help on bloods for daugher

[Joannak]

Hi my daughter just got her thyroid results she has suffered very bad symptoms from hair loss to a very large amount of weight gain over a 2 year period she has brain fog she’s only 17 and gets herself through her very demanding day currently at dance and drama school with coffee. She is currently not on any thyroid meds. We are based in Glasgow if anyone could message me with consultants we are willing to go anywhere in the uk as we have private health care cover. These bloods were done at 915am water fasted thankyou in advance

[Buddy195 Administrator]

Joannak, I would recommend you edit the attached results and remove personal names, to ensure confidentiality.

Has your daughter been tested for key thyroid vitamins (ferritin, folate, B12 and vit D)? Having these optimal will support her thyroid health.

[Joannak in reply to Buddy195]

I will get onto the Gp today about that

[SlowDragon Administrator]

Make appointment with GP

With hair loss she needs full iron panel including ferritin

Also Vitamin D, folate and B12 levels tested

What’s her diet like

Is she vegetarian or vegan

Does she have heavy periods

Her thyroid levels look ok

[Joannak in reply to SlowDragon]

I am going to ask the Gp to run these for me to check my thyroid levels were very similar to this very similar symptoms once on split t3 t4 it helped massively, I have booked a private endo up here in Scotland luckily have private health insurance

[greygoose]

I hate these stupid graph things! Difficult to see the numbers. However, her TSH appears to be just over 2, so looks like her thyroid is starting to struggle, and needing a bit more stimulation than it should.

Her FT4 is still in-range, but low. Her FT3, looks to be slightly over mid-range (can't work out the percentages because I can't see the numbers!) and is higher in-range than her FT4, which is not normal, and would also suggest that her thyroid is struggling.

So, not technically hypo yet, but this needs keeping an eye on.

[Joannak in reply to greygoose]

Thankyou yes it’s been getting progressively worse checked her last bloods she literally sits down and falls asleep same eating dinner her folate was low but that’s now rectified

[Joannak in reply to Joannak]

her tsh is 2.06 t4 13.50 t3 5.36 anti TPO <9.00

Anti tg <10

[greygoose in reply to Joannak]

Yup, but to work out percentage I need the ranges, too. Ranges vary from lab to lab, so we always need those that came with the results in question.

Do you have numbers for folate? How was it 'rectified'? What about her other nutrients?

[Joannak in reply to greygoose]

Last folate was 19 last year we introduced folate supplement but usual teenagers get lazy with taking these things

[greygoose in reply to Joannak]

Yes, but was it folic-acid or methylfolate? And did she take a B complex with it? Just taking one B vit in isolation doesn't help much because they all work together and need to be kept balanced. How is her B12?

[Joannak in reply to greygoose]

Need to get that checked she did get bloods 2021 with the go am going to ask them to run again if not with ask the endo to do it we used methyfoalte she couldn’t stomach the folic acid

[Joannak in reply to Joannak]

Ranges with Randox

Tsh 0.35-5.5 optimal

ft4 11.9 -21.9 optimal

ft3 3.1 -6.8 optimal

Which is very strange my consultant says tsh near to 1 ft4 between 16-18 t3 6 and over

[greygoose in reply to Joannak]

OK, so ignore the optimal comment. The ranges are so wide, results cannot possibly be optimal all the way through.

Besides, optimal is not a number, it's how you feel. If you don't feel good, then the numbers aren't optimal for you - although they might be for someone else.

tsh 2.06 (0.35-5.5)

t4 13.50 (11.9 -21.9) 16.00%

t3 5.36 (3.1 -6.8) 61.08%

So, let's forget optimal for a moment, and talk euthyroid - i.e. with absolutely no thyroid problem. A euthyroid TSH is around 1, at 2 the thyroid is struggling to respond to the stimulation, and at 3 you are technically hypo.

A euthyroid FT4 would be around 50% through the range, with the FT3 slightly lower.

That is what you might call 'normal'.

As you can see, your daughter's FT4 is only 16.% through the range - very low - and her FT3 much higher at 61.08%. Which is not normal. But, when the thyroid is struggling for some reason, it tends to make more T3 than it usually would, and more T3 than T4 to keep the person alive. So, that is a strong indicator that there is a problem.

Which is very strange my consultant says tsh near to 1 ft4 between 16-18 t3 6 and over

Your consultant seems to be very confused about whether he's talking euthyroid or treated hypo. Euthyroid levels are above. But, when hypo and taking thyroid hormone replacement, you may or may not need the levels he quotes.

Taking the range as the one you have given, that would give us percentages of:

FT4: 41.00% - 61.00%, which would be too low for most hypos - especially at 41%!

FT3: 78.38%, which would probably be good but impossible to acheive unless you were taking T4+T3. Which would be fine. BUT with that level of FT3, it would be impossible to have a TSH of 1. It would be suppressed. So, seems to me there are some things he's not very clear about.

Good that she was taking methlyfolate, but as I said above, just taking one isolated B vit is not going to do much good. You need to take them all together. Also, her B12 should have been tested before starting folate supplements, because taking them would mask symptoms of B12 deficiency. How long ago did she stop taking them?

[Joannak in reply to greygoose]

Yes am on combo t4 t3 my tsh is 0.06 t4 18.90 and t3 6.07 I had bloods done 930am had my last split t4 t3 at 4pm which might of made my t4 slightly higher

[greygoose in reply to Joannak]

OK, so your FT4/3 are where your endo thinks they ought to be, but your TSH is far from 1! Is he ok with that?

[Joannak in reply to greygoose]

Yes he is because eventually I’ve started to feel better unfortunately am in survival menopause I was on the novothyral 100 they took me down to 75 and I really suffered the past year 😞

[Joannak in reply to greygoose]

thankyou so much for all this help greygoose

[Joannak in reply to greygoose]

she’s had one folate tablet restarted last night will stop and get her vitamins run this week