Hi
New here.
I've been fobbed off for years by my GP, so have had a blood test done in my husband's country which I could do with some help interpreting please. I've copied the parts below that were out of the normal ranges. I think the first four relate to white blood counts.
LÖKOSİT 3,50 (4,37 - 9,68)
EOSİNOFİL% 4,0 (0,9 - 2,9)
NOTROFİL 1,79 (2,06 - 7,02)
LENFOSİT 1,26 (1,3 - 3,5)
FREE T4 0,87 (0,93 - 1,71)
NotAFlyingMonkey
If you had the test to see if you have a thyroid problem then it would be best to post all the thyroid results for proper interpretation.
Did you have the test early morning, before eating or drinking anything but water?
Do you take any medication or supplements? B Complex or Biotin supplements gives false results with many blood tests, including thyroid.
Raised eosinophil count can indicate infection. As for the other tests it would be helpful translate to English.
Thanks for the response. The blood test was ordered by a neurologist, as I have had a series of falls recently. It was first done thing, fasting. I was looking at the results that have been flagged by the lab as outside of their acceptable range. I don't take any supplements, just blood pressure meds.
Were there any other thyroid test results? TSH, FT3, thyroid antibodies.
Was B12 tested?
FREE T4 0,87 (0,93 - 1,71)
TSH 1,82 ( 0,27 - 4,2)
VİTAMİN-B12 216,00 (197 - 771)
NotAFlyingMonkey
There are two things to consider here.
VİTAMİN-B12 216,00 (197 - 771)
This level is extremely low and I would suspect B12 deficiency.
You can check for signs and symptoms 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. Your GP may say that your level is within range, point out how wide the range is and that your level is just 3.3% through the range. Emphasise any symptoms that you might have, symptoms should take precedence over numbers where B12 is concerned.
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.
Do you also have a folate result? B12 and folate work together.
Any other nutrients tested - Vit D, Ferritin?
FREE T4 0,87 (0,93 - 1,71)
TSH 1,82 ( 0,27 - 4,2)
I am not medically trained, and I am not diagnosing, but what could be indicated here is Central Hypothyroidism. This is where the problem lies with the hypothalamus or the pituitary rather than a problem with the thyroid gland. With Central Hypothyroidism the TSH can be low, normal or slightly raised, and the FT4 will be very low/below range. Your results fit this criteria.
TSH is a pituitary hormone, the pituitary checks to see if there is enough thyroid hormone, if not it sends a message to the thyroid to produce some. That message is TSH (Thyroid Stimulating Hormone). In Primary Hypothyroidism the TSH will be high. If there is enough hormone then there's no need for the pituitary to send the message to the thyroid so TSH remains low.
However, with Central Hypothyroidism the signal isn't getting through for whatever reason so the message isn't getting through to the thyroid to produce hormone, hence low FT4. It could be due to a problem with the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism).
As Central Hypothyroidism isn't as common as Primary Hypothyroidism it's likely that your GP hasn't come across it before.
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...
and another one:
academic.oup.com/jcem/artic...
You could do some more research, print out anything that may help and show your GP.
You 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 at
tukadmin@thyroiduk.org
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 refers you, 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.
Thank you so much for taking the time to give me such a detailed response, I really appreciate it.
Turkish English
LÖKOSİT leukocyte 3,50 (4,37 - 9,68)
EOSİNOFİL eosinophil 4,0 (0,9 - 2,9)
NOTROFİL neurotrophin 1,79 (2,06 - 7,02)
LENFOSİT Lymphocyte 1,26 (1,3 - 3,5)
A quick update to say I had a slightly difficult conversation with my GP this morning about the blood test I had done in Turkey. She started out refusing to refer me to an endocrinologist as my TSH was normal. I pointed out that as normal levels for that but low levels of FT4 could be indicative of Central Hypothyroidism, did she think that could be the case? She agreed to redo my blood tests, but not to test my FT3 and 4 levels, which I said wasn't helpful, given I have spent years feeling rough and that my symtoms seemed to me to fit with thyroid issues. She gave in reluctantly.
Certainly in my case I have been given anti depressants in the past, HRT, been told I need therapy all of which has cost the NHS money but which didn't actually help me. I honestly even went once to ask if they thought my brain fog was dementia, as I couldn't think what else it could be.
Thank goodness for the helpful contributors on this forum.
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