Lastest bloods

[beesting1966]

Recent results can I please have some help. I have Graves and Hyperthyroid.I also think I'm menopausal as getting really bad hot flushes ,joint pain and little sleep.

Serum ferritin 52 ug/l (15-300.00ug/l)

Serum folate >23.4ug/l(>3.00ug/l)

Serum vit B12 246ng/l(130.00-900.00

HbA1c level 42mmol/mol(<48.00mmo

Serum oestradiol level post menopausal range <55 pmol

Serum vit D total 25 hydroxyvitamin D lev 79nmol/L

Serum LH 14iu/L

Serum FSH level 35.9 iu/L

Se CA 125 level 16ku/L(<35.00u/L

Erythrocyte sedimentation rate 17mm/h(0.00-20.00mm/h)

Serum electrolytes

Sodium 142mmol/L(133.00-146.00)

Potassium 4.6(3.50-5.30mmol/L)

Creatinine 89umol/L (46.00-92.00umol/L)

GFr 57ml/min/1.73m2

SerumC reactive protein level 8mg/L(<5.00mg/L)

Plasma fasting glucose 4.9mmol/L(3.00-6.00mmol)

Thyroid function test

Serum TSH level 3.38mU/L(0.30-4.40mU/L)

Serum free T4 level 10.8pmol/L(8.90-17.30pmol/L

a few seconds

[PurpleNails Administrator]

Are you hyperthyroid with Graves & taking carbimazole? How much ?

How was your Graves confirmed? I see in your first post -

TSH receptor antibody level 4.3 u/L - assume this is a positive level -

Did you undergo thyroid surgery or RAI & now on replacement? If so what replacement do you take?

Looking at thyroid results:

Serum TSH level 3.38mU/L(0.30-4.40mU/L)

Serum free T4 level 10.8pmol/L(8.90-17.30pmol/L

This suggest hypothyroid.

TSH & FT4 is in range (so doctor will say satisfactory) but the higher the TSH the more the thyroid is struggling- around 1 is healthy.

FT4 is too low at 22% of range.

There is no FT3 result . FT3 is the more powerful hormone. When FT3 is low you will feel hypothyroid.

HbA1c level 42mmol/mol(<48.00mmo

HbA1c measures the sugar attached to the haemoglobin, so it gives an average reading from past few months.

A usual classification is

* HbA1c below 41 mmol/mol (6.0%): Non-diabetic

* HbA1c between 42 and 47 mmol/mol (6.0–6.4%): Impaired glucose regulation (IGR) or Prediabetes

* HbA1c of 48 mmol/mol (6.5%) or over: Type 2 diabetes

So your reading of 42mmol edges you to prediabetic levels.

Did your doctor discuss this with you? Offer any advice? You may be able to attend a course to prevent level worsening.

[beesting1966 in reply to PurpleNails]

I was diagnosed in 2018 with Graves and Hyperthyroid after several blood tests which was confirmed by my GP then an Endo, I was started on carbimazole 30mg which I was on for nearly 2 years, it was then stopped by the Endo nearly 2 years ago as I was told I had been on it long enough, so taking nothing at all.

My doctor has not discussed anything of my bloods with me as yet.

Do you think I can be menopausal as well?

Thank you for your help to understand this PurpleNails

[PurpleNails Administrator in reply to beesting1966]

As you have been off antithyroid medication for some time GPs will be looking out for new abnormal results. There is no medication to adjust to improve levels. As yours are in range they will not take any action or deem treatment necessary when results in range.

I would continue to monitor it as the FT4 is lower end. If it were to go below range you will likley need levo. Above range TSH a few months apart or if TSH is above 10.

May have to look a private testing if GP doesn't agree to retest.

Not sure about menopause & hormones. GP has given you gel, so GP has grounds from test results to think you will benefit.

[beesting1966 in reply to PurpleNails]

Once again thank you for the information.

[pennyannie]

Graves is considered life threatening if not medicated with AT drugs and the most recent research is suggesting the longer one stays on the AT medication the better the outcome for the patient.

pubmed.ncbi.nlm.nih.gov/338...

Please confirm that you have the medical evidence of an over range and positive antibody blood test result, the proof of diagnosis and what your treatment plan was based on.

Do you have there your original blood test results and ranges at diagnosis prior to taking the AT medication, and could you share this with forum members and this should be for a TSH, T3 and T4 :

P,S. I've just looked back 4 years and found the original blood test and the TR ab positive results and ranges you shared with forum members.

Graves tends to wax and wane for years, with stress and anxiety being common triggers and the NHS have no answers for Graves, there is no cure and all the NHS can suggest is AT medication which buys you time, or offer definitive treatment of either a thyroidectomy or RAI thyroid ablation both resulting in your being permanently hypothyroid, and in my opinion equally disabling and still reliant on daily medication.

There are forum members here who have been on AT medication for very many years and some just resort to the AT medication during periods of stress when they sense their body undergoing another phase of Graves and likely triggered by stressful life events.

You can read more round Graves on the Elaine Moore Graves Disease Foundation website and Elaine has a section dedicated to alternative and more holistic treatment options and talks of reassessing possible life/work balance and finding ways of relaxing and finding things you enjoy and being a bit selfish with your time.

elaine-moore.com

[beesting1966 in reply to pennyannie]

Hi Pennyannie,It has been suggested that my recent blood work up looks like I have gone hypo and now Hashi instead of Graves.

I don't know what to do as I spoke to my doctor tody who has said everything is okay with my thyroid and I am just menopausal and put me o Oestrogel pump pack to rub into my skin twice daily.

[pennyannie in reply to beesting1966]

Well, Graves is an AI disease that waxes and wanes and generally triggered by stress and anxiety.

Once a Graves patients, always a Graves patient, there isn't a cure and Graves is for life.

It's a poorly understood and badly managed auto immune disease.

So, have I got this right ?

You haven't been on any AT medication for 2 years :

You are not taking any thyroid hormone replacement :

You need to have a full thyroid panel to include a TSH. T3 and T4 reading :

Yes - your T4 is low in the range so your T3 will likely also be low - but T3 hasn't been tested and this is the most important thyroid hormone and the one which runs the body, as explained in your other post.

Your Graves may have burnt itself out : and you have become hypothyroid and now need thyroid hormone replacement.

Taking any supplements containing soy will likely have some negative effect of your thyroid function - please read up :

" Just " menopausal sounds like a brush off to me.

I'm sorry your questions haven't been fully answered on the forum and I think it would be a good idea to start a new condensed post, giving the most salient points:

Start from some 4 years ago with your original TR ab result and TSH. T3 and T4 readings at diagnosis and the medication prescribed - listing briefly any other medications and other health issues and the health issues and symptoms you are living and dealing with now.

P.S. What I find most confusing is your original results as your T3 and T4 results do not look high enough for Graves Disease and more like Hashimoto's - and you tested positive for both Graves and Hashimoto's AI disease, which isn't uncommon, as then treatment for Graves takes precedence.