I received my blood test results from Blue Horizon with some Dr's notes, which I am trying to make sense of as my mind feel so fuzzy. Please may I ask from your interpretation of them?
TSH 3.170 [1] 0.27 - 4.20 mIU/L
Free T4 16.29 [2] 12 - 22 pmol/L
Free T3 5.2 3.1 - 6.8 pmol/L
rT3 (by LS/MS/MS) 20 [1] 10 - 24 ng/dL
Thyroid Peroxidase
antibody
▲ 264 [1] 0 - 24 IU/mL
Iron 8.1 5.83 - 34.5 μmol/L
UIBC 38.2 24.2 - 70.1 μmol/L
TIBC 46.3 40.8 - 76.6 μmol/L
Transferrin Saturation 17.5 15 - 45 %
Ferritin 68.59 [3] 13 - 150 μg/L
Total Vitamin D ▼ 51 [1] 76 - 250 nmol/L
Serum Folate ▼ 3.26 [1] 3.89 - 26.80 ng/ml
Vitamin B12 605.5 197 - 771 pg/ml
Zinc 13.20 [1] 9.6 - 20.5 μmol/L
Selenium 1.05 0.75 - 1.46 μmol/L
I have another list of other results for white blood count etc. but not sure these will be relevant too?
I received a few big paragraphs from the Dr explaining that 'The thyroid function is currently normal. 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.'
Also, I have 'high gamma GT' levels which could indicate an excess of alcohol (rarely drink anymore - every few months) or a viral infection, which I believe I had in 2014 when I was diagnosed as 'borderline' hypothyroid by my GP at the time. I also have 'high platelet levels'.
I would be very grateful if anyone can make some sense of this for me so I can understand it 🦋🌸 Thank you x
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Singinginthewind
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I understand from your previous post that you have symptoms but no diagnosis so you're not on any thyroid meds.
We always advise thyroid tests to be done no later than 9am to give the highest possible TSH which is needed for diagnosis, and nothing to eat or drink except water before the test as some food/drink might affect TSH. Also no biotin in any supplement for 3-7 days before the test. Did you do your test this way?
TSH 3.170 [1] 0.27 - 4.20 mIU/L
Free T4 16.29 [2] 12 - 22 pmol/L
Free T3 5.2 3.1 - 6.8 pmol/L
A normal healthy person would have a TSH of no more than 2, often below 1, with FT4 at around mid-range-ish. Your TSH is too high and suggests that your thyroid is struggling, and in some countries they apparently diagnose hypothyroidism when TSH goes over 3. Your FT4 is 43% through range so slightly low but as we're not tested in health none of us know what our "normal" levels are.
Thyroid Peroxidase antibody▲ 264 [1] 0 - 24 IU/mL
Raised antibodies confirm autoimmune thyroid disease, known to patients as Hashimoto's. This is where the immune system attacks and destroys the thyroid and is the most common cause of hypothyroidism.
Primary Hypothyroidism is diagnosed in the UK when TSH goes over 10, when it's autoimmune an over range TSH, but not necessarily as high as 10, plus over range antibodies gives a diagnosis and a GP should prescribe Levo. You wont get a diagnosis with this result so it's worth testing again in the future in the hope of catching an over range TSH with an over range TPO antibody result.
rT3 (by LS/MS/MS) 20 [1] 10 - 24 ng/dL
Unfortunately this test isn't worth doing. High rT3 can be caused by many things, only one of which is to do with the thyroid and that's when there is an excess of unconverted T4. Your rT3 is in range anyway so there's no need to look for a cause but other reasons are:
· Chronic fatigue
· Acute illness and injury
· Chronic disease
· Increased cortisol (stress)
· Low cortisol (adrenal fatigue)
· Low iron
· Lyme disease
· Chronic inflammation
Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.
