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Thyroid blood test including antibodies results help

CAM2711 profile image
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Hi everyone! I have for some time suspected I have had an issue with my thyroid (have every symptom going) but any blood tests I was getting done at the doctors where coming back ‘normal’ I decided to order the thyroid test kit online which included the antibodies, see below for my results; (just received these this morning tested on Monday)

T4 95 range 59-154

Thyroid stimulating hormone 1.36 range 0.27-4.2

Free thyroxine 15.4 range 12.0- 22.0

Free T3 5.1 range 3.1-6.8

Thyroid Peroxidase AB’s 429 range 0-34

Thyroglobulin antibody 297 range 0-115

Is anyone able to help interpret these please? The last two I believe are an indicator of an autoimmune disorder?

Also to note I have had folate / b12 tested at the GPS twice over the past year, in the first test folate was lower than the acceptable range and I was given folic acid 5mg to take. It was slightly above range the last time I got it done

thankyou

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SeasideSusie profile image
SeasideSusieRemembering

Hi CAM2711 and welcome to the forum

Thyroid Peroxidase AB’s 429 range 0-34

Thyroglobulin antibody 297 range 0-115

Is anyone able to help interpret these please? The last two I believe are an indicator of an autoimmune disorder?

Yes, you are correct. Your raised antibodies confirm autoimmune thyroid disease, known to patients as Hashimoto's, this is where the immune system attacks the thyroid and gradually destroys it.

For diagnosis and initiation of treatment with Levothyroxine, TSH has to be over range at the same time as raised antibodies on two occasions. At the moment your TSH is quite low in range and your FT4 and FT3 will be considered to be at good levels so no doctor will give you a diagnosis at this stage. The only thing you can do is to keep testing and wait for TSH to go over range.

Fluctuations in symptoms and test results are common with Hashi's.

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. It would be best to read, learn, understand and help yourself where Hashi's is concerned.

Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.

Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.

Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. It's essential to test Vit D, B12, Folate and Ferritin and address any problems. You are welcome to post these results, including reference ranges (plus units of measurement for Vit D and B12), for comment and suggestions for supplementing where necessary.

You obviously had folate deficiency to be prescribed folic acid, once the course has finished it's necessary to then maintain your level or it will drop again and folate deficiency will return. Folate is recommended to be at least half way through range.

What was your B12 level - can you post the result, reference range and unit of measurement please. The range is very wide for B12 and even if the result looks to be good often it's too low.

CAM2711 profile image
CAM2711 in reply to SeasideSusie

thanks so much for all the info - much appreciated! When I first got my bloods done my serum vitamin b12 was 472 range 191- 663 and serum folate was 3.1 range 3.89-26.8. When I got them redone serum vitamin b12 had dropped slightly to 360 and folate was up to 4.5.

SeasideSusie profile image
SeasideSusieRemembering in reply to CAM2711

CAM2711

OK, so folate is still very low.

It was slightly above range the last time I got it done

folate was up to 4.5.

If that is the result you are referring to then it is not above range, it is very low in range. The range is 3.89-26.8 so to be above range your result would have to be over 26.8.

So now you are no longer folate deficient, just very low. Presumably your prescription for folic acid has stopped? If so then you need to continue with a B Complex containing methylfolate which should improve your level and then maintain it.

I have used Thorne Basic B for a long time and always been happy.

If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.

When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).

When I got them redone serum vitamin b12 had dropped slightly to 360 (191- 663)

What's the unit of measurement - pmol/L or ng/L or pg/ml - this is important.

Do you have Vit D and ferritin results?

CAM2711 profile image
CAM2711 in reply to SeasideSusie

for serum vitamin B12 it’s ng/L - my ferritin was 43.4 ug/L range 13-150. Don’t seem to have been tested for vitamin D. I have all my blood results from the last two times I’ve had blood drawn.

Thyroid results Oct 2021 - Serum free T4 level 13.8, TSH 1.77

May 2022 - serum free T4 level 16.0, TSH 1.25

SeasideSusie profile image
SeasideSusieRemembering in reply to CAM2711

CAM2711

B12: 360 (191- 663)ng/L.

ng/L is the same as pg/ml below

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."

