After my initial blood tests (listed in my previous post) 2 weeks ago showed hypothyroidism and iron deficient anemia my gp ordered some additional tests to establish the cause. These were taken at 8:45am in the morning fasted.
Please could you help me interpret what they mean? If they are ‘normal’, what could be causing it the hypothyroidism and is it possible that it will resolve?
Tissue transglutaminase IGA 0.6u/mL [0-6.9] Celiac disease unlikely.
Cortisol 412nmol/L -no range given but says should be interpreted in light of clinical picture -Potentially Abnormal.
I should add, they also repeated my tsh and t4 tests which confirmed previous results, did a bone profile, liver function, oestradiol, LH and FSH. all normal bang in the middle of the ranges. Same for urea, creatinine and electrolytes.
previous thyroid tests for reference:
Serum TSH level 65.7 miu/L [0.27 - 4.2]
-Serum free T4 level 6.9 pmol/L [10.5 -22];
TIA for your help.
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Phoenix_24
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Hi Phoenix,others will be more clued up regarding the core vitamins but is that tsh correct 65.7?Its recommended it be around 1 or under.Your t4 levels nowhere even near the lab range.Your t3 is probably on the floor also.Has no one mentioned starting you on Levothyroxine?
Hi, yes it is correct, I was alarmed by that result but since I’ve heard of people with tsh in the hundreds. the gp started me on 50mg Levothyroxine just over a week ago, snd the thyroid tests were repeated and my tsh was 59 the second time, only slightly lower but I had already been taking the Levi for a couple of days.
If they are ‘normal’, what could be causing it the hypothyroidism and is it possible that it will resolve?
Oh, the choice is endless! Take your pick. If it isn't due to autoimmune, or a wonky pituitary then the chances of ever finding what caused it are slim to zero. But, it doesn't really matter because it is highly unlikely that it will resolve with a TSH that high, and the treatment is always the same: thyroid hormone replacement. So, your GP should stop chasing unicorns and put you on some levo straight away.
😄chasing unicorns. The GP has put me on levo though at only 50mg dose for now but I am tolerating it well so far so might ask if it can be increased before the next set of bloods in 6 weeks.
50 mcg is a 'normal' starter dose. So, I doubt if he will increase it before the six weeks testing. And he would be wrong to do so. It takes at least six weeks for the dose to settle in.
The NHS only tests one type of antibody - TPO and yours here are negative. If you test privately (not using MonitorMyHealth) you can also get Tg - Thyroglobulin antibodies tested.
If coeliac is unlikely you still may have Hashimoto's and a gluten free diet might still help you. You can trial that from now.
Its not possible for the thyroid to heal itself and hypothyroidism is known as a lifetime diagnosis.
It might just be that you have been hypo and untreated for a long time and thats why your vitamins are so poor all round.
Poor thyroid levels will affect cortisol.
Have you now started on vitamins to help improve your levels?
What supplements are you taking?
I am assuming you have been started on Levo, how much?
Be sure to take your iron 4 hours away from Levo and anything else. Take it with orange juice, the vit C will help it absorb.
Weirdly I have had symptoms for a long time and have had blood tests a few times over the last couple of years. Last test in July was normal for tsh and t4, I have been anemic and taking ferrous fumarate on and off for 2 years.
they started me on Levo 50mg, the doctor said I would definitely needs higher dose but because I’m very petite she didn’t want to start too high.
I am taking the Levo before bed and the ferrous fumarate 3 x day with orange juice or water and a fruit snack., last dose at 3pm. Also taking 50ug vitamin D with lunch and just started 100mg of magnesium though I’m taking that in the afternoon as I don’t know if it would interfere with the levo.
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50mg vit D is 2,000iu and may not be enough to get your results to optimal level. Retest in 3 months to check if you are taking enough. Vit D should be tested twice yearly.
Blood results that a GP says are 'normal' frequently show signs of being hypo, its all down to the interpretation.
Your folate was also low and a B complex recommended. Here are some suggestions.
With a TSH that high, I surprised they wanted another test, let alone only after another 2 weeks. For good measure you’d be looking at 2-3 months for a repeat test.
Either way, your hypothyroidism now seems to be confirmed. 50mcg is a starter dose. Is there any reason why you wasn’t started on a full replacement dose based on your weight?
I was surprised too but like you said it is confirmed, part of me did wonder if they’d made a mistake the first time. The gp said that she would start me in 50mg because I am petite. Base on my weight she should have put me on 75mg, I now wish she had!
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