Help with reading bloods: My 24 year old daughter... - Thyroid UK

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Help with reading bloods

WendyW1964 profile image
39 Replies

My 24 year old daughter has not been well for some time now and we've had an appointment with an endo doctor. Her symptoms in her words are:

physical fatigue not just tired (I have got to the stage where I have to lie down during the day and have gone from an active person to a very sluggish person.)

I have extreme thirst and can not leave the house without water. I consume lots of water as if I don’t I get headaches.

I have 3-5 migraines a week, I have to take anadin (paracetamol, aspirin and caffeine ones) as soon as the change of vision starts and lie in a dark room for a couple of hours. I also use a cold cap. These come at random times and can really affect my life. I have had a few instances where I have had people stood next to me and my peripheral vision could not see them.

I itch all over my body. Especially my legs at night.

When I wash or brush my hair I have excessive hair loss. There are no bald patches that I can see but it’s thinning.

I suffer brain fog and bad memory.

I have heat intolerance and wilt like a flower. A recent example of this was walking to work, it’s a 10 min slow walk and when I got to work I had to sit infant of a fan and drink ice water. When it’s hot at night I sleep with a fan on and if I’m out in hot weather I can not exert myself as this causes me to drip with sweat, headaches, sluggish and have to sleep in a cold room to recover.

I get heart palpitations at least 3 times a week. These happen randomly and I feel my pulse in my neck racing.

My bloods with the eno were low in ferritin and iron, my uncle, who suffers from malabsorption of iron sent my bloods to his haematologist who messaged him back saying get me to ask GP for an urgent referral and she will urgently triage me, due to my bloods.

In the bloods from endo my cortisol and prolactin were high and I have research this in conjunction with my symptoms and I keep coming across people with pituitary adenoma. My cousin at my age had really bad migraines, like me, and she had a scan on her head/neck/base of scull and they found am aneurysm which was straddling the nerve for her peripheral vision.

She is asking for a scan as she wants to rule out Pituitary adenomas plus she is going to see a haematologist as her iron has been low for a long time now (14) and her endo just suggested taking off the shelf iron tablets. She has had thyroid bloods taken as her symptoms suggested there was a thyroid problem and they seem normal. She is really fed up with being made to feel she is a hypochondriac. She knows her own body and is convinced something (other than stress and no proper sleep routine as sugested by endo) is causing her to feel like this. Any help on where she can go next or if anyone has had similar symptoms, would be appreciated.

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SlowDragon profile image
SlowDragonAdministrator

can you repost results

These are impossible to read

For full Thyroid evaluation she needs TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

See detailed reply by SeasideSusie

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

WendyW1964 profile image
WendyW1964 in reply to SlowDragon

I have the bloods on a memory stick and i'm trying to find a way to upload. Is there a guide I can use for this site?

TiggerMe profile image
TiggerMe in reply to WendyW1964

You can use the Snipping Tool and add them one at a time as a reply or as a photo?

Jaydee1507 profile image
Jaydee1507Administrator in reply to WendyW1964

You can just type out the relevant tests. Most important are TSH, FT4 & FT3.

Antibodies are useful along with any vitamin results - ferritin, folate, B12 & D3.

Alternatively take a screenshot and post that.

SlowDragon profile image
SlowDragonAdministrator

You can upload single images - one image per reply

Looking for

TSH, Ft4 and Ft3 tested together

TPO and TG antibodies tested

Vitamin D, folate, ferritin and B12

We need to know ranges on results too

WendyW1964 profile image
WendyW1964 in reply to SlowDragon

bloods

Photo
WendyW1964 profile image
WendyW1964 in reply to SlowDragon

My daughter wrote to the endo as he just referred to her fatigue and none of her other symptoms. He also told her to come off her contraceptive pill which she is wary of as the symptoms she suffered before taking the pill could come back on top of her current poor health. Any views on this would be appreciated.

photo
SlowDragon profile image
SlowDragonAdministrator in reply to WendyW1964

you need to follow endocrinologist request

It’s only 4-6 weeks

Does she have PCOS

WendyW1964 profile image
WendyW1964

bloods

Photo results
TiggerMe profile image
TiggerMe in reply to WendyW1964

Deficient in Folate

Low in B12

Vit D too low... all of these want to be in top third of range

Needs a good B Complex like Thorne Basic B or Igennus and Vit D3 + K2 MK7 3000 - 4000 iu

Low in Ferritin... need a full iron panel

Ft4 is on the low side but thyroid is likely struggling due to the above... No fT3 so hard to know what is going on there.... has she been diagnosed?

