Hello! Just received my blood tests ( Blue Horizon) as my GP would only test me for TSH.Can you please help me understand what is wrong with me. Doctors note on test results: "The positive thyroid antibody result however increases the possibility of your having or ultimately developing autoimmune thyroid disease, such as Hashimoto's thyroiditis or Grave's disease.
The isolated drop in total iron binding capacity is probably not significant as the rest of the iron storage results (Iron, transferrin saturation and ferritin) are all within range."
Which one is it Graves or Hashimoto's?
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Fifek
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Well, it's not Graves' with those hormone results. Graves' is hyperthyroidism, with suppressed TSH and extremely high FT4 and FT3.
Yours looks more like Hashi's, which is basically hypothyroid, but with occasional temporary 'hyper' swings. But you're not hypo at the moment, according to those results. Could be that you've caught it early, or that you're just coming down from a 'hyper' swing. Only time will tell on that one. Although an ultrasound of the thyroid might give further information.
As you ask what is wrong with you, I'm assuming that you have some sort of symptoms. They could be caused by your very low vit B12. I don't think it's low enough to suggest Pernicious Anemia, but it is important to raise the level to at least over 550. To do that, I would suggest you buy a bottle of sublingual methylcobalamin (B12) 1000 mcg. And, a bottle of B complex containing methylcobalamin and methylfolate. And take one of each every day. When you've finished the bottle of methylcobalamin, continue with the B complex as a maintenance dose.
Thank you so much for your fast reply. I'm currently on 75mcg levothyroxine, dose has been increased 3 months ago from 50. I've been diagnosed hypothyroid in January 2021. I'm finally starting to feel better but I still get fatigued, my hair hasn't been growing, brittle nails, still no eyebrows and some strange rashes on my skin.... So now hashimoto's.... and I haven't seen my GP since diagnosis, only telephone appointments...Thank you again for your help xxxxx
I think it's time your doctor retested you and increased your dose to 100 mcg. You still have a lot of symptoms so you're obviously not on an optimal dose. Three months is a long time to be on 75 mcg!
Knowing you have Hashi's doesn't change anything. It's just that now you know why you are hypo. But the treatment is the same: thyroid hormone replacement - levo, etc.
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 your serum B12 is over 500 (or Active B12 level has reached 70), you 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 you stop vitamin B complex, you 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
Thank you very much for your reply Slow dragon.I'm currently taking Levothyroxine 75mcg. I'm feeling better then when I was first diagnosed with hypothyroidism January 2021 but still no improvement in hair growth, no eyebrows, often feeling fatigued, that might be down to lowB12, strange rashes on my skin...Will start with improving my B12 levels and see how that makes me feel.
Thank you again for your help and all the useful links you've provided. Xxxx
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
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