some advice: just has the private blood test done... - Thyroid UK

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some advice

Historically_valid profile image

just has the private blood test done after having borderline results with gp this year. Both antibodies are really high 255 but my thyroid hormones are relatively normal. I’ve been told previously to have repeat bloods yearly as I’m at higher risk of developing hypothyroidism.

I’ve also insisted on an ultrasound scan as just after Christmas my lower throat was swollen on one side and felt uncomfortable. It was confirmed that my thyroid is indeed enlarged. This was another reason why I wanted a more in depth blood test. I’ve not been back to gp since my scan but wondering if anyone has advice with enlarged thyroid gland, really high thyroid antibodies but normal thyroid levels. Thanks

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Historically_valid
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19 Replies
Buddy195 profile image
Buddy195Administrator

Welcome to the forum Historically_valid

So we can offer better advice, can you tell us more about your thyroid condition, eg ongoing symptoms, plus blood test results (with ranges in brackets) for:

TSH

FT3

FT4

Plus key vitamin tests (ferritin, folate, vitamins D and B12)

When medics say results are normal/ within range, this may not be the same as optimal, so it’s definitely worth sharing results with us.

If your GP is unable to complete all the above (eg if TSH is within range, some surgeries may not be able to access FT4 and FT3 tests), you could look to do this privately, as many forum members do, for a better picture of your thyroid health:

thyroiduk.org/help-and-supp...

Can you confirm the time of day your bloods were taken?

Historically_valid profile image
Historically_valid in reply to Buddy195

time of test was in the morning around 9:20am. I’ll pop some photos of the private results I received today

Results
SlowDragon profile image
SlowDragonAdministrator in reply to Historically_valid

so your ferritin is deficient

Are you vegetarian or vegan?

My folate was low in my previous bloods with gp as was my iron and was put on medication recently both went back up but iron has gone down quick again

Low vitamin levels are frequently as result of low thyroid levels

Aiming to maintain ferritin at least over 80

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.

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 testing

Medichecks iron panel test

medichecks.com/products/iro...

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

Great replies from @FallingInReverse

re ferritin and Three arrows

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great reply by @fallinginreverse

healthunlocked.com/thyroidu...

Iron patches

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...

Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue

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 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.

Historically_valid profile image
Historically_valid in reply to SlowDragon

Thank you, no I’m neither vegetarian nor vegan but if I eat meat it’s mainly chicken but my diet is fairly varied but will look in to some of these changes

Historically_valid profile image
Historically_valid in reply to Buddy195

these are the antibody ranges

Results
greygoose profile image
greygoose

Can you give us the actual numbers - results and ranges - please? Just telling us 'high' and 'normal' is not telling us anything.

However, the high antibodies do mean that you have autoimmune thyroiditis - aka Hashi's. Hashi's is a disease where the thyroid is slowly destroyed by the immune system, mistaking it for the enemy. So, yes, at some point you are going to go hypo - although it might make itself felt at first by a temporary false-hyper stage.

What is your TSH at this point?

Historically_valid profile image
Historically_valid in reply to greygoose

Just added photos of the results above. Does the thyroid being enlarged in the scan usually confirmation of this too out of curiosity?

greygoose profile image
greygoose in reply to Historically_valid

I can only see one for ferritin, which doesn't help us much with the thyroid.

That said, it is very, very low, and you need to see your GP about this, and get him to do a full iron panel.

It's not so much the size of the thyroid that confirms Hashi's. It can be enlarged for other reasons. But, the... forget what the word is, the consistancy or something of the tissue and how much damage has been done will confirm Hashi's.

Historically_valid profile image
Historically_valid in reply to greygoose

Thank you, just managed to upload the others. Sorry I’m not very good at uploading things!

greygoose profile image
greygoose in reply to Historically_valid

So, both your Hashi's antibodies are high, so there's no doubt about the Hashi's. However, doctors tend to ignore antibodies because they don't really know what they are.

Historically_valid profile image
Historically_valid in reply to greygoose

These are the thyroid ranges

Results
greygoose profile image
greygoose in reply to Historically_valid

OK, so your TSH is not high enough to interest a GP. And your FT3 is good.

However, your FT4 is too low and the fact that it is lower in its range percentage-wise than the FT3 is confirmation that there is a problem - it should be slightly lower. But, I doubt a GP would know that.

Historically_valid profile image
Historically_valid in reply to greygoose

Thank you for the advice, it’s all new to me but have been suffering with a range of symptoms for years which are blamed on other things but since my neck swelling and just generally getting worse I feel like I’m constantly hitting my head against a wall which is why I opted for the private test to give me more of an idea

Buddy195 profile image
Buddy195Administrator

I like my key vitamin levels to be:

Vitamin D (100-150nmol/L)

Vitamin B12 (Total B12 at top of range or for Active B12 100 or above)

Folate (at least half way through range)

Ferritin (half way through range) Although some point to 90-110ug as optimal.

I can only see your ferritin which is very low. As a first step, you could look to follow dietary advice on:

dailyiron.net/

I would also ask GP to run a full iron panel (recommend before considering supplementing iron). Can you share other vitamin results?

Many with Hashimotos (myself included) benefit from a gluten free diet. It may be worth trialling for a couple of months to see if this helps you.

Historically_valid profile image
Historically_valid in reply to Buddy195

these are the antibodies

Results
Historically_valid profile image
Historically_valid in reply to Buddy195

These are the thyroid results

Results
Historically_valid profile image
Historically_valid in reply to Buddy195

vitamin results

Results
Historically_valid profile image
Historically_valid in reply to Historically_valid

My folate was low in my previous bloods with gp as was my iron and was put on medication recently both went back up but iron has gone down quick again

SlowDragon profile image
SlowDragonAdministrator

Have you had coeliac test done yet

as per NICE Guidelines

nice.org.uk/guidance/ng20/c...

Or buy a test online, about £20

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

With loads of vegan dairy alternatives these days it’s not as difficult as in the past

Post discussing gluten

healthunlocked.com/thyroidu...

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.

Most common by far is gluten. Dairy is second most common.

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies

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