NEW THYROID RESULTS

[jenny876]

Hi, I have new thyroid results - have been taking carbimazole as last results were:

TSH 0.01 mU/L (0.27 - 4.2)

Free T3 8.90 pmol/L(3.1 - 6.8)

Free Thyroxine 29.5 pmol/L (12-22

Thyroglobulin Antibodies X 337.00 kIU/L (Range: 0 - 115)

Thyroid Peroxidase Antibodies 10.8 kIU/L (Range: 0 - 34)

NEW

TSH 0.072 (5.5 high)

FT4 14.80 (11.9-21.6)

FT3 4.13 (3.1-6.8)

Thyroglobulin Antibodies 335 (115 high)

Thyroid Peroxidase Antibodies 11.0 (34 high)

Should I continue with Carbimazole? I feel particularly dreadful with heart palps and fatigue and under eye shadows / swelling. Thanks

[Jaydee1507 Administrator]

Can you tell us how much carbimazole you are taking and how often?

Free T4 (fT4) 14.8 pmol/L (11.9 - 21.6) 29.9%

Free T3 (fT3) 4.13 pmol/L (3.1 - 6.8) 27.8%

You may be taking slightly too much but I am not experienced with dosing of carbomazole so I will tag PurpleNails who should be able to help further.

[jenny876 in reply to Jaydee1507]

Ive been taking 5mgs daily for last 2 weeks. Thank you!

[PurpleNails Administrator]

Would be helpful to add more history to your profile, with history or hypo & hyper.

Some of your posts mentions previous hyper in 2019. How was that treated / any interventions?

How long was your hypothyroidism treated doses / length of time.

A saw a result of TPO being negative. What about other antibodies? TG, TSI, TRab. Did you ever arrange TRab test?

Current carbimazole dose causing levels to drop too low..

You began on 20mg, when was it dose lowered? Usually dose is taken for 6 weeks before testing & adjusting. Testing too soon after adjustments will not show how a dose will settle. Your levels may rise & be stable on 5mg.

Propranolol can also be adjusted if palpitations symptoms inproved. Always reduce propranolol slowly.

[jenny876 in reply to PurpleNails]

Had hyperthyroidism in July 2019 for which I took 15mgs carbimazole daily for 1 month. Ive been seeing endocrinologist since end of 2019 and have history of thyroiditis, subclinical hypothyrodism and then persistent compensated hypothyroidism. More recently hyperthyroidism.

Prescribed levothyroxine 25mcg in November 2022 and took on and off until June 2023 ( I requested the levo myself and no doctor could say to me I should take it or shouldnt take it so didnt commit to taking it daily).

Last had Thyroglobulin Antibodies tested March 2022 and they were normal - now 335 (115 high). Have not had TG, TSI, TRab tested - would I have this done private? Do medichecks do it?

I reduced carbimazole myself just due to feeling so unwell and a total lack of any professional guidance. Do you think I should take 5mgs daily? Couldnt keep taking propranolol due to low blood pressure. Thanks

[PurpleNails Administrator in reply to jenny876]

Medichecks does have this test.

medichecks.com/products/tsh...

Although TRab measures blocking, neutral and stimulating antibodies. The test name emphasises stimulating (as this is what cause the hyper in Graves) but TSI (stimulating antibodies) which is separate test.

Both TRab & TSI are markers for Graves.

This is an expensive test & also must be by venous draw.

Your thyroid seems to fluctuate unexpectedly. Your levels were low but not taking consistent replacement can be counterproductive. Similarly antithyroid medications being reduced quickly is possibly confusing the out come of results.

I think it might be best to stay on 5mg and re test after 6 weeks of consistently dose.

Other option is block and replace method. Has a doctor ever considered that approach?

[jenny876 in reply to PurpleNails]

Ive read about the block and replace but very much doubt my doctor or endocrinologist would be aware of it/willing to try. I am going to see a private endocrinologist so could ask them. I will try the 5mgs daily for 6 weeks and then get retested - in the meantime I will also see about getting TRab & TSI tests. Thank you very much for your advice

[jenny876 in reply to PurpleNails]

Is this the test I need? TSH Receptor Stimulating Antibodies Blood Test

medichecks.com/products/tsh...

[PurpleNails Administrator in reply to jenny876]

Yes

[SlowDragon Administrator]

Essential to test vitamin D, folate, ferritin and B12

Also get coeliac blood test BEFORE considering trial on strictly gluten free diet

Think you may need to go down the block and replace option

[jenny876 in reply to SlowDragon]

All tested on Friday

Vitamin D - 74 (50 - 375 sufficiency)

No Folate test but folic acid is 7.4 (3.80 - 26.80 optimal)

Ferritin 19.7 (5.8 - 34.5 optimal)

B12 390 (197 - 771 optimal)

Have low white blood cell count and neutrophils - not sure of the significance of this. Tests also show I had a current or recent strep infection. I was unwell with a virus in April of this year. Thanks

[SlowDragon Administrator in reply to jenny876]

That’s very odd range for ferritin ….Usually it’s 30-150

Folic acid and B12 too low

Vitamin D might be better 100-125nmol

What vitamin supplements are you taking

Improving these should help reduce symptoms

Only add one at a time, then wait 10-14 days to assess before adding another

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 separate B12 supplement and 2 weeks later add a separate vitamin B Complex 

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

B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

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...

Low 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

healthline.com/nutrition/fo...

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)

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

Other options

healthunlocked.com/thyroidu....

Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

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 folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to jenny876]

Strep throat and Carbimazole

Best ask GP about this or go to A&E

stgeorges.nhs.uk/wp-content...

[jenny876 in reply to SlowDragon]

had the virus in april - throat is fine now. Been taking Vitamin D and just started on Vitamin B12 spray. Have zinc and selenium to start and need to get Bcomplex and folate. Thank you very much for all the advice.

[SlowDragon Administrator in reply to jenny876]

You don’t need vitamin B complex as well as separate folate

Just vitamin B complex

But stop vitamin B complex 5-7 days before test …..then take folate instead