Unusual pattern in thyroid test?

[Thorpe1984]

Can anyone help me make sense of this please? I have pernicious anemia and also low ferritin, I have one more picture to post too.

[greygoose]

Can you give us a bit more information, please, so that we can answer your question:

* Do you have a diagnosis of any thyroid problem?

* Are you taking any thyroid hormone replacement - if so, what and how much?

* What time of day was the blood draw?

* Do you take biotin, either on its own or in a B complex?

* Is this a private test or done through your doctor?

* Did you also get FT3 and antibodies tested?

[Thorpe1984 in reply to greygoose]

I have no previous diagnosis of thyroid problem, my hair is coming out really bad so did a test on monitor my health, it’s an NHS lab. I took the blood around 10am.FT3 is 5.2

I take a vitamin b complex, There is no mention of biotin in it.

Thanks

[greygoose in reply to Thorpe1984]

Biotin is B8, which is usually in a B complex.

I agree with Susie, that's just what I was thinking: Central Hypo. Yes, it will be difficult to get your GP to take it seriously. But, surely even a GP cannot imagine that an FT4 below range can be in any way normal. Let us know how you get on.

[Thorpe1984 in reply to greygoose]

No it has every b vitamin apart from b8 strangely! I am currently having several fights with the gp, my ferritin is 32! I have antibodies for instrinsic factor and b12 level was 188 before injections started! My hair is coming out so bad which prompted me to do this test privately, the GP only tested TSH level for thyroid! When u feel so poorly and no one seems to want to help it’s very frustrating isn’t it! Thanks for help

[greygoose in reply to Thorpe1984]

Oh, it's worse than frustrating. It made me homecidal at one point: I wanted to kill my doctor! lol Fortunately, I didn't.

If your ferritin is that low, it's not surprising you're losing your hair. All of mine fell out one day, in the shower. I went to my doctor and he said 'well, what do you expect at your age'! I said, look mush, your waiting room is full of old ladies 'my age', and not one of them is wearing a woolly hat! Except me, of course, hiding my baldness.

Doctors know nothing about nutrients, they don't learn about them in med school. They know next to nothing about hormones - never even heard of half of them. And they have very little idea how to interpret blood test results. One wonders, really, what useful purpose they do serve.

[Thorpe1984 in reply to greygoose]

You made me chuckle at least! Lol 😂 It really is frustrating isn’t it! Are you in the UK? Apparently 32 ferritin is within normal range here! I have put myself on iron tablets! Unbelievable!!

[greygoose in reply to Thorpe1984]

No, I live in France. But they're not much more clued up here than anywhere else. It's a universal problem. Ranges tend to vary from lab to lab, rather than country to country. I can't remember what the range was last time I got it tested - which was rather a long time ago! But, in any case, it was over-range. But, then, so was CRP, an inflammation marker. High levels of inflammation can cause levels to be falsely high. The doctor didn't know that!

[SeasideSusie Remembering in reply to Thorpe1984]

Biotin is actually B7

[Thorpe1984 in reply to SeasideSusie]

Well it has b7 in it! Can this affect the test?

[SeasideSusie Remembering in reply to Thorpe1984]

A B Complex usually contains a relatively small amount, mine contains 400mcg.Biotin in hair supplements tend to contain a much higher dose, maybe 5,000mcg or 10,000mcg.

The small amount in a B Complex would probably be fine if left off for 3 days but the higher amount in the hair supplement would be best left off for a week to avoid affecting test results.

It will only affect results if the lab uses biotin in the testing procedure, many labs do.

[greygoose in reply to SeasideSusie]

Oh really? I could have sworn it was B8. lol Oops!

[SeasideSusie Remembering in reply to greygoose]

I thought you'd made a typo 😊

I'd not heard of B8 so I've done a bit of digging and found this

alternativemedicinecollege....

So it looks as though it sometimes gets mixed up, some articles say biotin is referred to as B7, B8 and Vitamin H. Others say that inositol is B8 and biotin is B7.

Inositol isn't listed in my B Complex (Thorne Basic B) but I have seen it listed in others. I've never seen B8 listed and biotin isn't listed as B7, always biotin. Folic acid or folate are never listed as B9 either.

They don't like to make it easy do they 🙄

[greygoose in reply to SeasideSusie]

Oh! Vit H! I once knew a girl who told me she was taking vit H after having a baby. I'd never heard of vit H! We didn't learn about it when we were doing vitamins in school biology. And, as she was losing her hair, I thought it stood for vitamin Hair! lol OK, so that would make sense if it was biotin.

No, they don't make it easy at all. We have B1, B2, B3, B5, B6, B7, B9 and B12. What happened to 4, 8 (well, there seems to be some confusion over that!), 10 and 11?

