Elderly mums thyroid yest results

[Buntzs]

Hi

This is my first time posting

I would be very extremely grateful of any advice regards my elderly mothers thyroid results if possible

Thanks so munch in advance, Jean

[SeasideSusie Remembering]

Buntzs

Does your mom have a diagnosis of a thyroid condition and take any thyroid meds?

Does she take any supplements?

Her Vit D level confirms Vit D deficiency, she should show this to her GP who should prescribe loading doses of D3 totalling 300,000iu over a few weeks. Come back and tell us what GP says and does for further advice.

B12 below range suggests B12 deficiency. She should be tested for Pernicious Anaemia (one cause of B12 deficiency) which would mean B12 injections. Check to see if she has any symptoms here, click on the + next to each heading for full list:

b12deficiency.info/signs-an...

She should list all symptoms to discuss with GP.

Ferritin could be a lot better, it's recommended to be half way through range (82 with that range). She can help raise Ferritin by eating liver regularly, no more than 200g per week due to it's high Vit A content, or liver pate, black pudding and other iron rich foods. She shouldn't supplement with iron tablets unless an iron panel is done to confirm iron deficiency and a full blood count to see if she has anaemia.

[Buntzs in reply to SeasideSusie]

Good morning, sorry I m just getting back to you. I ve tried contacting doctor this morning re mums test results & waiting on nurse practitioner getting back to me as i was told that apparently Doctors would not except results for bloods that haven't been requested by them. Mum has had bloods regularly more so since April after an overnight in hospital for blood pressure,most recent bloods done on 13/12/21 I was told they came back ok. Thyroid problems are in our family as 3 of her children have been diagnosed also other members of immediate family & been told that mums was fine. Only thing that had show up was iron deficiency & she was put on ferrous sulphate tabs for 5 weeks then they were stopped on Monday 20/12 by Doctor as levels were ok. I hope this makes sense as I am new to this & am just trying to do whats best for her. I will keep you updated & I thank you so much for your help.

[SeasideSusie Remembering in reply to Buntzs]

Buntzs

i was told that apparently Doctors would not except results for bloods that haven't been requested by them.

Many doctors don't like patients getting their own blood tests and refuse to accept private ones. Depending on what your mom has already experienced from her GP all you can say is something along the lines of she was experiencing symptoms and according to them there was no problem (or whatever happened, I'm just guessing this scenario ) and as there are so many members of her immediate familywho have thyroid disease then she decided to do her own, more comprehensive testing and that you're glad she did because it's thrown up some worrying results - Vit D, B12, TPO antibodies.

One thing you may not know is that in the UK patients are legally entitled to their test results, be this by online access (which some surgeries offer) or to have a print out of their test results.

When doctors look at test results all they see is whether or not the result is within range, they do not consider anything borderline to be a problem, to them a range is a range and if you're within that range, even by just one point, then there is nothing wrong with you because the result says you're "normal". The actual art of "doctoring", ie listening to the patient and taking their symptoms into account, has long gone, numbers rule (it's all they're taught now!).

So your mom needs to get her test results from the surgery so do please get this organised. Don't ask the doctor, they don't like it, your mom just needs to ask the receptionist for a print out (or to register for online access if that's appropriate). Don't be fobbed off. Don't accept verbal or hand written results, mistakes can be made, it needs to be online access (if her surgery offers it) or a print out which will show the test name, the result and the reference range (similar to the results she's had from the private test).

Only thing that had show up was iron deficiency & she was put on ferrous sulphate tabs for 5 weeks then they were stopped on Monday 20/12 by Doctor as levels were ok.

So there we have a prime example of numbers rule! It will be very interesting to see what these "OK" levels are. Iron deficiency actually can take months to improve, one would not expect 5 weeks of ferrous sulphate to do much at all. I expect her level just crept back into the bottom of it's range so the GP is satisfied. Was an iron panel done or just ferritin each time? An iron panel consists of Serum Iron, Transferrin Saturation, Total Iron Binding Capacity (TIBC) and Ferritin.

When she was retested was she advised to leave off the iron tablets for a few days before the test? Was she advised that the test should be done after a 12 hour fast? If not then her result can't be relied upon as that's the proper way to do an iron test.

Also, it's not enough to just get levels back into range, we need to get the levels optimal and then, if necessary, adjust dose to a maintenance dose to sustain that level. Obtaining iron through diet might well be enough when levels are optimal.

Taking her private test results into consideration, I've already mentioned that she has Vit D deficiency and B12 deficiency (possibly Pernicious Anaemia), and now that you have confirmed iron deficiency a pattern is emerging.

I am puzzled by her high folate level, does she take any supplements for this? Does she take any supplements at all?

Her Thyroid Peroxidase antibodies are raised and this confirms autoimmune thyroid disease, known to patients as Hashimoto's disease. It doesn't matter that they're only slightly raised, it still confirms Hashi's. This is where the immune system attacks and gradually destroys the thyroid. Antibodies fluctuate and one test may come back positive (as this one has) and another one may show lower antibodies, but the patient still has Hashi's, it doesn't go away. Hashi's can cause gut/absorption problems and low nutrient levels or deficiencies so I'm thinking that her dire nutrient levels are connected to the Hashi's.

