Hi, can anyone shed some light on my thyroid results please? I've gained weight recently and have had some irregular menstrual cycle issues over the past year.
I wondered if my tests show any sign of an autoimmune issue? I couldn't quite work out from the levels if I have a very low number of antibodies or too many - I've read that the presence of any antibodies isn't a good thing. Tests were taken at 8.30am after fasting if that helps.
Thanks in advance for any help!
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Thanks for the swift reply SlowDragon Are these the ranges you'd need?
FT4 - 12.6 pmol/l (11.9 - 21.6 optimal)
FT3 - 3.71 pmol/l (3.1 - 6.8 optimal)
I definitely have insufficient Vitamin D and am now taking a treatment dose:
Vitamin D - 18 nmol/l (<25 Deficiency)
Folic Acid - 25.9 μg/l (3.8 - 26.8 Optimal)
Iron - 13.4 μmol/l (5.8 - 34.5 Optimal)
Ferritin - 40.17 μg/l (10 - 120 Optimal)
B12 - 350 ng/l (197 - 771 Optimal)
I don't have a diagnosis or any medication. I'm 39 - I'm wondering if I'm perimenopausal, but had my FSH levels tested too and they came back as within range (5.3 U/l on day 3 of cycle, range: 3.5 - 12.5 Follicular Phase )
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
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
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
Post discussing how biotin can affect test results
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
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.
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
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 264l
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.
Your antibodies are negative. But that does not rule out Hashi's 100% because antibodies fluctuate all the time. Plus, a certain percentage of Hashi's people never have high antibodies, and are diagnose by unltrasound. Have you had an ultrasound of your thyroid?
There are people that say you shouldn't have any antibodies at all, but I doubt that can be true. In all the years I've been reading blood test results on forums, I've never seen anybody with zero antibodies, even when they turned out not to have a thyroid problem.
So, if a blood test is postive for Hashi's, you can take that as absolutely true. But, a negative test will always be iffy. And only time will tell.
At moment LOW TSH and LOW FT4 and Ft3 ……suggesting central hypothyroidism
If this remains the case after improving low vitamin levels
You will need referral to thyroid specialist endocrinologist
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
SlowDragon Thank you so much for the really comprehensive reply, that's so useful.
TSH/FT3 and 4: Based on your comments, should my TSH level be increasing to offset the low FT3 and FT4 (not sure if that's how it works)?
Vitamin D: I am indeed on that exact loading dose over 7 weeks. I'll try to request a retest afterwards and will purchase one of those Better You sprays.
B12: Funnily enough, I've had some strange symptoms over the past year or so, such as a numb area on my thumb and occasional tremors in my jaw and core/stomach. I hadn't linked this with B12 deficiency, will definitely supplement to see if it makes any difference. I'm not currently vegetarian but when I previously was for a short period, I developed tinnitus and was never sure if that was linked.
Folic Acid & Biotin: I'm currently trying to conceive so am taking prenatal vitamins. Just realised they contain Biotin (150 µg) so I'm guessing this might've actually skewed all of my results? Perhaps I should get a retest after a week off of the biotin.
Ferritin: Thanks, I'll look into increasing my intake.
Thanks also for the referral list and suggestions, I really appreciate all of the info!
Based on your comments, should my TSH level be increasing to offset the low FT3 and FT4 (not sure if that's how it works)?
Yes TSH is message from pituitary to tell thyroid to increase output
With thyroid levels are “normal/good” when thyroid is working as it should……and not on any replacement thyroid hormones Ft4 and Ft3 would be roughly 50% through range
TSH should increase if Ft4 falls. Your body will work hard to maintain Ft3 (active hormone) at expense of Ft4 (storage hormone)
your TSH is very low considering how low your Ft4 is
I'm currently trying to conceive so am taking prenatal vitamins. Just realised they contain Biotin (150 µg) so I'm guessing this might've actually skewed all of my results? Perhaps I should get a retest after a week off of the biotin.
Could you actually be pregnant ?
Are you taking pre natal supplements AND a separate biotin …..or just pre natal supplement
Thanks again SlowDragon , particularly for the breakdown of how those levels are supposed to interact.
I’m definitely not pregnant currently. I did have a missed miscarriage last spring, so I’m sure some of these levels could have played a part. Though my Vitamin D was higher then (59 nmol), B12 roughly the same, serum folate (> 20.0 ug/L, range 3.89 to 26.8) Previous TSH levels then were 1.61 mIU/L (and a low of 1.32 mIU/L in 2018), but no ft3 or 4 levels available. No doctor has ever flagged my thyroid results as low, and I was under the impression that TSH below 2 - 2.5 was optimal to conceive.
I’m not sure if it adds more to the picture, but I have slightly high prolactin and low testosterone and free androgen. Other hormones all within range.
Day 3 / Day 21 (of cycle) results:
Prolactin:
3) 355 mIU/l
21) 671 mIU/l (>496 High. But I hadn’t fasted before this test)
Testosterone :
3) 0.139 nmol/l
21) 0.275 nmol/l (<0.29 Low)
Free Androgen Index:
-3) 0.2 %
21) 0.45 % (<0.3% Low)
The biotin is part of the prenatal vitamins, and also includes a low dose of D, B12, etc.
So your B12 is definitely low if there’s B12 in pre natal supplement
Request GP test for Pernicious Anaemia
And suggest you see thyroid specialist after next blood tests having improved low vitamin levels
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
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