WendyW1964 profile image
WendyW1964 in reply to TiggerMe

She originally thought her thyroid was causing her symptoms. We got her bloods done and they came back with low iron/ferritin and sky high vitamin D. She has private health so we asked to be referred to an endocrinologist. He has just said take iron tablets and multi vitamins for the next 4 months and then have bloods re done. She is really upset as she feels so unwell.

TiggerMe profile image
TiggerMe in reply to WendyW1964

Low folate, B12 and ferritin make you feel dire... did I miss read the Vit D I though it was low?

These will all effect her thyroid function as good levels are essential... my daughter had similar results and is now bouncing around again having supplemented 🤗

TiggerMe profile image
TiggerMe in reply to TiggerMe

Needs to be 100-150nmol/L not interested in sufficient we like optimum!

WendyW1964 profile image
WendyW1964 in reply to TiggerMe

what supplements did she take?

TiggerMe profile image
TiggerMe in reply to WendyW1964

The Heme iron, Thorne Basic B and separate B12 spray as a loading dose for 2 months, Vit D + K2 oral spray

Still trying to find the best B12 version for her as could be higher but at least now midway, now switched her to Igennus Super B as a holding dose of one a day... can take two

TiggerMe profile image
TiggerMe in reply to WendyW1964

Try heme iron Three Arrows is good but comes from America so rubbish timing... Iron bisglycinate is another that is easier on the stomach.... what are the chances of her eating chicken liver pate a couple of times a week?

Is she happy taking pills? If not Better You do a range of mouth sprays which many like

WendyW1964 profile image
WendyW1964 in reply to TiggerMe

Thank you. Re her iron her uncle who doesn't absorb iron and has been having iron infusions for the past year has shown her bloods to his heamatologist and she said get an urgent referral and she will get it quickly triaged. The GP today has done a private referral to a heamotologist.

TiggerMe profile image
TiggerMe in reply to WendyW1964

Not the most pleasant way to do it 😕 presumably they test whether she can absorb first? So that leaves the need for a good B Complex and Vit D

TiggerMe profile image
TiggerMe in reply to TiggerMe

Didn't see a full iron panel in the results? Is it low

WendyW1964 profile image
WendyW1964 in reply to TiggerMe

Don't think he did this. He just said her ferritin was 14 and she needs to get it to 50.

TiggerMe profile image
TiggerMe in reply to WendyW1964

It's possible to have low ferritin and still have high iron so we always warn people to get a full iron panel done before supplementing... iron is funny old stuff!

WendyW1964 profile image
WendyW1964

bloods

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WendyW1964 profile image
WendyW1964

bloods

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WendyW1964 profile image
WendyW1964

bloods

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WendyW1964 profile image
WendyW1964

bloods

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WendyW1964 profile image
WendyW1964

bloods

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WendyW1964 profile image
WendyW1964

bloods

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Kindkim2 profile image
Kindkim2

hi! Sorry that you feel this way, I can’t see the images clearly but I can relate to you. I was diagnosed with a pituitary enlargement they could not find a tumor, and last year with hashimoto thyroid disease. My symptoms are similar, I do have bad insomnia that the one that makes me feel horrible. I would cut gluten right away, stop eating processed food. Look into the AIP diet I have stated to follow this diet it’s only been a month and half and I feel that my body is feeling better, now working on my sleep and is important to keep stress down. What ever it is going on the body can heal it self if you give it the right condition! Stay positive

birkie profile image
birkie

Hi WendyW1964❤️

A couple of symptoms jump out at me one being extreme thirsty, also vision, headache sweating and itching fatigue .

