Trying to understand lab tests' results

[Martina]

Hello, I have received my latest blood test results concerning thyroid, my GP said everything is fine, but I doubt it. I'm in Belgium, so probably unit values differ from those used in the UK

TSH 4 mIU/L (0.270-4.200)

Free T3 2.2 pg/mL (2.0-4.4)

Free T4 11.0 pg/mL (9.3-17.0)

Thyroperoxidase antibody 18.6 IU/mL <34

Thyroglobulin antibody 17.6 IU/mL <115

I don't take any thyroid medications.

Thank you very much for your help in interpreting these results!

[SeasideSusie Remembering]

Martina

Your results are classed as euthyroid (normal) because they all fall within range, albeit TSH is high and FT4/FT3 are low in range.

However, your TSH is very close to the top of the range and in some countries hypothyroidism is diagnosed when TSH goes over 3.

Here is a graph showing the TSH level in healthy people, so you can see most healthy people have a TSH nearer 1:

healthunlocked.com/thyroidu...

I don't know how things work in your country but here in the UK even if we have TSH over range (range varies but goes no higher than 5) we have to wait until it reaches 10 for a diagnosis of Primary Hypothyroidism.

[Martina in reply to SeasideSusie]

Thank you very much SeasideSusie for your response. How should I consider my condition: as hypothyroid, Hashimoto's.....? What should I do?

[SeasideSusie Remembering in reply to Martina]

Martina

You don't have Hashimoto's, your antibodies are less than the upper limit.

You will not be classed as having hypothyroidism because all your results are within range.

What should I do?

Find out at what level of TSH hypothyroidism is diagnosed in your country.

Ask whether they diagnose and treat subclinical hypothyroidism - that is where the TSH goes over range but FT4 is still within range.

Keep an eye on your levels by testing maybe twice a year.

If your FT4 goes below range you may be able to get a diagnosis of hypothyroidism.

I would also test the key nutrients and aim to keep them at optimal levels:

Vit D - 100-150nmol/L or 40-60ng/ml

B12 - top of range

Folate - at least half way through range

Ferritin - half way through range although some experts say the optimal level for thyroid function is 90-110ug/L.

[Martina in reply to SeasideSusie]

Thank you so much for these very useful explanations. My Vit D level is 41 ng/ml, Ferritin is 114 µg/L, Vit B12 456 pmol/L (145-569), Folate 26.3 nmol/L (10.9-84.5). I have been taking supplements of Vit D, B12 and folate as I'm vegan and I have the MTHFR Snp.

I was thinking I might be low in selenium to help with conversion T4-T3, but I have read on this forum that it's best to have a test before supplementing with it. In the meantime I'll try to include more of the selenium-containing foods.

I have also read on Izabella Wentz' website thethyroidpharmacist.com that Selenium supplements are associated with a risk of non-melanoma skin cancer (squamous cell carcinoma), so people at high risk of skin cancer should not take these supplements. Are you aware of this risk?

I'm very grateful for your help!

[SeasideSusie Remembering in reply to Martina]

I have also read on Izabella Wentz' website thethyroidpharmacist.com that Selenium supplements are associated with a risk of non-melanoma skin cancer (squamous cell carcinoma), so people at high risk of skin cancer should not take these supplements. Are you aware of this risk?

No I'm not. I don't read her site and haven't seen it anywhere else but I haven't widely read about selenium.

You can get selenium from Brazil nuts providing they have been grown in selenium rich soil and the packaging says this, even better if they mention the area grown in. See

honey-guide.com/2012/11/19/...

Here in the UK there are very few brands of Brazil nuts that mention the selenium content or where they are grown, so if you decide to look into this then if the packaging doesn't say how much selenium or "grown in selenium rich soil" then there is probably no selenium content. Selenium content, when mentioned on packaging, varies from 50mcg to 75mcg of selenium per 30 gram serving of nuts here in the UK.

[Martina in reply to SeasideSusie]

Thank you very much for all the information so kindly provided.

[shaws Administrator in reply to Martina]

Did you have your blood drawn at the very earliest - fasting (you can drink water), If taking thyroid hormone we miss taking the dose until after blood draw.

If not your blood results may not be accurate.

[Martina in reply to shaws]

Yes, Shaws, my blood was drawn early in the morning, after a 12 hour fast.

I do not take any thyroid hormone.

Thank you for your comment.