0.02, T4 20.1, T3 8.00. So T4 normal, T3 getting there and TSH static at the moment. I actually feel well and am taking 10 mg carbimozole. My experience f this aweful disease is to trust my doctor because without the medication I have felt aweful and presently work full time teaching and working as an outdoor instructor.

One of the problems is that it takes so long to see any change you have to be patient, if you are slowely going in the right direction I woud go with it. it takes months.

I have found eating and egg a day has been my saviour, when i start to feel week and weird I have a boiled egg and recover really fast, I have to keep ontop of my protein levels(protein weight gainer shakes can supplement your diet.

Exercise to build your muscle mass help me as well, I go bouldering and do ballet and the moment I am looking and feeling normal.

Good luck, I hope this helps