You can check for signs of B12 deficiency here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. 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 and if you have B12 deficiency is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.

If you don't have any then my suggestion would be to take a sublingual B12 to increase your level to 550 plus, also take a B Complex to keep all the B vitamins balanced. One bottle should be enough then you stop the B12 and just continue with the B Complex.

Suggestions for B12 supplements which include two forms of bioactive B12 - methylcobalamin and adenosylcobalamin which you might want to check out:

Cytoplan sublingual B12 lozenges

cytoplan.co.uk/vitamin-b12-...

Nature Provides sublingual liquid

amazon.co.uk/Bioactive-METH...

Note that the Nature Provides supplement contains a much higher dose than the Cytoplan one.

Ferritin: 43.4 ug/L (13-150)

This is low. Ferritin is recommended to be half way through range and some experts say the optimal level for thyroid function is 90-110ug/L.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.

I would consider a private Vit D test if GP wont do it. There is an NHS lab that offers an easy dried blood spot fingerprick test to the public for £29:

vitamindtest.org.uk/

I think your levels are low due to your Hashi's.

CAM2711 profile image
CAM2711 in reply to SeasideSusie

Thankyou very much again for all this information! I will ring my GP tomorrow and ask for repeated blood tests for all of these, I am also going to ask to be tested for coeliac disease! I’m sure they will love me 😀

SeasideSusie profile image
SeasideSusieRemembering in reply to CAM2711

If you don't ask, you don't get 😊

Come back with new results/ranges when you have them.

PurpleNails profile image
PurpleNailsAdministrator

T4 95 range 59-154

Thyroid stimulating hormone 1.36 range 0.27-4.2

Free thyroxine 15.4 range 12.0- 22.0

Free T3 5.1 range 3.1-6.8

The thyroid function levels are in range & would not be treated.

 Thyroid Antibody levels are positive.  

This can indicate a future issue.

With autoimmune thyroiditis (know as Hashimoto’s in other areas of the world) the immune system is attacking thyroid and gradually destroying thyroid function.  

Thyroid Peroxidase AB’s 429 range 0-34

Thyroglobulin antibody 297 range 0-115

Over time your thyroid levels  (FT4 & FT3) could become low & TSH will rise to signal thyroid to increase & work harder.  

There’s no way to treat the autoimmune aspect but having antibodies means you can monitor closely and once the levels are close to abnormal (hopefully before) you can commence replacement T4 (levothyroxine) 

Ensuring good nutrients (folate,ferritin, B12 & vitamin D) will help prevent any compounding of symtoms which can occur.

Many people find if nutrients are optimal levo when started is better tolerated & help with conversion of the T4 to T3. 

CAM2711 profile image
CAM2711 in reply to PurpleNails

Thankyou very much for your reply I appreciate it!

SlowDragon profile image
SlowDragonAdministrator

low vitamin D is strongly linked to autoimmune thyroid disease

GP should test vitamin D on your behalf

If GP is unhelpful use NHS private test kit

vitamindtest.org.uk

Vitamin D and thyroid disease 

grassrootshealth.net/blog/t...

pubmed.ncbi.nlm.nih.gov/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these

patients.pubmed.ncbi.nlm.nih.gov/273...

Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.

pubmed.ncbi.nlm.nih.gov/300...

The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.

ncbi.nlm.nih.gov/pmc/articl...

Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.

SlowDragon profile image
SlowDragonAdministrator

coeliac blood test should be done

nice.org.uk/guidance/ng20/c...

1.1 Recognition of coeliac disease 

1.1.1 Offer serological testing for coeliac disease to:

people with any of the following: 

persistent unexplained abdominal or gastrointestinal symptoms 

faltering growth

prolonged fatigue 

unexpected weight loss

severe or persistent mouth ulcers

unexplained iron, vitamin B12 or folate deficiency

type 1 diabetes, at diagnosis

autoimmune thyroid disease, at diagnosis

irritable bowel syndrome (in adults)

first‑degree relatives of people with coeliac disease

CAM2711 profile image
CAM2711 in reply to SlowDragon

Thankyou for this! This will be great to say to the GP tomorrow when asking for these tests - generally I find them very unhelpful and dismissive but I’m hoping with the thyroid antibody results they will oblige.

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