Just trying to work out if thyroid looks ok please and doesn't need any further investigation?
I know I'm iron deficient with a low ferritin level but have been supplementing for 8 weeks now and have got up from 8 ug/L to 31 ug/L and am no longer anaemic either as Hb has raised a little too. I also include my iron panel taken a couple of days after the thyroid panel.
The Thyroid panel was fasted in the morning. The iron panel was in the afternoon haven taken both my iron doses and having eaten so that I could check I was not overloading on supplements as I'm aware supplementing can cause overload.
Would really appreciate any advice on both iron and thyroid please!
Edit: I forgot to mention - undiagnosed and not on medication. Thank you greygoose for flagging missing info.
Inflammation
CRP HS 1.970 mg/L (Range: < 3)
Iron Status
Iron 14.0 umol/L (Range: 10 - 30)
TIBC 54.8 umol/L (Range: 45 - 81)
UIBC 40.8 umol/L (Range: 13 - 56)
Transferrin Saturation 25.5 % (Range: 25 - 45)
Ferritin X 29.50 ug/L (Range: 30 - 150)
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Bertiepuss
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You don't say if you're already diagnosed with hypo and on thyroid hormone replacement. We need to know because the interpretation of your results would be different.
Ah right, sorry, new person mistake! Of course you need this information! I haven't been diagnosed and don't take any thyroid meds but have many symptoms of hypothyroid. I've been trying to work out what is what. Clearly my low ferritin which is a very long standing issue that my GP has ignored is a problem but trying to work out if anything thyroid related is also playing a part. GP tested TSH only, said it was fine no need to test further which is when I ordered the thyroid panel with other vitamins to check other values. I just have know idea what the other thyroid numbers mean. If they look ok then I don't need to keep investigating the thyroid route and can concentrate on other avenues.
OK, well, I'm afraid it's not that simple. First of all, let's have a look at what these things are:
TSH: Thyroid Stimulating Hormone, produced by the pituitary to tell the thyroid to make more thyroid hormone. So, in theory, the lower your thyroid hormones - T4 and T3 - the higher your TSH should be. Yours isn't that high - although getting on that way. It should be around 1. So, doctors who believe - erroniously - that the TSH 'tells them all they need to know', look at yours and say 'no problem'. But, that's not necessarily true...
FT4: basically a thyroid storage hormone that doesn't do much until it is converted into T3, the active hormone. If there were no thyroid problem, one would expect it to be around mid-range. Yours is just under.
FT3: the active thyroid hormone needed by every single cell in your body to function correclty. Should be just slightly lower in-range than the FT4. Yours is very low! And, although doctors don't understand it, that is the most important number.
Your FT3 is saying there's a problem, but your TSH isn't reflecting that. So, could be a condition we call Central Hypo, where the problem is with the pituitary or the hypothalamus rather than the thyroid itself. The majority of doctors have never even heard of Central Hypo - their education is sadly lacking - and those that have heard of it believe it's rare. (Medical definition of 'rare': something I don't know anything about so refuse to test for!)
But, we cannot tell anything for certain on the basis of one abnormal blood test. You would need to do a couple more with the same sort of results, at about six weekly intervals to engage the interest of your GP.
Your antibodies - a test that will tell you if you have autoimmune thyroiditis - are negative. But even that could change in subsequent blood tests because antibodies fluctuate all the time. So, basically, don't give up on your thyroid, do more testing!
Wow, thank you so much for a very clear and concise explanation! Medichecks said all looks good (in range) in the report so I had hoped any replies to my post may have confirmed that. Clearly that's not what you are saying and I have never heard of Central hypo so thank you for raising my awareness. Researching it seems to show the NHS only look at FT4 and TSH not FT3 which in my case is the one you are saying it not so great.
I know low ferritin and hypothyroidism have many overlapping symptoms, of which I have many, plus other nuero issues that may be B12 deficiency related. It's so difficult to piece it all together especially when the GP only looks at one thing at a time.
I did a private thyroid test 3 years ago with very similar results - again was not flagged abnormal TSH 2.48 FT4 13.6 FT3 3.5
Maybe as I address the low ferritin then FT3 might improve of it's own accord? Or maybe if it doesn't then that points more to the pituitary/hypothalamus problem of central hypo. As you suggest I will test again a couple of times and go from there. Thank you again for taking the time to reply, I very much appreciate it 😊
Medichecks said all looks good (in range) in the report
Well, obviously everything's in-range. You don't need to go to med school for seven+ years to see that. But, one would have hoped that one of their teachers would have pointed out that just being within the range doesn't automatically make it good. They don't really understand what a 'range' is. Maybe this article would be of interest to you:
The normal range: it is not normal and it is not a range
Medicheck doctors are just common or garden GPs, they are not thyroid experts.
Researching it seems to show the NHS only look at FT4 and TSH not FT3 which in my case is the one you are saying it not so great.
That is true. Most of them don't even know what T3 is! I've had several doctors admit that to me, as have others on here. And, yours is too low, even though it's within the range.
I know low ferritin and hypothyroidism have many overlapping symptoms, of which I have many, plus other nuero issues that may be B12 deficiency related.
