(Edited) Latest Bloods & TPOab 246

[Opposite]

Good afternoon,

Please can someone help me to understand what my latest bloods indicate?

I have hyperthyroidism and now hope I have the antibodies results to determine a cause.

Ranges in brackets. Please note this is after 3 months of carbimazole, I had Thyrotoxicosis in December.

TPOab = 246 (0-34)

TRab = 1.5 (0-3.3)

TSH = 0.01 (0.27-4.2)

Serum Urea = 2.1 (2.8-8.1)

Serum Potassium = 2.5 (3.5-5.1)

T4 = 13.1 (4.5-11)

Does this mean I have Graves, Hashimotos, or is it inconclusive?

Thank you in advance.

(Apologies if you read the original post, I found the ranges)

[SlowDragon Administrator]

well it looks more like Hashimoto’s

Trab is below top of range

TPO above top of range

Low potassium - could be due to folate deficiency

mayoclinic.org/symptoms/low...

When were B12 and folate last tested

You also need ferritin and vitamin D tested

Stop iron supplements 5-7 days before testing iron panel

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...

[Opposite in reply to SlowDragon]

Thank you for your reply.

I haven't had those tested, they will be next on my list.

So does a TPOab of 246 not give a definitive diagnosis?

I had hoped that was the answer I was waiting for.

I know Hashimotos can cause Hyperthyroidism but everything I can find online is about treating Hypo - and obviously that's not me.

Being a 'typical' patient just once would be so nice.

[pennyannie]

Hey there again :

Well this is showing a TRab of 1.50 with a cut off being 3,30 - so a negative result for Graves :

But showing over range TPO at 246 where the range is given as a cut off at 34 : and a positive for Hashimoto's Auto Immune thyroid disease.

So your symptoms are more likely to be transient hyper phases - swings in symptoms - with the thyroid becoming increasingly damaged with every attack and you needing further support in the form of thyroid hormone replacement - initially T4 - Levothyroxine.

Many forum members find the research and suggestions of Dr Izabella Wentz worthwhile :-thyroidpharmacist.com

[Opposite]

Thank you so much.

If my thyroid was previously Hypo, that would explain the weight gain at least!

I'm on carbimazole. My appointment with the Endo is on 21st March. I'm still Hyper so not sure they will switch my meds yet.

I'll do some reading on the link provided. Thank you.

[humanbean]

Your potassium level is shockingly low. Is that a typo?

If it isn't a typo then you need to see a doctor urgently.

Info on hypokalemia : en.wikipedia.org/wiki/Hypok...

Normal potassium levels in humans are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels below 3.5 mmol/L defined as hypokalemia.[1][2] It is classified as severe when levels are less than 2.5 mmol/L.

Your level of 2.5 mmol/L (I'm assuming those are the units of measurement, but please check) is on the cusp of being a severe deficiency which would need hospital treatment to improve it.

And low potassium would make you feel absolutely dreadful.

Make sure you read this part of the page :

en.wikipedia.org/wiki/Hypok...

[Opposite in reply to humanbean]

No, that's what it says on my portal. The Endo didn't even mention it when I called to discuss the TPO results. Perhaps it's expected with Thyrotoxicosis?

He said all my results are improving, so I'll see if I can find it on previous tests. I've had four sets of bloods done since October and they are in 3 different formats so it's all rather confusing!

I will do some reading on that too, I guess. Thank you for flagging.

And I will buy some bananas!

I'm hesitant to start yet another supplement.

[Opposite in reply to humanbean]

Well... that's an enlightening read.

Half my symptoms are in there.

Thank you for this. I'm going to buy a potassium supplement and discuss it with my GP.

[helvella in reply to humanbean]

I agree VERY strongly with you, humanbean

While a banana is not a bad idea, even a medium tomato and an apple would (together) have more potassium! And probably less sugar.

Potassium

Fact Sheet for Health Professionals

ods.od.nih.gov/factsheets/P...

Although from the USA, these fact sheets can be helpful so long as you are careful to check the units used.

[Opposite in reply to helvella]

Thank you. I'm doing some reading now, and adding things to an online shop as I go!

My restless leg syndrome could be caused by this! I've had that for years.

I'm increasingly grateful for this forum. I'm learning so much. I wouldn't have worried about this with numbers so small. I was focused on the TPOab.