This is rather a nice article but it doesn't explain about the missing numbers, which is what I really want to know:

purityproducts.com/blog/b-v...

[SeasideSusie Remembering in reply to greygoose]

Will save that article and study it later. It does make you wonder about the missing ones.

[SeasideSusie Remembering]

Thorpe1984

You can add further images on replies below, one picture per reply by clicking on the last icon on the row beneath the message box - the rectangle with the mountains in.

Assuming that you don't already have a diagnosis of hypothyroidism your results suggest possible Central Hypothyroidism which is suggested by low, normal or minimally elevated TSH with a below range FT4.

Central Hypothyroidism is when the problem lies with either the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism) rather than a problem with the thyroid itself.

Central Hypothyroidism is not as common as Primary Hypothyroidism where it's the thyroid itself which fails. Many doctors may not have heard of Central Hypothyroidism so it's important to find a doctor or endocrinologist who specialises in thyroid, most endos specialise in diabetes.

Information about Central Hypothyroidism which you may need to encourage your GP to look into this:

bestpractice.bmj.com/topics...

endocrinologyadvisor.com/ho...

[Thorpe1984 in reply to SeasideSusie]

Thanks, sounds like another battle with GP 😩 pretty fed up with it

[Litatamon in reply to SeasideSusie]

"Central Hypothyroidism is when the problem lies with either the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism) rather than a problem with the thyroid itself.

Central Hypothyroidism is not as common as Primary Hypothyroidism where it's the thyroid itself which fails. Many doctors may not have heard of Central Hypothyroidism so it's important to find a doctor or endocrinologist who specialises in thyroid, most endos specialise in diabetes."

I have some questions regarding the above. My apologies OP for hijacking your thread somewhat. Hope you get it all figured out.

I do not have a T4 out of range. But it has dropped closer - lower - over time. Is it normal to drop four to five points? Could that be a sign of central?

I have many thyroid symptoms and have pernicious anemia as well. But normal thyroid readings.

My thyroid is enlarged and two of my nodules are now causing issues (wheezing).

How would a thyroidectomy impact central hypothyroidism? It is what is being suggested to me due to the wheezing. I guess I am asking in case this possibility might be forever missed with a thyroidectomy.

[SeasideSusie Remembering in reply to Litatamon]

Litatamon

I do not have a T4 out of range. But it has dropped closer - lower - over time. Is it normal to drop four to five points? Could that be a sign of central?

It just sounds like you're becoming more and more hypothyroid if you had a normalish FT4 and it's dropping. With Central Hypothyroidism the crux of it is bottom of range/below range FT4 with a normal, low or minimally elevated TSH. You previously posted results showing FT4 at 13 (9-19), this would not suggest Central Hypothyroidism.

My thyroid is enlarged and two of my nodules are now causing issues (wheezing).

That suggests more like autoimmune thyroid disease which, looking at your previous posts, has already been suggested and discussed.

[Litatamon in reply to SeasideSusie]

Thank you. Appreciate the insight.

I am simply trying to get a grasp on everything before I make the decision of a thyroidectomy - which is brand new to me. I will never be diagnosed with auto-immune thyroid disease, as my numbers are normal.

[SlowDragon Administrator]

Low vitamin levels tend to lower TSH

ESSENTIAL To test folate and vitamin D too

Ferritin

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first and regularly retest 3-4 times year when supplementing

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Why low ferritin needs improving

healthunlocked.com/thyroidu...

Iron/ferritin and restless legs

healthunlocked.com/thyroidu...

Helpful post about iron supplements and testing

healthunlocked.com/thyroidu...

Post about iron supplements

healthunlocked.com/thyroidu...

[Hedgeree]

Hi Thorpe1984,

I have similar results to yourself also with low ferritin, and am also undiagnosed with a below range FT4 (9.83 pmol/L range 12-22) it's been bottom of the range and now below for many years . So I'm still battling with my gp and was told to come back next year for repeat blood tests despite being symptomatic.

Do you eat a vegetarian or vegan diet? I'm trying to raise my ferritin levels but have also found I'm iodine deficent so not sure if that is the cause of my below range FT4.

But I've managed to now get a referal to an NHS endo (hoping they will be able to help me!?) but it took some doing and my appointment is early next year; so keep on at your gp! I found writing a polite letter (or two!) to the practice manager and the gp gets a better outcome.

So if you've not already done so, I'd suggest writing to your gp, outlining your symptoms and what help you need with any research references to back it up.

The members of the forum are very helpful and will give you great advice.

Best wishes.

[shaws Administrator]

If you have P.A. you can get more injections than the 4 a year we usually get.

[Thorpe1984 in reply to shaws]

How do you get extra?