Blood results

[MyJourney200]

Hi all,

I've added my 15 year old daughters blood results. Dr says to repeat bloods in 8 weeks. She feels tired gets dizzy and feels cold at times. Would appreciate any thoughts on her blood results. I have hashimotos and thyroid cancer runs in my family ( myself and sister).

Many thanks

[SlowDragon Administrator]

She needs thyroid antibodies tested

TPO and TG antibodies

Vitamin D and ferritin levels too

Ft4 is very low

Ft3 is high ….perhaps she had recent Hashimoto’s flare

Was test done early morning?

B12 and folate low

What vitamin supplements is she taking, if any

[MyJourney200 in reply to SlowDragon]

Thanks for your reply SlowDragon. Test was done at 11.30. She is taking 14mg of active iron daily for the last 2 months.

[SlowDragon Administrator in reply to MyJourney200]

TSH would have been higher at 8-9am

What’s her most recent iron panel results, including ferritin

How low were iron and ferritin before starting on iron supplements

Is she vegetarian or vegan

Does she eat dairy or fish

[MyJourney200 in reply to SlowDragon]

These are the only blood tests that she has ever had done. She's not vegetarian or vegan. Eats dairy but not fish. I will book an early appointment for the next blood test.

[SlowDragon Administrator in reply to MyJourney200]

Should never supplement iron without testing

Iron is extremely toxic in excess

GP should do full iron panel test for anaemia immediately

[MyJourney200 in reply to SlowDragon]

Interesting, it was my GP who started her on iron tablets because of the way she was feeling.

[SlowDragon Administrator in reply to MyJourney200]

But didn’t do any blood tests!?

[SlowDragon Administrator in reply to MyJourney200]

Heavy periods?

Pale lower eye lids?

[MyJourney200 in reply to SlowDragon]

No blood test donePale lower eyelids and gums, periods are normal

[SeasideSusie Remembering]

MyJourney200

I am not medically trained and I am not diagnosing but those results could possibly suggest Central Hypothyroidism which is where the problem lies with the pituitary or the hypothalamus rather than the thyroid. In Central Hypothyroidism, the TSH can be low, normal or minimally elevated and the TSH is low, usually below range.

As your GP is retesting in 8 weeks, take a look at the 3rd graph in this link, entitled

Healthy Thyroids: FT4 Fluctuation:

thyroidpatients.ca/2020/07/...

Note where the FT4 is lowest during the day and it might be prudent to ensure that the test is done around that time.

Normally we would suggest a test no later than 9am before eating or drinking anything but water, and that is so that TSH is highest, but when looking at Central Hypothyroidism the TSH signal doesn't work properly due to the problem with the pituitary so it's the low FT4 that is important here.

As Central Hypothyroidism isn't as common as Primary Hypothyroidism it's likely that your GP hasn't come across it before. If the FT4 comes back low again next time it would be worth using the following information.

Your GP can look at BMJ Best Practice for information - here is something you can read without needing to be subscribed:

bestpractice.bmj.com/topics...

and another article which explains it:

ncbi.nlm.nih.gov/pmc/articl...

and another here:

endocrinologyadvisor.com/ho...

You could do some more research, print out anything that may help and show your GP.

She may need to be referred to an endocrinologist. If so then please make absolutely sure that it is a thyroid specialist that you see. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them). You can email ThyroidUK

[e-mail]

for the list of thyroid friendly endos. Then ask on the forum for feedback on any that you can get to. Then if your GP makes a referral, make sure it is to one recommended here. It's no guarantee that they will understand Central Hypothyroidism but it's better than seeing a diabetes specialist. You could also ask on the forum if anyone has been successful in getting a diagnosis of Central Hypothyroidism, possibly in your area which you'll have to mention of course.

B12 is low at 289pg/ml. Does your daughter have any signs of B12 deficiency, check here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If she does have any signs 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.

According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

However, your GP probably wont agree with that as they're not taught much, if anything, about nutrients. Some people with a B12 level in the 300s have been found to need B12 injections.

Folate is a little on the low side (again GP wont agree because anywhere within range is fine by them) but folate is recommended to be at least half way through it's range. Folate and B12 work together.

[MyJourney200 in reply to SeasideSusie]

Thanks for your very informative reply SeasideSusie. I will read through all the information. Blood test was done at 11.30.