The results are in! : Incredibly impressed with... - Thyroid UK

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The results are in!

Horsey07 profile image
10 Replies

Incredibly impressed with the speedy service from Blue Horizon! The results are as follows (with their doctor’s comments, but I’d really appreciate any extra feedback from the experts here).

FT4= 14.3 (12-22)

TT4= 86.1 (66-181)

FT3 = 4.73 (3.1-6.8)

TSH =3.51 (0.27-4.2)

Thyroid antibodies = 318 (<115). Very high and indicates the possibility of Hashimoto’s.

Ferritin = 54.1 (13-150)

B12 = 235 (191-663).

Cortisol = 501 (166-507)

Serum folate= 20.5 (8.83-108)

Vitamin D = 58 adequate.

Magnesium = 0.94 (0.66-0.99)

Anti thyroidperoxidase = <9 (<34).

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Horsey07 profile image
Horsey07
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The only thing I can comment on is the cortisol result, if the bloods were done first thing in the morning then the cortisol result is normal. However if you have other symptoms of high cortisol it might be worth doing a 4 point saliva cortisol test.

SeasideSusie profile image
SeasideSusieRemembering

Horsey07

FT4= 14.3 (12-22)

TT4= 86.1 (66-181)

FT3 = 4.73 (3.1-6.8)

TSH =3.51 (0.27-4.2)

Anti thyroidperoxidase = <9 (<34)

Thyroid antibodies = 318 (<115). Very high and indicates the possibility of Hashimoto’s.

You are, as you already know, heading towards hypothyroidism but you don't yet have the magic TSH of 10 for a diagnosis of primary hypothyroidism, nor can it be subclinical because it's still in range.

Although your Thyroglobulin antibodies are raised, the NHS tend to only look at Thyroid Peroxidase antibodies with subclinical hypothyroidism at primary level:

nice.org.uk/guidance/ng145/...

Tests for people with confirmed subclinical hypothyroidism

Adults

1.5.1 Consider measuring TPOAbs for adults with TSH levels above the reference range, but do not repeat TPOAbs testing.

**

Ferritin = 54.1 (13-150)

This is on the low side. Ferritin is recommended to be half way through range and some experts say that the optimal ferritin level for thyroid function is 90-110ug/L.

Including lots of iron rich foods in your diet can help raise your level:

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

**

B12 = 235 (191-663). Severely deficient

Can you check this again please. lt is in range, they would not have marked this as severely deficient.

This level is very low. Many people with a B12 level in the 300s have been found to need B12 injections. Check for signs and symptoms of B12 deficiency here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If you do have any then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.

**

Serum folate= 20.5 (8.83-108) - can you check this range, it's normally 8.83-60.8

Folate is recommended to be at least half way through it's range.

You can help raise your folate level by eating folate rich foods and supplementing with a good quality, bioavailable B Complex such as Thorne Basic B. Do not start taking this until further investigation of your B12 has been carried out and B12 injections (or supplements) started.

**

Vitamin D = 58 adequate.

Just into the adequate category of >50. However, the Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.

To reach the recommended level from your current level, you could supplement with 4,000iu D3 daily.

Retest after 3 months.

Once you've reached the recommended level then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.

D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.

For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.

For Vit K2-MK7 I like Vitabay or Vegavero brands which contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.

Magnesium helps D3 to work. We need magnesium so that the body utilises D3, it's required to convert Vit D into it's active form, and large doses of D3 can induce depletion of magnesium. So it's important we ensure we take magnesium when supplementing with D3.

Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

**

Magnesium = 0.94 (0.66-0.99)

Testing magnesium is unreliable. About 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood. So testing what's in the blood isn't giving an accurate picture of our magnesium status.

A red cell magnesium test is the better indicator of magnesium status, not the standard serum magnesium test.

**

Cortisol - Pauline has commented on that.

SlowDragon profile image
SlowDragonAdministrator

So your high TG antibodies confirms autoimmune thyroid disease also called Hashimoto’s

TSH is higher than average, but not high enough for GP to start levothyroxine

Vitamins are all low. Not surprising, especially as vegetarian

What vitamin supplements are do you normally take

All four vitamins need improvement

Aiming for vitamin D at least around 100nmol

Serum B12 at least over 500

Ferritin and Folate at least half way through range

First step is to get all four vitamins OPTIMAL

Get coeliac blood test done before trialing strictly gluten free diet

Why gluten intolerance can upset cortisol levels

kalishinstitute.com/blog/gl...

Cortisol is high as adrenals try to compensate for lack of thyroid hormones

Horsey07 profile image
Horsey07 in reply to SlowDragon

Thank you so much for this. I can’t tell you what a relief it is to know I’m actually ill rather than an hysterical hypochondriac! Given that I already feel really rubbish and struggle to cope with the basics of life would it be worth seeing someone privately, rather than waiting for the NHS to decide I need/deserve help?

SlowDragon profile image
SlowDragonAdministrator in reply to Horsey07

As SeasideSusie pointed out results show high TG thyroid antibodies and NOT high TPO antibodies

That makes it slightly more complex as currently NHS only recognises autoimmune thyroid disease is you have high TPO antibodies or high TPO & high TG antibodies

Many patients struggle to get autoimmune thyroid disease diagnosed with just high TG antibodies

pubmed.ncbi.nlm.nih.gov/303...

Elevated TgAb levels are associated with symptom burden in HT patients, suggesting a role of thyroid autoimmunity in clinical manifestations of HT. Based on these results, we recommend screening for TgAb antibodies in HT patients with symptom burden.

Horsey07 profile image
Horsey07 in reply to SlowDragon

That’s slightly odd because this is the doctor’s comment on that particular result -‘ The positive thyroid antibody result, however, increases the possibility of your having or ultimately developing autoimmune thyroid disease, such as Hashimoto's thyroiditis or Grave's disease’, and a quick Google for high anti thyroglobulin came up with this - ‘These antibodies can also be a sign of Hashimoto disease’. This whole process is completely baffling for me, I’m so grateful for all the guidance on this website.

SlowDragon profile image
SlowDragonAdministrator in reply to Horsey07

Yes….NHS currently refuses to acknowledge autoimmune thyroid disease if only TG antibodies are raised

SlowDragon profile image
SlowDragonAdministrator in reply to Horsey07

It’s down to you, especially as vegetarian to maintain optimal vitamin levels by self supplementing

First step is to work on improving low vitamin levels over next 2-4 months

Only add one supplement at a time and then wait for at least 10-14 days before adding another

Suggest you start with B12, then add vitamin B complex

As vegetarian you likely need B12 daily

Followed by vitamin D with vitamin K2 and magnesium

Meanwhile getting coeliac blood test done

Trialing strictly gluten free diet

retest FULL thyroid and vitamin levels in 3-6 months

SeasideSusie profile image
SeasideSusieRemembering in reply to SlowDragon

SlowDragon it's the Tg antibodies that are raised 318 (<115) not TPO Anti thyroidperoxidase = <9 (<34)

SlowDragon profile image
SlowDragonAdministrator in reply to SeasideSusie

Well spotted….I missed that

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