My partner hasn't been diagnosed with a thyroid problem and is not on any thyroid medication. The fact that he might have a problem only came to light whilst he was testing for vitamin deficiencies. He has tested TSH, FT4, FT3 three times over the last 7 months, and tested antibodies, once. In all three tests, his TSH was a surprise, as we never suspected his results would not be "normal."
All testing was done at 9am, only water beforehand, no biotin ever and same ranges for all tests.
Test 16/1/23
TSH 3.9 (0.27-4.2) FT4 74% within the range. FT3 57% within the range.
Test 30/5/23
TSH 3.02 FT4 94% within the range. FT3 84% within the range.
Test 6/7/23
TSH 3.76 FT4 96% within the range. FT3 62% within the range.
Peroxidase and thyroglobulin tests were both negative.
I'm no expert, but I do know that with a TSH like that over 3 tests, 7 months apart, and FT4s at top of range and rising, he could have a problem?
( His vitamin levels are now better after supplementation.)
Any insight/opinions would be gratefully received. Thankyou.
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grumpyold
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or.... playing devils advocate .......it could be that TSH level IS his 'normal'..
there must be 'some' people with their healthy / usual TSH at that level or the 95% ref range wouldn't include it.
His results are (more or less) stable ..... and pragmatically , adding any Levo or T3 at this point would very likely leave him with LOWER fT4 / fT3 levels than he currently has.
So even if there is a thyroid problem developing here , its hard to know what you could do about it at the moment.
See person 7 here .. they were (allegedly) healthy .
I think you're right. His "normal" is just higher. I'm not keen to add any levo at this stage and just thought we'd monitor him. He has no symptoms so I think we'll let sleeping dogs lie.
Vitamins : Folate 10.6 ug/L (3-25?) at 16/1/23 test and this reduced to 10 ug/L at 30/5/23 test for some reason.
Ferritin 178 ug/L (10 -400?) at 16/1/23 test and 205 ug/L at 30/5/23 test (an increase.)
Active B12 85pmol/L (40-210) at 16/1/23 test but decreased to 74 pmol/L despite supplementation with 100% pure methylcobalamin for 5 months.
Vitamin D 70nmol/L at 16/1/23 test so supplemented for 5 months with VitD + K2 2000iu plus 1400 magnesium glycinate which brought the Vit D up to a more acceptable 101nmol/L for the 30/5/23 test.
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and add a separate vitamin B Complex after a week
Then once serum B12 is over 500 (or Active B12 level has reached 70), may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
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
In week before blood test, when stop vitamin B complex, might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Post discussing how biotin can affect test results
He's a carnivore but I'm a pescaterian so I'm afraid if he wants meat he gets it himself. Consequently he only eats beef in sandwiches, or maybe ham, very occasionally.
For the past few months he has been supplementing with Vit B12 1000ug a day pure methylcobalamin which doesn't contain biotin, but I have no idea why his active B12 would have fallen since he began supplementing last January.
I'll look into your other suggestions and let him share my folate (never folic acid 😱!).
For the past few months he has been supplementing with Vit B12 1000ug a day pure methylcobalamin which doesn't contain biotin, but I have no idea why his active B12 would have fallen since he began supplementing last January.
Well that’s not much B12 especially in view of his age and very little red meat
As we age we loose the ability to absorb B12 as well from our tummy. I'd try much higher supplementation like 5000. You could always top up the methyl with some hydrox.....Bit Bs work together do it important to take a basic B complex when supplementing with B12.
His folate is actually still rather low and if it rises his B12 will fall because they work in synch. A good folate level is above 15. His active B12 is definitly on the low side and given all the supplementation beforehand you might suspect absorption problems and possible B12 deficiency in which case no oral/sublingual etc supplementation is going to work but you would need B12 injections before the problem escalates. You could also check for PA (pernicious anaemia). Unless you are free of any B12 supplements, fortified foods, energy dring for at least 4 months your blood serum levels are not a realistic measure of B12 levels but will be artificially inflated so his active B12 is probably much lower than you think.
To be honest I think you would really need to address the B12 fairly soon. If you are on FB I owuld recommend joining the Pernicious anaemia/B12 deficiency group and learning about B12 deficiency sooner rather than later. Good luck with persuading him to take the iron panel. I know the pain!
the key thing to ask really is about whether he has symptoms?
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