Out of interest, do any other family members with thyroid disease have autoimmune (Hashi's) as the cause of their hypothyroidism?

For a diagnosis of autoimmune thyroid disease and to be started on Levothyroxine, the test results need to show an over range TSH with raised antibodies. At the moment, because you mom's TSH is 2.11 she wont get a diagnosis, it must go above the top limit of the range. Primary Hypothyroidism isn't diagnosed until TSH goes over 10, but when antibodies are raised then a diagnosis of autoimmune thyroid disease can be made when the TSH just goes over range.

For any future thyroid tests follow the advice we always give:

* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH

* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.

[* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.]

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with phlebotomists or doctors.

My brain's a bit scrambled today and I feel as though I've rambled on, I hope you can make sense of this.

[Buntzs in reply to SeasideSusie]

Hi thank you for getting back to me. Managed to get nurse practitioner on phone. She asked me to drop paper copy of bloods into surgery for her to check & would get back to me. Phone back half hour later & said that she has left a prescription for vitD higher dose tablet 2 to be taken once wkly. Also tablets for vit B12 & is asking D/N to come in do bloods to check for liver & kidney function ( i think these are to be done as mum is on antibiotic ) she explaind that thyroid function is working ok but she is showing signs of autoimmune disease !!! Mum is not on any vitamins & any bloods that have been taken was never explained that they had to be done they you have said. I myself was diagnosed 24 yrs ago with SLE & thyroid, I have been on medication for both since. At the time my mum says that she thinks that it was in family as an aunt of hers had same symptoms but obviously in these days it wasn't recognised. I know of two other members of my mums family that have been diagnosed with Lupus & thyroid issues. Before this i feel when asking Doctors regarding my mum s health as she has dementia & with her age that its just about making her comfortable. I am definitely going to push more on these matters also get access to online. I agree with you that its now sad in these times its quantity & quality of care. Thanks again

[SeasideSusie Remembering in reply to Buntzs]

Buntzs

Vit D: 18nmol/L

said that she has left a prescription for vitD higher dose tablet 2 to be taken once wkly.

So what is the total amount of Vit D prescribed once weekly?

As she has Vit D deficiency she should be on loading doses totalling either 280,000iu or 300,000 over 6-8 weeks, so ideally she would be getting either 50,000 IU once a week for 6 weeks (300,000 IU in total), or 20,000 IU twice a week for 7 weeks (280,000 IU in total).

Once the loading doses have been completed she will need a reduced amount so you should make sure that she is retested after she has finished the loading doses so that you know how much she should then take going forward. Most doctors, if they continue prescribing, only give 800iu daily which isn't enough. You may need to buy your own when you find out what new dose she needs.

If GP wont retest then do this privately (link below) and post your new result at the time for members to suggest a new dose to bring your level up to what's recommended by the Vit D Council/the Vit D Society - which is 100-150nmol/L - 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:

vitamindtest.org.uk/

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. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day or a full fat yogurt, chunk of cheese, buttered toast, etc. (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.

If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The company has told me the K2-MK7 is the Trans form

natureprovides.com/collecti...

It may also be available on Amazon

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.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

Also tablets for vit B12

At this stage I believe this is the wrong thing to do. She has below range B12 level which strongly indicates B12 deficiency. One cause of B12 deficiency is Pernicious Anaemia which is an autoimmune disease. She has Hashi's which is autoimmune. When you have one autoimmune disease it's often the cause you have others. So she really should be tested for Pernicious Anaemia before starting B12. Pernicious Anaemia means that you can't absorb B12 and you need regular B12 injections.

Check for signs and symptoms of B12 deficiency here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If she has any then list them to discuss with the GP and ask for testing for B12 deficiency and Pernicious Anaemia. She should 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.

You could ask for further advice on this over on the PA forum here on HealthUnlocked:

healthunlocked.com/pasoc

Not all surgeries offer online access so if it doesn't then ask for those print outs of her test results.

[humanbean]

Something that happened to me throughout life on many occasions is that a doctor would tell me that they would arrange for "full bloods" to be done. I assumed - and I'm sure that this was intentional - that I was going to be given thorough blood tests e.g. liver function, iron, kidney function, vitamins etc.

When I finally got a copy of my complete GP record a few years ago I found that "full bloods" usually meant I was given a "Full Blood Count" and nothing else - no liver or kidney check, no checks for iron, no checks for vitamin D, no B12, no folate etc...

I would strongly recommend that your mother asks for access to her current and historical medical records online, including blood tests results and reference ranges going back as far as possible. You will probably be shocked at how few tests have been done, how many borderline or below range results have been ignored etc.

[Hylda2 in reply to humanbean]

Now you have me worried! Dr ordered full range of blood tests and all I can see is FBC on patient access. Need to keep an eye on my kidneys as I’m on Flecainide. 😬