Yes, but, what cause the ferritin and B12 deficiency? Most often it's hypothyroidism.
It's so difficult to piece it all together especially when the GP only looks at one thing at a time.
I have never been able to understand that, given that most things are related. How on earth do they ever manage to diagnose anything without looking at the whole picture? No wonder so many hypos suffer needlessly.
Maybe as I address the low ferritin then FT3 might improve of it's own accord?
Anything's possible, but it's rather doubtful. It's far more likely that the low ferritin is due to the low FT3 than the other way around. Low T3 means low stomach acid, and therefore difficulty digesting food and absorbing nutrients. So, when you have two completely different nutrients like that, low in range, it's unlikely just to be down to diet. Unless you're veggie or vegan.
Or maybe if it doesn't then that points more to the pituitary/hypothalamus problem of central hypo.
No, what points to Central Hypo is the correlation between the thyroid hormones - T4 and T3 - and the TSH. Your FT4 is also low-ish - although not as low as your FT3 - so one would expect the TSH to be a lot higher:
Low thyroid hormones = high TSH
High thyroid hormones = low TSH
Like a seesaw: one goes up, the other goes down, etc. But you have lowish TSH + lowish FT4/very low FT3. It doesn't balance.
Thank you greygoose. Yes, I was aware of the problem with reference ranges and 'normal' results but thank you for the article it was a thorough explanation and good to read.
My longstanding symptoms have been ignored all my life and I've acquired the usual diagnoses of fibro, cfs, depression, and vestibular migraine. Add to that, PCOS, Asthma aged 8 but resolved in late 20's, terrible infected tonsils that suffocated me until they were removed aged 15, insomnia since puberty although not so bad now and an intolerance to almost everything both emotional and physical that rocks the boat from normal. Now also osteopenia has been added to the list. I recently requested all my historic blood results and I found one at age 7 (38 years ago) that the doctor had hand written on the results sheet 'early iron deficiency anaemia'. This was never followed up with my Mother (why not for goodness sake!) but she did say at age 2 I had to have iron injections so this iron problem has gone on forever it seems.
You asked so I will tell - I am vegan, and veggie since a child. I could not stomach meat, neither the taste nor texture, right from weaning, and I had a massive sense of injustice about animals being eaten from as far back as I can remember. But that's a controversial discussion! Unfortunately I was very fussy with all food and had a pretty limited (very processed) diet until my late 20's when I finally realised nutrition was so important and I taught (forced) myself to eat green vegetables, nuts and pulses until I grew to love them. I also dealt with chronic IBS and constipation for as long as I can remember until I realised it was gluten causing the problem about 10 years ago. My Dad is coeliac...
Which came first though - did low stomach acid come from my poor diet as a child and cause a hypo problem to begin years ago or could an inborn error of central hypo cause low stomach acid and resulting malabsorption? Either way I am where I am. My husband, like me has been vegan for 6 years, before that an omnivore. His ferritin levels are perfect so his vegan diet provides enough iron and probably his iron recycling system functions better than mine. He also doesn't deal with the horrendous monthly blood letting I have endured for years. However, as an omnivore, he developed vitiligo and insomnia, a problem with gluten and more recently subclinical Hashimotos . Somehow the Hashi's stays at bay and looking at his thyroid panel while referring to your excellent description of each of the hormones, his picture actually looks much better than mine despite him having a small goitre and slightly raised antibodies.
I have read your bio, my goodness, you poor thing, you've endured so much and I'm very sorry the medical profession has failed you so badly. Your childhood ailments sound so familiar. I'm truly grateful for your help and you certainly are much more knowledgeable than the doctors. Please may I come back to you again in a few weeks time once I've completed the 2 further tests?
Which came first though - did low stomach acid come from my poor diet as a child and cause a hypo problem to begin years ago or could an inborn error of central hypo cause low stomach acid and resulting malabsorption?
More like the second option.
Unfortunately, doctors aren't the least bit interested in our symptoms. And they have no idea how to diagnose by symptoms, either. They treat each symptom as if it is a seperate disease. But, one should ask them: which is the more likely scenario: that we have 25 diseases with one symptoms each? Or 1 disease with 25 symptoms? More likely the second option again. But, because hypo symptoms are non-specific, and they honestly and truly do not want to diagnose us with under-active thyroid (too much hard work? or are they just aware they'll be out of their depth?) they try their best to ascribe every symptom to 'something else'. A very said state of affairs.
Please may I come back to you again in a few weeks time once I've completed the 2 further tests?
Interesting you think the second option of central hypo causing low stomach acid is more likely, if indeed central hypo is the problem, only further tests will tell.
It is a sad state of affairs indeed but I've also gone down the naturopathic route, spent thousands, like 20k I don't have, on this and that supplement, because of this and that theory... has not lead to relief either. Never tried thyroid hormone replacement though. I will continue to research. If you have any recommended reading material please do let me know as this is only the beginning of my thyroid investigations and I need to learn from trusted material if possible.
Great to chat with you, thank you, I look forward to speaking again in a few weeks time 😊
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