Doses your daughter need the toilet quite alot? (to urinate) especially through night?.

Does she feel shaky and sick?

As she had here calcium checked?

If her calcium is over her parathyroid hormone should also be checked.

Look up primary hyperparathyroidism and normocalcemic hyperparathyroidism, it can easily be ruled out with bloods.

These are the symptoms I have and were diagnosed this year, the vision loss is awful, I've always to drink water I'm constantly thirsty, have headaches, fatigued to the point I sometimes just want to sleep all day.

I don't have a thyroid now through graves disease.

But it won't harm yourself and your daughter to go down every avenue.

Best of luck and I hope she gets sorted soon❤️

TiggerMe profile image
TiggerMe in reply to birkie

I think the Calcium result is 2.51 (2.2 - 2.6)

birkie profile image
birkie in reply to TiggerMe

In normocalcemic hyperparathyroidism the calcium is at the top end.. My resting calcium was 2.25 before it started jumping up to 2.51,2.53 but because it's not over range gps and endocrinologists think you can't have a parathyroid problem, no so.If she could find out what her calcium was before she started to feel unwell that's a starting point, but to me it looks at the top end (2.51) I'd be asking for a PTH test along with calcium and vid D.

Also what gps and endocrinologists don't realise is the calcium can bounce in and out of range, so doing only one cal test would not rule it in or out, 3 consecutive tests should be done to see how the calcium and parathyroid hormone are performing.

SlowDragon profile image
SlowDragonAdministrator

so

Her TSH is higher than typical

Ft4 low

Quite likely her thyroid is struggling

Low thyroid levels results in low stomach acid, this leads to poor nutrient absorption

Ferritin is deficient as below 30

She needs FULL iron panel test for anaemia

B12, folate and vitamin D low

Is she vegetarian or vegan?

Work in improving low vitamin levels then get FULL thyroid including thyroid antibodies and vitamin levels retested in 2-3 months

We never recommend multivitamins

A) only for the “worried well”……not high enough doses to correct low levels

B) iodine not recommended for anyone with suspected autoimmune thyroid disease

WendyW1964 profile image
WendyW1964 in reply to SlowDragon

She is not vegetarian or vegan. She enjoys cooking meals from scratch so doesn't eat much processed food. The endo said take multi vitamins, iron tablets and vitamin D for 4 months then have bloods re done. She is gutted to have to wait 4 months as she is applying for full time work and her headaches/migraines plus fatigue scare her.

SlowDragon profile image
SlowDragonAdministrator in reply to WendyW1964

Get her started on vitamin D, magnesium, B vitamins

Getting full iron panel test

Meanwhile significantly increase iron rich foods in diet

Then in 6-8 weeks get FULL thyroid and vitamin testing including thyroid antibodies

TiggerMe profile image
TiggerMe in reply to SlowDragon

Good shout SD, I forgot the magnesium!

SlowDragon profile image
SlowDragonAdministrator

vitamin D

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

SlowDragon profile image
SlowDragonAdministrator

only add one supplement at a time

Then wait 10-14 days to assess before adding another

Starting with vitamin D, then magnesium

Then look at low B12

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 10-14 days later add a separate vitamin B Complex 

Then once serum B12 is over 500 (or Active B12 level has reached 70), 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

Highly effective 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

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

Post discussing different B complex

healthunlocked.com/thyroidu...

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 stop vitamin B complex, 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...

helvella.blogspot.com/p/hel...

SlowDragon profile image
SlowDragonAdministrator

Deficient Ferritin

First step is to get FULL iron panel test

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

Posts discussing Three Arrows as very effective supplement

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Iron patches

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron

healthline.com/nutrition/he...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Ferritin range on Medichecks

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

SlowDragon profile image
SlowDragonAdministrator

retest thyroid and vitamin levels in 2-3 months

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

See detailed reply by SeasideSusie

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

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