Recent blood test results

[Senior1449]

Hi everyone I am new to the forum and would like your advice on recent blood test results please.

My story of under active thyroid and now diagnosed with Graves’ disease.

2010 I was told I had an under active thyroid and was started on levothyroxine 50mcg, I was on levothyroxine in varying amounts until 2020 when I became quite ill and was diagnosed as having Graves’ disease.

I am currently on 40mg of carbizamole and 100mcg of levothyroxine.

I have paid for a private blood test and have just the results back and was hoping someone could help me understand them.

I will attach my results.

Thank you for any help.

[greygoose]

Hi Senior1449, welcome to the forum.

So, how was your 'Graves' diagnosed? Did they test your Graves' antibodies - TRAB and TSI? Because those antibodies you've had tested there are saying that you actually have Hashi's - aka Autoimmune Thyroiditis. Unfortunately, many doctors don't know the difference! But, if you actually do have Hashi's, and not Graves', you are on the wrong medication. And, now, you are very hypo, not hyper at all. So, I would suggest you find out if they ever tested Graves' antibodies at all. And talk to your doctor about lowering the carbi, if not stopping it altogether because if you carry on taking it, you're going to get more and more hypo - and probably very ill.

It's difficult to read the numbers on your results because they're very small, and if we enlarge them, they get fuzzy. But, from what I can make out, your folate is very low - below-range - and your B12 is in-range but too low. I would suggest you get yourself a good B comples, one with methylcobalamin (B12) and methylfolate, and treat that yourself because your doctor won't have a clue! Thorne Basic B is a good one, as in Igennus.

I am currently on 40mg of carbizamole and 100mcg of levothyroxine.

This is called 'block and replace'. But, it makes sense if you don't have Grave's. Get your doctor to do some more testing, or refer you to an endo.

[SlowDragon Administrator in reply to greygoose]

This is called 'block and replace'. But, it makes sense if you don't have Grave's.

Think you meant

This is called 'block and replace'. But, it DOESN’T make sense if you don't have Grave's.

[greygoose in reply to SlowDragon]

Well, I actually meant to say 'it makes no sense.' lol But, once again, my fingers refused to type the negative! So weird. But, I have noticed on here that it happens to other people, too. So, perhaps it's another hypo symptom? 🤣

Sorry for the error, Senior1449 . It makes nooooooo sense!

[Senior1449 in reply to greygoose]

Hi Greygoose

Thanks for your reply.

I had Trab in 2020 I can’t find the results but seem to remember them been around 100.

Thanks

[greygoose in reply to Senior1449]

OK, so I saw the result and range below, and it would seem you do have Graves' and - apparently - Hashi's together.

BUT, your treatment - your block and replace - is out of kilter, because you are now very hypo. Maybe too much 'block' or maybe not enough 'replace'. I don't know much about it, but something is wrong and you are now very hypo, and your doctor needs to do something about it, to bring your TSH down to about 1 or under, and raise your thyroid hormone levels: FT4 and FT3. If you continue like this, it is going to make you very ill again.

[Senior1449 in reply to greygoose]

I will try get in with the endo asap and hopefully get to the bottom of it.

[greygoose in reply to Senior1449]

Good. He's been very negligent to allow you to get into that state!

[SlowDragon Administrator]

I was on levothyroxine in varying amounts until 2020 when I became quite ill and was diagnosed as having Graves’ disease.

Can you add test results from 2020 diagnosis

Would agree with greygoose these results suggest only Hashimoto’s (autoimmune HYPOthyroid)

Hashimoto’s frequently starts with transient hyperthyroid results and symptoms and is often misdiagnosed as Graves’ disease

Carbimazole is not correct treatment for Hashimoto’s on its own.

Graves’ disease must be confirmed by high TSI or Trab antibodies

It’s possible, but relatively rare, to have Hashimoto’s and Graves’ disease together. Then treatment is “block and replace “ - as you are currently taking

The aim is to keep TSH around 1 and Ft4 and Ft3 around 60-70% through range

Was test early morning and last dose levothyroxine 24 hours before test

FT4: 14.2 pmol/l (Range 12 - 22)

Ft4 only 22.00% through range

FT3: 4.1 pmol/l (Range 3.1 - 6.8)

Ft3 only 27.03% through range

Now results show You are hypo and need a reduction in Carbimazole and/or dose increase in levothyroxine

If you don’t have Graves’ disease you need to reduce, then stop Carbimazole and just continue with levothyroxine

Meanwhile folate is deficient and B12 levels are poor BECAUSE you are currently hypo

What vitamin supplements are you taking

[Senior1449 in reply to SlowDragon]

Hi slow dragon

Thanks for your reply.

I can’t find the results from 2020 of trab but have added one from March this year.

I did the test 07.30 and was 24hr between taking levothyroxine.

[Senior1449]

Hi Thank for the welcome and reply’s.

I had a TRAB test in march this your and the results were

Trab 34.4

I have just started taking-

B complex vitamins.

Vitamin d 5700.

Vitamin k 102.

Thanks

[helvella Administrator Thyroid UK in reply to Senior1449]

It is essential to quote the reference interval (range) for the TRab test. They vary from lab to lab - sometimes very significantly.

[Senior1449 in reply to helvella]

Hi Helvella thanks for your reply.

TRAb 34.4 range 0.0- 0.9

Thanks

[helvella Administrator Thyroid UK in reply to Senior1449]

That is a very definite positive!

[SlowDragon Administrator in reply to Senior1449]

So very definitely positive

So Endocrinologist needs to either reduce Carbimazole a little or increase levothyroxine