Hi Can someone please read my mums medichecks results. She has been over active thyroid for around 4 years. She is currently on 5mg Carbimazole. She has the usual symptoms, extreme tiredness, thin hair and nails. Thanks for reading x
Medicheck results - Over active: Hi Can someone... - Thyroid UK
Medicheck results - Over active
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Sorry photo is unreadable
Can you rephotograph or crop in tighter
Or type results up
Hopefully you can read them now? Kind regards Kerry
What’s her diet like
Is she vegetarian or vegan
Being hypothyroid frequently causes low stomach acid this leads to poor nutrient absorption and low vitamin levels as direct result
B12 is extremely low Any Active B12 below 70 needs further testing
She needs full testing for Pernicious Anaemia
Likely to need B12 injections
If not injections, then daily B12 supplements
Folate also very low
Vitamin D far too low as well
Aiming for vitamin D at least around 100nmol
Her diet is not great as she does not like veg. She takes Vit D 3 prescribed by the doctor. I dont think she could sustain a Gluten free diet as she is disabled so eats a lots of ready meals that she can just throw in the oven.
See my reply below about her high parathyroid test result
parathyroid.com/low-vitamin...
There are two reasons for having low vitamin D. One reason for low vitamin D is not serious and simply means you need to take some vitamin D pills. The second reason for a low vitamin D is much more serious (and less common) and may indicate that you have primary hyperparathyroidism and need an operation to remove a small parathyroid tumor. These folks should not be taking vitamin D until after the parathyroid operation. If you have low vitamin D, you must understand which of these two groups you are in.
She needs vitamin D, calcium and parathyroid levels tested together NOW
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Has she definitely been confirmed as having Graves’ disease. Autoimmune HYPERTHYROID.
Graves is confirmed by high TSI or Trab antibodies
She should have been tested by GP or endocrinologist at diagnosis
Look at old blood test results
Her high thyroid antibodies suggests she might/possibly has autoimmune thyroid disease also called Hashimoto’s which is HYPOTHYROID
It is possible to have Hashimoto’s and Graves’ disease at same time
Her current thyroid results suggest she needs dose reduction in Carbimazole
Or endocrinologist can prescribe levothyroxine alongside Carbimazole
Known as “block and replace “
Ft3 and Ft4 are both on low side
Vitamin levels are terrible
What vitamin supplements is she currently taking
Many Hashimoto’s and Graves patients find it extremely beneficial to be on gluten free diet
Has she had coeliac blood test done
Is she on strictly gluten free diet?
Hi Slow Dragon
I have some of her early thyroid results that were taken at addenbrooks endo team. results as below.
I think she was originally given 20mg of carbimazole but was reduced around a year ago.
Dec 2017
Parathyroid 8.2 (1.6 - 6.9)
TSH 0.01 (0.27 - 4.20)
FT4 23.6 (11.00 - 22.00)
TPO 306 (^34)
Oct 2019
TSH 2.26 (0.35 - 5.580)
FT4 13.6 (10.5 - 21.0)
FT3 4.4 (3.5 - 6.5 )
I just found TSI results from Oct 2019 0.53 (<0.56iu/L)
So her results never showed she had Graves’ disease
TSI results from Oct 2019 0.53 (<0.56iu/L)
Result is negative (just)
When did she start Carbimazole?
Dec 2017
TSH 0.01 (0.27 - 4.20)
FT4 23.6 (11.00 - 22.00)
TPO 306 (^34)
These results strongly suggest Hashimoto’s NOT Graves’ disease
We see many early stage Hashimoto’s patients misdiagnosed as Graves patients
Carbimazole is not correct treatment for Hashimoto’s patients
Hashimoto’s frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid
After this test she should have had vitamin D, folate, ferritin and B12 tested
Plus thyroid ultrasound scan
Hashimoto’s can be confirmed by ultrasound
As already mentioned, possibly had Graves and Hashimoto’s
This is more complex and managed by endocrinologist…..usually with “block (Carbimazole) and replace (levothyroxine)
Parathyroid 8.2 (1.6 - 6.9)
Was vitamin D, calcium and parathyroid tested together after this high parathyroid result
High parathyroid can be due to vitamin D deficiency
Oct 2019
TSH 2.26 (0.35 - 5.580)
FT4 13.6 (10.5 - 21.0)
FT3 4.4 (3.5 - 6.5 )
These results show hypothyroid…..if on Carbimazole, dose presumably was reduced
Suggest you insist on thyroid ultrasound scan
Retest TSI or Trab antibodies for Graves’ disease
Improving low vitamin levels absolutely essential
Strictly gluten free diet likely to help as well
Get parathyroid, vitamin D and calcium levels tested together
If she has high parathyroid levels she Must NOT supplement vitamin D
parathyroid.com/low-vitamin...
There are two reasons for having low vitamin D. One reason for low vitamin D is not serious and simply means you need to take some vitamin D pills. The second reason for a low vitamin D is much more serious (and less common) and may indicate that you have primary hyperparathyroidism and need an operation to remove a small parathyroid tumor. These folks should not be taking vitamin D until after the parathyroid operation. If you have low vitamin D, you must understand which of these two groups you are in.
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Will flag a few other members to comment
PurpleNails
greygoose
SeasideSusie
bantam12 re parathyroid issue
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My first thought would have been Hashimoto's as well. Agree with retesting Graves antibodies.
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TSH 0.75 (0.27-4.2)FT4 15.7 (12 - 22)
FT3 4.2 (3.1 - 6.8)
The current results (if I’m reading correctly?) show FT4 37% & FT3 29% through range.
You could either stop carbimazole altogether and retest in 4 weeks to see if levels rise or drop. Or reduce dose and monitor.
5mg carbimazole is considered lowest dose as it’s the lowest manufactured but you can reduce by either splitting a pill or taking every other day.
The antibody results do not suggest Graves as although TSI are present the level does not exceed the positive level limit. The TPO & TGab suggest under active autoimmune thyroiditis (Hashimotos). This often starts with elevated hyper so the levels need to be closely monitored as you may find these levels drop.
Has there been any calcium results? Usually If there have been 2x over-range calcium readings this usually prompts calcium, phosphate, PHT (parathyroid hormone) & vitamin D be tested together. It can be a marker for parathyroid issues.
The parathyroid is located near thyroid but had a completely separate function (controlling calcium).
Does she take any other medications. Propranolol is often prescribed in conjunction with carbimazole and this can affect PTH lowering it.
Hi Purple nails. many thanks for your reply. Mum is on a right cocktail of drugs for nerve damage in her spine. She did have calcium issues before covid and was being seen by addenbrooks, but since then, they cancelled her appointment and now she cannot be seen. None of the drugs she is on is propranolol though. I think she needs to take your advise, stop the carbimazole and restest. i have sent an email to her doctor on her behalf and have asked that they give her a further blood test to check the things that Slow dragon mentioned, I am awaiting a response. I will check her results again from addenbrooks and see where wer were last at with the calcium and Parathyroid. thanks again for your response
It’s seems wrong to me all these hospital specialists postpone appointments and don’t follow up. I had a referral cancelled and was told to refer once “covid over”. I told the GP and they didn’t believe me she said they’re not allowed to do that. But they had, it taken months to get another referral & now on wait list. No appointment available.
There’s nothing to prevent blood tests & monitoring remotely. Before covid this is how was I was reviewed every 6 weeks. I don’t draw blood easily so do have to go to hospital for tests but then I’m telephoned. At start of 1st lock down the specialist wrote to me and said as I was “more or less stable” I could be left for 10 weeks. Last check was 12 weeks. Seems to get further apart each time!