Serum iron: 55 to 70% of the range, higher end for men - yours is just 7.92% through range
Saturation: optimal is 35 to 45%, higher end for men - yours is 17.5%
Total Iron Binding Capacity (TIBC): Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is low at 15.36% through range
Ferritin: normally recommended to be half way through range although some experts say the optimal level for thyroid function is 90-110ug/L.
Your serum iron and saturation are very low, yet your ferritin isn't dire but could be better. Iron is very complicated and I suggest you discuss all this with your GP. If you are prescribed iron tablets then each one should be taken with Vit C to aid absorption and help prevent constipation and iron should be taken 2 hours away from any other supplements and medication as it affects their absorption. Iron tablets should be left off for 7 days before any iron test and you should fast for 12 hours before the blood draw.
Total Vitamin D ▼ 51 [1] 76 - 250 nmol/L
This level is possibly not one your GP would prescribe for but you are better off doing it yourself anyway.
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.
To reach the recommended level from your current level, you could supplement with 5,000iu 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:
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.
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.
◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.
◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.
You should discuss with your GP.
Vitamin B12 605.5 197 - 771 pg/ml
Just about OK. 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."
Zinc 13.20 [1] 9.6 - 20.5 μmol/L
I have read that zinc should be half way through range so that would be about 15 so you're not too far away. I'd just look to see about including zinc rich foods in your diet.
Selenium 1.05 0.75 - 1.46 μmol/L
42.25% through range. I don't know the optimal level but at least you're not deficient.
If other results are in range and not flagged there's probably nothing to worry about unless they're on the edge of their ranges.
I can't help with the high gamma GT and platelet levels.
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.
At this stage definitely discuss iron and folate with your GP as they need addressing, and address the low Vit D level yourself. I'd retest with a full thyroid/vitamin panel (Blue Horizon Thyroid Premium Gold or Medichecks Advanced Thyroid Function Test will be sufficient) 3-4 months after adding the last supplement.
Thank you so much for such a detailed reply SeasideSusie, I really appreciate it. I've had to re-read it quite a few times as my brain takes so long to focus and understand. Am I reading it right by saying the results show there is an issue with my thyroid but not quite to the levels to be able to get a full diagnoses and treatment by my GP? I feel so sick and desperate, I was hoping this may get me some treatment of some kind
Also, I forgot to say I have raised ALT levels over 100 and they have been like that since my last blood test in Jan this year. Would thyroid problems cause this raise? I have to be careful with the supplements because of this reason as when I take them, my liver feels like it pulsates and I feel sick.
'We always advise thyroid tests to be done no later than 9am to give the highest possible TSH which is needed for diagnosis, and nothing to eat or drink except water before the test as some food/drink might affect TSH. Also no biotin in any supplement for 3-7 days before the test. Did you do your test this way?'
I had the tests done at 9.30am. I had nothing to eat or drink except water since 6.30pm the previous evening. I don't take Biotin and I stopped vitamin supplements a week before.
'Serum iron: 55 to 70% of the range, higher end for men - yours is just 7.92% through range
Saturation: optimal is 35 to 45%, higher end for men - yours is 17.5%'
This is the range for men, I am female so would it be much different?
Am I reading it right by saying the results show there is an issue with my thyroid but not quite to the levels to be able to get a full diagnoses and treatment by my GP?
Your results will be classed as normal because they are all within range and a GP will stick to the guidelines and would not diagnose with your levels. Even with symptoms you wont get a diagnosis with results that are within range. For Primary Hypothyroidism TSH must go over 10, for autoimmune thyroid disease TSH must be over range with raised antibodies:
If the TSH level is above the normal reference range, the free thyroxine (FT4) level should be measured in the same sample.
Suspect a diagnosis of primary hypothyroidism if TSH levels are above the normal reference range (usually above 10 mU/L) and FT4 is below the normal reference range.
Suspect a diagnosis of subclinical hypothyroidism if TSH levels are above the normal reference range and FT4 is within the normal reference range.
Autoimmune thyroid disease is suspected — raised levels may suggest autoimmune primary hypothyroidism.
