Help interpreting results :) : Hi there, I'd be... - Thyroid UK

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Help interpreting results :)

JaneOBrien profile image
20 Replies

Hi there, I'd be so grateful for some help trying to interpret test results. I started getting symptoms of joint stiffness, low energy, skin breakouts and generally not feeling myself, in 2021. Due to the joint inflammation in my feet and fingers, I was diagnosed with Inflammatory Arthritis, but there is no inflammation showing in my bloods. My mum and auntie both have thyroid issues and over the years they've asked me to look into whether I might have something going on. I have had several tests and they results are always interpreted as 'normal' but i'm not so sure. Here are my results from the last 3 tests:

February 2024:

TSH 2.9 (0.27 - 4.2)

FT3 4.8 (3.1 - 6.8)

FT4 14.9 (12 - 22)

December 2023:

TSH 2.09 (0.27 - 4.2)

FT3 3.8 (3.1 - 6.8)

FT4 12.4 (12 - 22)

October 2022:

TSH 3.77 (0.27 - 4.2)

FT3 5.1 (3.1 - 6.8)

FT4 16.9 (12 - 22)

I'd be so grateful for any help on whether this is worth following up. I just don't feel that I have arthritis and something else is going on here.

Jane x

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JaneOBrien
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JaneOBrien profile image
JaneOBrien

Also a note that my vitamin D3 had dropped to low in range at the latest test, it was at 53.8 (50 - 250) and my B12 was 68.1 (37.55 - 188).1 so definitely going to start supplementing with the recommended vitamins from these pages.

Medichecks recommended I get an MMA test to check for underlying B vitamin deficiency - does this sound necessary?

Aside from this my ferritin was 51.3 (30 - 180) and folate was 31 (7 - 35) - my folate shot up since my last test and not really sure why. I did take some folic acid in December as I was on some arthritis medication that blocked folate absorption. But it's been a long time so i'm surprised that would still be in my system... i'm not on any medication now.

Mixteca profile image
Mixteca in reply toJaneOBrien

I think it's worth getting an MMA test done and would also check homocysteine. You likely have a B12 deficiency/pernicious anaemia and these, and other tests, are relevant to that condition. Best to test before supplementing and post on PAS forum for further advice.

SlowDragon profile image
SlowDragonAdministrator

can you add ranges on all results please

B12 …..looks EXTREMELY low

JaneOBrien profile image
JaneOBrien in reply toSlowDragon

sorry B12 should have been 68.1!! i'll add ranges now, thanks so much for the help - it's so so appreciated

JaneOBrien profile image
JaneOBrien in reply toJaneOBrien

ranges all added!

JaneOBrien profile image
JaneOBrien in reply toJaneOBrien

SlowDragon I hope the ranges are clear in the above post. Grateful if you have any opinions!

SlowDragon profile image
SlowDragonAdministrator in reply toJaneOBrien

So all vitamins are low ….apart from folate

Are you vegetarian or vegan

Active B12 below 70 is considered suspect

However you’re only just under that

Suggest you start supplementing and should see improvements

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

A week later add a separate vitamin B Complex 

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

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

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 you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until Active B12 around 100

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

SlowDragon profile image
SlowDragonAdministrator in reply toJaneOBrien

Low vitamin D

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

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 with Hashimoto’s, 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 when supplementing

Can test via NHS private testing service

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...

Retest thyroid and vitamin levels again in another 3 months INCLUDING thyroid antibodies

Test early morning and only water to drink between waking and test

SlowDragon profile image
SlowDragonAdministrator in reply toJaneOBrien

Ferritin

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

have you had CRP tested - test for inflammation

High CRP will raise ferritin

Ferritin can look normal, especially with any inflammation…..but iron be low

It’s also possible to have low ferritin but high iron

Full iron panel test

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...

JaneOBrien profile image
JaneOBrien in reply toSlowDragon

Thank you so much SlowDragon this is all such thorough and useful advice. I'm going to start taking a better B complex (previously i was taking Together Health B Complex and can see now that this wasn't satisfactory) - will start with Thorne. I have ordered Vitamin D+K2 from British Supplements (5000UI) so am looking forward to trying this and I will also add in Magnesium. I will be so happy to have some of my energy back and to have less soreness in my joints. I didn't mention in my post but i'm only 30 and used to be very active so hoping to get this back :)

I will re-test again in 3 months. I don't understand enough about my thryoid hormone results yet but I was thinking that my T4 is low in range. But maybe this would be affected by vitamin supplements too.

Thank you again - so much

SlowDragon profile image
SlowDragonAdministrator in reply toJaneOBrien

Start with separate B12 first

Options on which one listed in my first repl

Week later add vitamin B complex

SlowDragon profile image
SlowDragonAdministrator in reply toJaneOBrien

but I was thinking that my T4 is low in range. But maybe this would be affected by vitamin supplements too.

Yes your thyroid hormones are low

But not (yet) low enough to get diagnosed

Thyroid may be struggling because of poor vitamin levels

So first step is to improve low vitamin levels

This should improve symptoms

May improve thyroid levels too

Low vitamin levels tend to lower TSH and TSH is all most medics (incorrectly) look at

Improving low vitamin levels may increase TSH so you can get diagnosed as hypothyroid

Or vitamin levels are low because of low thyroid hormones

JaneOBrien profile image
JaneOBrien in reply toSlowDragon

This makes sense thank you. I will try 3 months on the vitamins then test again. I’m feeling really hopeful now :) yes B12 first then B complex - I will follow your advice!

I will also make sure not to eat before test next time as I did not know this and had eaten breakfast.

SlowDragon profile image
SlowDragonAdministrator in reply toJaneOBrien

As both antibodies are negative consider getting ultrasound scan after next test….if thyroid hormones remain low

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

DaisyTed profile image
DaisyTed

I can’t comment on your test results, but have you tried a gluten-free diet? My joint stiffness totally went away after I cut out gluten, as I was having an inflammatory response to it.

JaneOBrien profile image
JaneOBrien in reply toDaisyTed

thanks for your reply! Yes I’ve cut out Gluten and Dairy. Although I have had a couple of slips up with gluten so maybe I need to keep committed to absolutely zero gluten and see if that helps. Thank you!

Sleepman profile image
Sleepman

SlowDragon ranges now added.

Such a busy forum. Do not be bashful and repost the same question with ranges added if responses are quiet.

I am pretty novice but would say get Thyroid antibody test done. TPO.

This will show if autoimmune type likely and may persuade them to give you thyroid hormone it looks like you need. As prescriptions are free forever if underactive thyroid it is likely hard to get diagnosed. Also if you take thyroid it shuts down the thyroid and takes over I think.

I read a recent post about low dose naltraxone LDN that I will try to locate but hopefully the Ateam can comment.

JaneOBrien profile image
JaneOBrien in reply toSleepman

Thank you Sleepman my antibody test showed:

photo of test results
JaneOBrien profile image
JaneOBrien in reply toJaneOBrien

low dose naltraxone LDN - this sound interesting..!

Sleepman profile image
Sleepman

Antibodies look low, so hopefully not autoimmune type.

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