Help with Thyroid results please. : hi everyone... - Thyroid UK

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Help with Thyroid results please.

CarolineAnne profile image
4 Replies

hi everyone, I would be grateful for some advice on thyroid results for my younger brother please.

I have Auto immune Hypo since 2004 and so does one of my brothers and my mum. My other brother has had lots of symptoms of depression and has deteriorated recently. He has high anxiety and slightly paranoid about things - he thinks people are talking about him etc.

I took him to the GP and he had a thyroid test in December. The result s were:

TSH 7.21 ( 0.55-4.78 mIU/L)

FT4 13 pmol/L (11.50- 22.70 pmol/L)

Thyroid Peroxidase Antibodies - NA

He did another test 24 January and the results were:

TSH 6.41 ( 0.55 - 4.78mIU/L)

FT4 10.6 pmol/L (11.50-22.70 pmol/L)

all other tests were good - he supplements Vit b12 and Vitamin D Ferritin was low at 28 but I’ve ordered him some iron.

The lab sheet says to test in another year! But the GP say he will test again in three months.

Any advice? Should we ask for the other Anti bodies to be tested? Thanks.

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4 Replies
SlowDragon profile image
SlowDragonAdministrator

with two test results with TSH over 5 and symptoms he should be started on levothyroxine NOW

Especially as second test Ft4 was BELOW RANGE

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

standard starter dose is 50mcg

Retest in 6-8 weeks

Symptoms of hypothyroidism

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

Obviously essential to test thyroid antibodies too and vitamin levels

Either test now or at next test after 6-8 weeks on 50mcg

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

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

SlowDragon profile image
SlowDragonAdministrator

Ferritin was low at 28 but I’ve ordered him some iron.

Before starting on iron he needs full iron panel test

GP should be testing and treating him

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

Stop iron supplements 5-7 days before test

Medichecks iron panel test

medichecks.com/products/iro...

Is he vegetarian or vegan?

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.

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...

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...

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:

Females 18 ≤ age < 40 30 to 180

Females 40 ≤ age < 50 30 to 207

Females 50 ≤ age < 60 30 to 264

Females Age ≥ 60 30 to 332

Males 18 ≤ age < 40 30 to 442

Males Age ≥ 40 30 to 518

The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.

SlowDragon profile image
SlowDragonAdministrator

What were vitamin D, folate and B12 results and ranges

CarolineAnne profile image
CarolineAnne in reply toSlowDragon

Thank you Slow Dragon for all that info. I have spoken to his GP today and she has refused a trial of thyroxine and refused an Endocrinology referral. She said that it was sub clinical hypothyroidism and offered him antidepressants. I tried to argue my case and she agreed to test TPO but said that she was not allowed to test TGaB! She has put cholesterol down too. His folate and vitamin B12 are below. Vitamin D wasn’t tested but he supplements with the Vitamin B12 and vitamin D sprays from Holland and Barrett.

Folate 10 ug/L (> 5.40 ug/L)

Vit B12 655 ng/L ( 211-911)

He also has full blood count if you wouldn’t mind looking over that as there are some strange results. Thank you

Total white cell count 14.97 10*9/L (4-11 10*9/L)

RBC count 5.08 10*12/L

Haemoglobin estimation 154 g/L 130-170

Haematocrit 0.473 L/L 0.40-0.50

MCV 93.1 fl 82-105

MCH 30.3 pg 27-33

MCHC 326 g/L 315-345

Platelet count 229 10* 9/L 140-400

Neutrophil count 7.99 10*9/L 2.00- 7.00

Lymphocyte count 4.96 10*9/L 1-3

Monocyte count 1 10*9/L 0.20-1

Eosinophil count 0.64 10*9/L 0.02-0.50

Basophil count 0.14 10*9/L 0.91-0.10

Comments:

Hypochromasia 0.3 % < 6.00%

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