Do not arrange repeat testing of TPOAb.
A diagnosis of subclinical hypothyroidism is suspected — positive TPOAb can predict progression to overt hypothyroidism.
Do not arrange repeat testing of TPOAb.
Also, I forgot to say I have raised ALT levels over 100 and they have been like that since my last blood test in Jan this year. Would thyroid problems cause this raise?
I'm afraid I have no knowledge of that.
'Serum iron: 55 to 70% of the range, higher end for men - yours is just 7.92% through range
Saturation: optimal is 35 to 45%, higher end for men - yours is 17.5%'
This is the range for men, I am female so would it be much different?
No, that's not the range for men, those are optimal levels and the higher figures mentioned apply to males, so an optimal level for a male would be nearer 70% for Serum Iron and an optimal level for a female would be nearer 55%, similarly with the Saturation. For both of these your levels are very low.
I thought I'd jump in with regard to raised liver enzymes.I was just wondering if you've ever been tested for coeliac disease, my son had raise liver enzymes before he was diagnosed coeliac, his doctor thought he might have been overindulging in the alcohol as he was at Uni, but he was teetotal. When he got his diagnosis his liver enzymes returned to normal within a few weeks of going strictly Gluten free, this was not a symptom of coeliac disease that his GP or the registrar knew of initially.
If you've already been tested for coeliac or are gluten free you can disregard the information of course.
Hi KnitwittyThank you 😊 that is really interesting as I do notice I feel so much better when I don't eat gluten and it ruins my day and longer if I eat a sandwich, cake, pastries or anything with wheat/gluten in. It actually makes me cry and feel quite depressed. I did get tested for coeliac in January and it came back negative. I do naturally try to stay away from wheat so maybe it could have missed it?
Can I ask if your son had lots of negative symptoms with the elevated enzymes too?
Thank you for your help, I never knew this could be related x
My son was ill for a long time prior to his diagnosis, he kept being fobbed off by his GP's they gave him anti depressants and said he was stressed due to exams, they said his bowel problems were the after effects of a bout of food poisoning in 6th form. We saw a consultant when he had to leave university and defer for a year who laughed when I asked if he could have bowel cancer.
It took 3 long years to get a diagnosis, and by the time he was diagnosed the was desperate because he was afraid to leave his flat in case he had an "accident" . It was a huge relief to finally get his diagnosis, but it took a long time before he stared feeling properly better. He returned to Uni and even spent a year abroad as part of his degree so we are so very proud of him , he used to be very outgoing and sociable but the length of time it took for him to get a diagnosis has changed him in so many ways and he is still very reluctant to eat out and socialise with abandon.
His main symptoms were gas, bloating and diarrhoea not easy things to cope with when you first leave home but I suspect that they were mainly due to the reaction to gluten and not necessarily associated with the raised liver enzymes.
If you haven't been tested for coeliac disease it would be worth asking for a blood test to rule it out but be aware that you need to eat plenty of meals containing gluten twice a day for 4-6 weeks before you have the blood test to ensure that it will be picked up.
I have Hashimotos and I am strictly gluten free and my antibodies are now consistently in single figures , but I got glutened on a meal out and both antibodies were raised when I have a thyroid blood test a couple of weeks after the "gluttening ". I have not had my liver enzymes tested so I couldn't tell you whether mine would be raised by eating gluten.
Sorry I missed you saying that you had been tested for coeliac already, but as you say that could have been missed if you weren't eating many foods containing gluten.If you do trial eating gluten free, it's not something that can be done in dribs and drabs, it's all or nothing. As it is making you depressed and weepy , it may well be worth trying it for a few months to see if you have any improvement.
I can recommend Two excellent cookery books by Becky Excell.How to make anything Gluten free and How to Bake anything gluten free. You can feed these foods to people who eat gluten and they can't tell the difference ,the cookery one even has a section on "Fakeaways" so that you can get the sort of takeaway food that you thought you'd never eat again. I hope you feel better very soon.
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