HELP with results

[EQAC]

Hello,

I have just had my 2 month wait to get my levels checked again and my anti bodies, they want to speak to me on Monday regarding my results but just wondered if any one could try help me understand them at all?

Sorry I'm slightly unsure of how to even type them properly -

Free T4

12 July - 10 pmol/L

29 July - 11.5 pmol/L

27 September 12 pmol/L

Vitamin D

36.7 nmol/L

showing red - out of range?

Thyroid Peroxidase ab -

941.6 -red

showing out of range ?

Ferritin

157 ug/L

TSH -

4.3 mU/L

hopefully i have put them correctly there?

thank you in advance

[SeasideSusie Remembering]

EQAC

We need the ranges to be able to interpret your tests, eg

TSH: 2.5 (0.27-4.20)

FT4: 15 (12-22)

I think you are undiagnosed and not on any medication?

For diagnosis we need the highest possible TSH and this is at 9am, TSH is highest early morning and lowers throughout the day. Test should also be done before eating or drinking anything other than water, and no biotin/B Complex or other supplement containing biotin for 3-7 days before the test. Is this how you did your tests?

For diagnosis you would need 2 x over range TSH with raised antibodies. Your antibodies are raised, we can see that and you've confirmed they're marked red.

Vit D: 36.7 nmol/L

This is in the inadequate category and your GP may prescribe D3 to bring it up to 50+.

Come back and tell us what your GP is going to do about this, if you are prescribed D3 and the dose. There are important cofactors needed when taking D3 which your GP wont know about an this can be explained in detail when we know what's happening.

Ferritin: 157 ug/L

Again we need the range. On the surface this looks like a good result. Are you supplementing?

Was an inflammation marker tested, eg CRP? Ferritin can be raised due to inflammation so in that case it wouldn't be an accurate result.

[EQAC in reply to SeasideSusie]

Hi SeasideSusie,

i have added the ranges that i can find against the results online?

I am currently trying to find out what the problem is - if there is one?! - not on any medication.

Thats exactly how they was done - done even a bit earlier than 9 am due to work.

Free T4

12 July - 10 pmol/L (9-23pmol/L)

29 July - 11.5 pmol/L (9-23pmol/L)

27 September 12 pmol/L (9 - 23 pmol/L)

Vitamin D

36.7 nmol/L- (50-150 nmol/L)

Thyroid Peroxidase ab -

941.6 (0-5 IU/mL)

showing out of range ?

Ferritin

157 ug/L - (10-120 ug/L)

TSH -

4.3 mU/L (0.3 - 4.2 mU/L)

[SeasideSusie Remembering in reply to EQAC]

So these are the ranges that came with your result? As ranges vary from lab to lab we have to use only the ranges that come with your results.

Do you only have 1 x TSH result?

[EQAC in reply to SeasideSusie]

these are the ranges i can view online against my results on the graphs etc

sorry - no - TSH -

12july - 5.82 mU/L ( 0.3-4.2 mU/L)

29july - 4.28 mU/L (03. - 4.2 mU/L)

27 sep - 4.3 mU/L (0.3-4.2 m U/L)

[SeasideSusie Remembering in reply to EQAC]

EQAC

12july - 5.82 mU/L ( 0.3-4.2 mU/L)

29july - 4.28 mU/L (03. - 4.2 mU/L)

27 sep - 4.3 mU/L (0.3-4.2 m U/L)

Thyroid Peroxidase ab - 941.6 (0-5 IU/mL)

So you have 3 x over range TSH plus raised antibodies.

Over range TSH plus in range FT4 = subclinical hypothyroidism.

Subclinical hypothyroidism plus elevated antibodies = autoimmune thyroid disease (known to patients as Hashimoto's)

This should be enough to get you a diagnosis but if GP is reluctant then emphasise any symptoms that you have and ask for a trial of Levothyroxine.

Ferritin and Vit D addressed in reply above.

[SlowDragon Administrator]

TSH is highest in morning

Were all these tests done early morning ?

Symptoms of hypothyroidism 

Suggest you print out and tick all that apply

thyroiduk.org/wp-content/up...

request GP test B12 and folate too

Plus coeliac blood test should be done as you have autoimmune thyroid disease

Approx how old are you?

Standard starter dose of levothyroxine is 50mcg unless over 60 years old

[EQAC]

Hello,

Tests was done early morning just before 9am

Doctors have called this morning saying i am in normal range and only the antibodies are out of range slightly and need to get it re-tested in 6weeks time. They have said about taking Vitamin D also which they have said to by over the counter.

I am 27 -28 soon.

[SlowDragon Administrator in reply to EQAC]

Oh dear

See different GP

Take this list along ….tick any symptoms that apply

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

Ft4 is rock bottom

TSH over 5

technically you need 2 tests with TSH over 5 ……but that’s splitting hairs ….your 3 tests are all around 5 and Ft4 very low

Starting levothyroxine - flow chart 

gps.northcentrallondonccg.n...

vitamin D

GP should prescribe vitamin D at 1600iu daily for 6 months

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

Alternatively self supplement

At least 2000iu daily and more likely to need 3000iu

Request GP test B12, folate and ferritin now

You also need coeliac blood test done as high thyroid antibodies confirms autoimmune thyroid disease

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.