Advice on my daughter's blood results please.

[n1mble2]

My daughter who is 18 took a Thyroid Gold Blue Horizon blood test a few weeks ago (please see photo attached).

She has really struggled with anxiety over the last 18 months and also at times previous to this. She has also been incredibly fatigued, which has been very tricky during A Levels. As both her grandmother and I suffer from hypothyroidism I have wondered if this could be an issue.

She is on Sertraline (100) for anxiety and also biotin for hair strength and renewal (as she pulls it out with anxiety) which I'm worried might have skewed her blood results (although she couldn't remember whether she'd taken the biotin before her blood tests when I asked her the day after!).

Her Cortisol seems very high - what might that mean??!

Should her Free T4 be higher in the range for optimal energy/health?

Any advice would be appreciated.

[SeasideSusie Remembering]

N1mble2

It's really important that she remembers about the Biotin . If it's a Biotin supplement it may be a high dose one, do you know what dose it is? It's the higher dose Biotin that causes false blood test results, the small amount in a B Complex may make little difference

Her cortisol is very high. Do you know what time of day she did the test? Hidden is our girl for blood cortisol tests so hopefully she will be around to comment.

Do either you or your mother have Hashi's? Her TPO antibodies are quite high in the range.

Her B12 is absolutely dire. She should ask to be tested for B12 deficiency and pernicious anaemia.

Ask her to check for signs of B12 deficiency :

b12deficiency.info/signs-an...

If she has any she should list them to discuss with her GP and insist on testing. If she's told her result is within range she must emphasise how low in range it is and that guidelines suggest that it's symptoms that should be prioritised over the result.

Her Folate is also very low but she should not take any folic acid or folate supplement until further testing of B12 has been carried out and B12 injections or supplements started.

A normal healthy person would have a TSH of no more than 2, often around 1, with FT4 possibly mid-range-ish. However, not knowing whether or not she took her biotin supplement makes it difficult to know if her thyroid results are reliable.

[humanbean]

I have no idea whether the biotin your daughter takes has affected her cortisol test result.

If I assume it hasn't (not all testing machines are affected by biotin) then your daughter probably needs to be tested for Cushing's Syndrome because of her very high cortisol.

Hidden knows more about this than I do.

[SlowDragon Ambassador]

What’s her diet like?

Is she vegetarian or vegan

[n1mble2 in reply to SlowDragon]

No she isn’t vegetarian or vegan. She eats lots of fruit, some veg, meat and probably too many carbs as pasta and pancakes are her comfort food!

[SlowDragon Ambassador in reply to n1mble2]

So her low B12 is unexplained

GP should be testing for Pernicious Anaemia before starting on B12 injections or daily sublingual B12 and folic acid

Obviously extremely high cortisol needs investigation

Referral to adrenal specialist endocrinologist

nhs.uk/conditions/cushings-...

24 hour urine collection test likely next step

Come back with new post once you see GP