Blood test results. Any help appreciated - Thyroid UK

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Blood test results. Any help appreciated

Tristan23 profile image
7 Replies

These are my recent results. I am currently on 50mg of propylthiouracil a day (started this dose on the 26th of September) I am just a bit confused with the results and how I'm feeling, I get chest pains which are very hard to explain, doctors say it's anxiety.

Folate: 10.8 (R 8.83 - 60.8)

B12: 65 (R 37.5 - 188)

Vitamin D: 79 (R 50 - 250)

Ferritin: 209 (R 30 - 400)

CRP HS: 0.54

Thyroid Peroxidase Antibodies:

115 (R 0-34)

Thyroglobulin Antibodies:

85.7 (R 0 - 115)

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PurpleNails profile image
PurpleNailsAdministrator

Your verging to above range TSH & low (hypothyroid) FT4 & FT3 levels. 

Was the cause of your hyper confirmed? 

you may need to stop PTU altogether.  

Was TRAB or TSI confirmed positive?

High TPO indicates autoimmune thyroiditis (hypothyroidism).

Tristan23 profile image
Tristan23 in reply toPurpleNails

Endo only said that antibodies were slightly raised for graves but never confirmed as far as I'm concerned.No cause had been identified either, to me it doesn't look like they care about the cause.

Last time i spoke with endo, they want me on ptu for another 2 months then test blood again.. The test is usually only T4 and TSH

PurpleNails profile image
PurpleNailsAdministrator in reply toTristan23

Specialists look at TPO as autoimmune & therefore present with Graves too.  I suspect they haven’t tested for Graves specific - they are going by TPO. 

 has either TRab or TSI been tested - you need results & range.  

Doctors aren’t interested in cause because antibodies only indicate diagnosis.   Antibodies are too confusing.  It’s the levels which guide treatment.  Doctors look at TSH, sometimes FT4.  

Speak to doctor as of you stay on PTU you’ll likely be pushed more into hypothyroid levels.   Doctor freak at hyper levels, they are much more comfortable leaving someone in hypothyroid state, unless very severe & prolonged it isn’t dangerous, they often say if in range all is acceptable. You may feel different if symptoms are affecting you.

SeasideSusie profile image
SeasideSusieRemembering

Tristan23

Thyroid Peroxidase Antibodies: 115 (R 0-34)

Thyroglobulin Antibodies: 85.7 (R 0 - 115)

Those results suggest Hashimoto's rather than Graves disease. When you made your first post you were asked which antibodies were tested as Graves can only be diagnosed with postive over range TR AB - thyroid receptor blocking antibodies or TSI - thyroid stimulating antibody. Did you ever get this confirmed? If not you may have been misdiagnosed and given the wrong treatment (we see a lot of this on the forum).

Folate: 10.8 (R 8.83 - 60.8)

B12: 65 (R 37.5 - 188)

Vitamin D: 79 (R 50 - 250)

These are all too low. Folate is recommended to be at least half way though range, so around 35 plus with that range. Active B12 below 70 suggests testing for B12 deficiency. Vit D is recommended to be 100-150nmol/L by the Vit D Council, Vit D Society and Grassroots Health.

Do you take any supplements at all?

Ferritin is recommended to be half way through range so yours is good.

Tristan23 profile image
Tristan23 in reply toSeasideSusie

Hi. Graves had never been confirmed as far as I know.. Just that the antibodies were slightly raised back then.

I do take some supplements.. Vitamin D3 2500iu, zinc 25mg, magnesium 100mg and Vitamin C 150mg.

Any suggestions on how to raise my Folate etc?

SeasideSusie profile image
SeasideSusieRemembering in reply toTristan23

Tristan23

Any suggestions on how to raise my Folate etc?

First of all, check to see if you have any 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 then you can help raise your B12 and folate by supplementing with a good quality B Complex. 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).

For Vit D you might want to check out a recent post that I wrote about Vit D and supplementing:

healthunlocked.com/thyroidu...

and you can check out the link to how to work out the dose you need to increase your current level to the recommended level if you're not already taking the right dose..

The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).

Once you've reached the recommended level 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, 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 my suggestions are Vitabay, Vegavero or Vitamaze brands which all 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.

Vitabay and Vegavero are either tablets or capsules.

Vitabay does do an oil based liquid.

Vitamaze is an oil based liquid.

With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops.

They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.

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

natureprovides.com/products...

It may also be available on Amazon.

One member recently gave excellent feedback on this particular product here:

Here is what she said (also read the following replies):

healthunlocked.com/thyroidu...

Another important cofactor is Magnesium which helps the body convert D3 into it's usable form.

There are many types of magnesium so we have to check to see which one is most suitable for our own needs:

naturalnews.com/046401_magn...

explore.globalhealing.com/t...

and ignore the fact that this is a supplement company, the information is relevant:

swansonvitamins.com/blog/ar...

Magnesium should be taken 4 hours away from thyroid meds and as it tends to be calming it's best taken in the evening. Vit D should also be taken 4 hours away from thyroid meds. Vit K2-MK7 should be taken 2 hours away from thyroid meds. Don't take D3 and K2 at the same time unless both are oil based supplements, they both are fat soluble vitamins which require their own fat to be absorbed otherwise they will compete for the fat.

Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.

Did you test zinc before supplementing. Zinc and copper should be balanced, we hypos tend to have one high and the other low, so we should test both so that we know if we need to supplement and which one.

SlowDragon profile image
SlowDragonAdministrator in reply toTristan23

Discuss with endocrinologist reducing your propylthiouracil a little…..as you’re now verging on being hypothyroid

Meanwhile start supplementing to improve B12 and folate

only add one supplement at a time and then wait 2 weeks before adding another

Initially starting with separate B12 before adding separate Vitamin B complex

Low B12 symptoms 

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months.

once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 drops 

healthunlocked.com/thyroidu...

B12 sublingual lozenges 

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

Two weeks later …to improve folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12

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