Blood Test Results: Hi! I have recently had... - Thyroid UK

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Blood Test Results

17 Replies

Hi!

I have recently had blood tests to check for potential under active thyroid… the results show my TSH levels are up to 3.47 (when they were last checked a couple of years ago it was 1.32) and a se thyroid peroxidase ab level of 6 (am I right I’m thinking this is thyroid antibodies? If so they’ve always been undetectable in the past tests I’ve had)… does this mean anything to anyone? It’s over a months wait for a phone call from the GP to discuss! I am also prone to Vitamin D deficiency, and this too has shown up on the test (low calcium and high alkaline phosphatase)

If anyone has had any experience of results like these so I have some idea what to expect, if anything at all, I would be very grateful!

Thanks

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17 Replies
SlowDragon profile image
SlowDragonAdministrator

Is this your first post on Thyroid forum

Are you currently taking any replacement thyroid hormones?

Looking at other posts ……you have asthma?

Are you on steroid inhaler

Steroids can lower TSH levels

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

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

in reply to SlowDragon

Thank you. I also noticed that the lab put a note on the tsh results saying Ft4 should be checked for pituitary function. So I will query this when I eventually get to speak to someone about it! I am not on any thyroid medication.

SlowDragon profile image
SlowDragonAdministrator in reply to

A GP would be unlikely to consider that asthma inhaler can render TSH result unreliable

Important to test Ft4 and Ft3 and both antibodies….plus all four vitamins

in reply to SlowDragon

I will mention it. I am under an endocrinologist anyway and he is aware of my asthma, he wants the results from the GP tests to see but will be another 12 months before I can discuss with him about it all. I believe I am still waiting for a full blood count too. My inhaler is low dose Fostair and I haven’t had to have oral steriods.

SlowDragon profile image
SlowDragonAdministrator in reply to

suggest you get full thyroid and vitamin testing done yourself

nhs rarely tests more than TSH these days …..which is inadequate

And you need BOTH thyroid antibodies tested

in reply to SlowDragon

Thank you, will look into the private testing and see what that shows up.

in reply to SlowDragon

One other question I have, does the thyroid have any effect on the liver? One of my liver results, Serum Gamma GT I believe, came back slightly high? Thanks!

SlowDragon profile image
SlowDragonAdministrator in reply to

Yes, being hypothyroid frequently results in high cholesterol

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

also this about Gamma GT

jcdr.net/articles/PDF/12898...

in reply to SlowDragon

Thank you so much that’s really useful to know and I’ll definitely mention that to my GP and endocrinologist too

PurpleNails profile image
PurpleNailsAdministrator

A TSH of 3.47 is in range but it’s higher than what is considered very healthy (around 1) 

The TSH is a pituitary hormone which signals thyroid to work harder. Lots of doctors think unless it’s really high above range the thyroid can manage to produce hormone.  

What you need tested is the thyroid hormone. FT4 & FT3.  Free thyroxine & free triiodothyronine.

If GP or lab can’t / won’t test, you have private options.

Lab ranges vary but the positive level for TPO / TPOab (Thyroid Peroxidase antibodies) is usually higher than 6 eg it would be negative unless above >34 (eg - the range needs to be checked).

in reply to PurpleNails

Thanks, that makes sense, so the fact that the TPOab is low is a good thing then? So frustrating I can’t just speak to someone for another month about it and clarify. I also noticed a note from the lab saying FT4 should be checked for pituitary function? I don’t know what that means but when I get to discuss the results I will query it! Thank you

PurpleNails profile image
PurpleNailsAdministrator in reply to

If you have a autoimmune condition attacking thyroid the damage caused means that substances that are usually in thyroid are released into your system. The antibodies are made to “clean up” the debris that shouldn’t be there.

So having a high enough level is accepted evidence of autoimmune activity.  

But antibodies fluctuate greatly, don’t always reflect the severity of the problem and  sometime antibodies don’t appear at all. For this reason, doctors say they don’t mean a great deal and are only helpful for diagnosis - when at a positive level.

Any treatment is based on thyroid function, not based on antibodies as the autoimmune aspect can’t be treated. 

Usually the lab decides of FT4 is test ped usually automatically if TSH is abnormal.

Wondering why lab are noting it should be checked when if they believe is should be checked they aren’t …well checking it.

The FT4 is from thyroid, TSH from pituitary  - but you need TSH, FT4 & FT3 tested all at same time to know if TSH from pituitary is responding the level of thyroid hormones.

In a month your results could be different, doctors usually let you know of they think treatment is needed but they aren’t very good at explaining what results mean and why you do or don’t need treatment. It’s simpler if you just comply with what they think.

Which is fine if they are right, but not fine if they are missing information & you are left unwell.

in reply to PurpleNails

Thank you, yes that note didn’t make sense to me either as to why they didn’t just check it… but I will query it when I get to speak to the GP re the results anyway, and I’ll ask for them all to be redone as I should have had a full blood count too but that doesn’t appear to have been done so I’ll ask about getting the thyroid results clarified and redone when that happens! It’s just so frustrating having to chase things and wait weeks/months. My main symptom really is constant tiredness.

SlowDragon profile image
SlowDragonAdministrator in reply to

So you should have had full iron panel test for anaemia including ferritin

Was this done?

in reply to SlowDragon

I am not 100% sure what exactly the full blood count I’m waiting for will show, I know they’ll definitely check for anaemia but I’m not sure exactly what the specific tests they’ll do is, I’ll ask for sure!

SlowDragon profile image
SlowDragonAdministrator in reply to

important to include ferritin in full iron panel test

Looking for ferritin at least over 70 minimum

Here’s Medichecks iron panel test to show what’s included

medichecks.com/products/iro...

are you vegetarian or vegan

Female or male

Pre or post menopause?

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Also See page 7 on here 

rcn.org.uk/-/media/royal-co...

If ferritin is low Look at increasing iron rich foods in diet 

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin 

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin 

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron 

Medichecks iron panel test 

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Excellent article on iron and thyroid 

cambridge.org/core/journals...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

Low Iron implicated in hypothyroidism 

healthunlocked.com/thyroidu...

Ferritin range on Medichecks 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

I have managed to get a full list of the blood test results I had done last week from my GP surgery, full blood count was missing so that will be repeated in 2 weeks including for anaemia, and FT3 and FT4 too, as well as a repeat liver screening. These will then all be sent to my endocrinologist to interpret, as I have Turner Syndrome which is the main reason to check for an under active thyroid.

Se thyroid peroxidase Ab conc - 6 (range -35)

Serum TSH level - 3.47 (range 0.27 - 4.30)

Serum calcium - 2.15 (range 2.10 - 2.55)

Serum adjusted calcium conc - 2.15 (range 2.15 - 2.55)

Serum inorganic phosphate - 1.17 (range 0.8 - 1.43)

Serum alkaline phosphatase - 132 (range 30-130)

Serum total protein - 67 (range 60-80)

Serum albumin - 43 (range 35-50)

IgA - 2.29 (range 0.80-2.80)

HbA1c - 36 (range 26-41)

Tissu Transglutaminase IgA - 0.6 (range 0.0-6.9)

AST serum - 37 (range -32)

Serum ALT - 25 (range -33)

Serum gamma GT - 67 (range 1-40)

Serum total bilirubin - 14 (range -21)

Serum LDH - Unsuitable due to haemolysis

Serum urea - 2.9 (range 2.5-7.8)

Serum sodium - 135 (range 133-146)

Serum potassium - 4.6 (range 3.5 - 5.3)

Serum cretinine - 74 (range 45-87)

GFR calculated abbreviatd MDRD - 79 (range 60-150)

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