Thank you again.

[humanbean in reply to Opposite]

Can I just say that you are avoiding the main problem. Eating potassium-rich foods is a good idea when your potassium deficiency has already been properly treated. But self-treatment now of such a poor level of potassium is not a good idea because your result is simply too low and it needs treatment quite urgently.

The other thing is that there might be a treatable reason for your potassium being that low, and supplementing might just disguise it for a little while without curing the problem.

I wouldn't have worried about this with numbers so small.

The problem is that sodium and potassium are two of the most important nutrients required by every cell in the human body because they control what goes in and out of cells. The reference ranges are so narrow for them, precisely because they are so important. Doctors are happy to have a huge reference range for things they don't consider life-threatening or urgent, but when they know the huge importance the ranges can be tight.

I think you should phone up NHS 111 and ask what you should do. Or alternatively there is an online site, but I have no idea how good it is :

nhs.uk/nhs-services/urgent-...

111.nhs.uk/

Note that any phone contact with 111 is renowned for taking absolutely ages to get a response.

[Opposite in reply to humanbean]

Not intentionally - I'm desperately trying to understand the problem.

Thank you very much for your concern. I really do appreciate it.

I have a GP appointment first thing in the morning and will make this the first thing I bring up.

Im under the care of Endocrinology, Urology, Heamatology, and having weekly GP appointments and they all receive my bloodwork. These bloods were taken 2 weeks ago (and have apparently improved since the last lot) so I am happy to wait until the morning - but I absolutely take your advice on board and am working to understand the issue.

[Opposite in reply to humanbean]

I've just found my potassium result from January and that is in range at 4.8.

Something has either caused it to drop drastically or it's a mistake.

Either way, this doesn't appear to be an ongoing problem. I'm not sure if that's a good thing or bad.

I will definitely discuss this with my GP in the morning.

[humanbean in reply to Opposite]

That's a relief, a level of potassium of 4.8 is a good level. I can't think what could have caused your levels to go down that quickly, but then I'm not a doctor. I hope your doctor has something constructive to say about it.

[Opposite in reply to humanbean]

It's been a fun few days.

The GP asked me to come in for blood tests right away, when I asked about my potassium level. She also sent an 'urgent' request for help to the Endo.

My results were uploaded to the portal last night, showing potassium at 4.1. The GP is closed today and the Endo, as seems to be normal, did not respond.

My Endo is useless, as far as I can tell. My GP sent several 'urgent' requests for help in January and received nothing until an instruction to switch me from Carbimazole to PTU in Feb. By that time, I had already been prescribed PTU, taken it for *about a week (my sense of time is skewed atm), and decided to switch back because my palpitations increased drastically.

So, my potassium appears to be fine but I am yet to find out if this was a mistake or if it can change that quickly.

I am also about to run out of Carbimazole (tomorrow) and have been requesting a new prescription for 2 weeks, which my Endo has not actioned despite multiple calls, and my GP won't issue without their approval.

After 10 years of advocating for the NHS, fundraising, and arguing with my 'natural medicine only' Mother to listen to qualified medical professionals, I am starting to hate the NHS.

Thank you for your advice and concern, anyway.

[SlowDragon Administrator]

meanwhile with low potassium eat a banana everyday

[Opposite in reply to SlowDragon]

That shouldn't be a problem, I'm eating everything else! Ha.

Thank you. I will.

[helvella]

I'm concerned that everyone might be ignoring other possibilities.

For example, an autonomous nodule pumping out thyroid hormone regardless.

It is very difficult when results are not entirely unambiguous and clear.

[Opposite in reply to helvella]

Oh no, please don't give me more to worry about!

I'm joking, thank you. I'll look into that too.

I'm not taking anything for granted. I'm very aware I don't quite fit into any of the diagnosis I've seen so far, and will keep pushing for answers.

My biggest worry was a tumour so I'm glad it appears to be autoimmune, as crazy as that sounds.

I really can't seem to learn much about Hashimotos because absolutely everything is about treating Hypo symptoms.

My appointment with the Endo is on 21st March and I will have a LOT of questions.

I did call them today and they said Hashimotos is 'most likely', so it appears they aren't settled on a diagnosis yet either.