Hello, I have had bloods done by Blue Horizon and wondered if any kind soul could interpret these numbers for me. Have been having a lot of what I thought were thyroid symptoms weight gain, constipation, dry skin, cracked heels, nails that are weak and won’t grow, fatigue, hair fall etc as TSH is on low side yet symptoms are more in line with hypothyroidism? I take HRT (bodybidentical is Estrogel and Utrogestan) so hormone levels should be fine.
Any pointers most gratefully received before I take the next step of trying to see someone privately as GP has been no help.
With such low levels of Free T4 and Free T3 I would have expected your TSH to be quite a bit higher. When the thyroid starts to fail the body will prioritise the production of T3 over T4.
T4 is the raw ingredient required for making T3. Your Free T4 is so low you have hardly any to make T3 with.
If your doctor and the lab insist on testing only TSH then they probably think your thyroid is perfectly healthy because your TSH is what you would expect to see in a healthy person. This means getting a diagnosis of being hypothyroid will be difficult and could take a long time.
Being hypothyroid but having much lower than expected TSH suggests that you might have Central Hypothyroidism. Please note I'm not a doctor.
The treatment for Central Hypothyroidism is the same as it is for Primary Hypothyroidism i.e. replacing the hormones that you are missing, except Central Hypo must be treated and monitored based on Free T4 and Free T3 (Free T3 is more important than Free T4), rather than TSH.
In Central Hypothyroidism the problem is with the pituitary rather than the thyroid itself. The thyroid isn't getting stimulated enough to do its job, due to lack of TSH (Thyroid Stimulating Hormone). TSH is produced by the pituitary. The thyroid itself may actually be healthy, although I believe that lack of stimulation might cause atrophy of the thyroid eventually.
Your in-range antibody results suggest you don't have autoimmune thyroid disease, although not everyone with autoimmune thyroid disease has positive antibodies. In those cases evidence may be found of autoimmune disease when the thyroid is scanned with ultrasound.
I think in order to get a diagnosis of Central Hypothyroidism (CH) your doctor must mention on the test request form that s/he suspects you have CH and wants Free T4 and Free T3 tested. If s/he does this then the lab ought to test Free T4 and Free T3.
I would suggest that you show your doctor a copy of the above results and ask him/her to put the copy in your medical records.
CRP is a measure of inflammation in the body. Unfortunately it won't tell you where the inflammation actually is. Some common sites for inflammation would be the lungs, the joints, the gut but you would have to investigate that possibility as a separate issue. Just having thyroid disease leaves many of us prone to inflammation, which may or may not be identified. If your Free T4, Free T3, and nutrients were optimised it might reduce inflammation.
The optimal level for CRP is under 1. But many of us live with it higher than optimal all the time.
Vitamin B12 (Active) - I've never seen that range or those units for Active B12. When I've had it tested myself the units have been pmol/L and the range has been something like 37.5 - 150. I tried to convert your result and range from nmol/L to pmol/L and got a really stupid answer. So, I'll just say that I aim for top of range or close to top of range for B12 whether it be Active B12 or Serum B12. I also often have a result over range, but I don't worry about that. B12 is not toxic. I suggest looking elsewhere for other opinions on what optimal might be.
Your result being 78.5% of the way through the range is actually good.
When it comes to supplementing B12 (if necessary) there are various options. Many of us use methylcobalamin. For more info on other B12 supplements and ideas on optimal :
Please check the units of measurement being used. Any American links will probably use different units of measurement than are normally used in Europe or the rest of the world.
Folate - Optimal for folate is upper half of the range i.e. with the range you've given it should be 15.3 - 26.7. I think your current level of folate should be improved.
A lot of people will take folic acid to raise folate. This is NOT a good idea for reasons given in these links :
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
So, your range starting at 13 is saying that levels from 13 - 29 are "normal", while NICE would disagree.
It is suggested on the forum that optimal for ferritin is approximately 50% - 70% through the range, which yours already is, so that is good, and there is no reason to raise it any higher.
Magnesium - The serum magnesium test is a very unreliable test. Most magnesium in the body is found in soft tissue, muscle, and bone. The serum contains 0.3% of the body's magnesium, and red blood cells contain 0.5%.
Another issue with the magnesium test is that if the serum runs low on magnesium the body just steals it from elsewhere. As a result it is rare for the test to show a low result, whatever the magnesium levels in the body. There is a (more expensive) test which checks levels of magnesium in the red blood cells, but I'm still not convinced it will be accurate.
If you want to decide for yourself whether your magnesium levels are low, okay, or high, see these links and read the Signs and Symptoms sections :
If you ever decide to supplement magnesium, please note that the kidneys must be functional in order to excrete any excess. So if you have failing kidneys don't supplement magnesium without consulting a doctor first.
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Interpreting Thyroid Results
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Interpreting results 
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