I posted this query a few days ago and it was kindly analysed for me by greygoose (comments further down). However, I didn't understand what he/she was telling me - so I wonder if anyone could explain for me? Do the results indicate hypothyroidism? Do I need meds or can I tweak via diet/vitamins?
Thanks very much - I'm a newbie here so struggling to understand references to percentages in particular.
After being diagnosed with atrial fibrillation five years ago and an ambiguous NHS blood test showing possible subclinical hypothyroid symptoms I decided, as my diet is mostly plant based, to take a vegan multivitamin/mineral including iodine. I had a private thyroid test done a few months later which appeared to be within "normal" parameters apart from ferritin.
I've just had another test (done at 9am) to see how things are, and again all seemed to be within parameters, apart from the B12 (which I supplement).
* Vitamin D (25 OH) 70 (50 - 200 nmol/L)
* Magnesium 0.96 (0.66 - 0.99 mmol/L)
* CRP <0.60 (<5.0 mg/L)
* Ferritin 51.80 (30 - 400 μg/L)
* Serum Folate 38.10 (8.83 - 60.8 nmol/L)
* Active B12 >150 (37.5 - 150 pmol/L)
* TSH 1.86 (0.27 - 4.20 mIU/L)
* Free T4 15.0 (12.0 - 22.0 pmol/L)
* Free T3 4.7 (3.1 - 6.8 pmol/L)
* T4 Total 86.7 (66 - 181 nmol/L)
* Anti-Thyroglobulin Abs 14 (<115 IU/mL)
* Anti-Thyroidperoxidase abs <9.0 (<34 IU/mL)
* Cortisol (Random) 450.0 (73.8 - 507.0 nmol/L)
greygoose replied:
"* Vitamin D (25 OH) 70 (50 - 200 nmol/L)
Too low. Should be more like 100
* Magnesium 0.96 (0.66 - 0.99 mmol/L)
Irrelevant. The results are not reliable with magnesium. Not worth testing.
* Ferritin 51.80 (30 - 400 μg/L)
Too low. Should be over 100.
* Serum Folate 38.10 (8.83 - 60.8 nmol/L)
* Active B12 >150 (37.5 - 150 pmol/L)
Good.
* TSH 1.86 (0.27 - 4.20 mIU/L)
On the high side.
* Free T4 15.0 (12.0 - 22.0 pmol/L) 30.00%
Too low. Should be more like 50% through the range.
* Free T3 4.7 (3.1 - 6.8 pmol/L) 43.24%
Too low. Should be just slightly lower in range than the FT4. The fact that it is higher is an indication that the thyroid is failing.
* T4 Total 86.7 (66 - 181 nmol/L)
Irrelevant.
* Anti-Thyroglobulin Abs 14 (<115 IU/mL)
* Anti-Thyroidperoxidase abs <9.0 (<34 IU/mL)
Negative, but that does not entirely rule out Hashi's.
* Cortisol (Random) 450.0 (73.8 - 507.0 nmol/L)
What time was the blood draw for this test? Cortisol levels change throughout the day - as does TSH.
It's not just about being in-range, it's about being in the right place within the range. All your results are in their ranges, but that does not make them normal for you. "
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Recommend taking with 100 mcgs of vitamin K in the form of MK-7
Ferritin is much trickier, especially tough to increase when you are vegetarian.
But first step is to get a full iron panel, as it’s possible to have high iron and low ferritin, and excess iron is toxic over time causing irreversible organ damage. Here are thing in an iron panel but you might see others as well:
Iron
Total iron-binding capacity (TIBC)
Transferrin saturation
Ferritin
High Sensitivity CRP (CRP-hs)
If you are in the UK (I am not) I think I know enough to say that you won’t get treatment for those thyroid numbers.
But improving your ferritin and D are great next steps, while you watch and see how your thyroid goes.
That’s my layman’s opinion. You may get others : )
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
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.
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.
Well, why didn't you tell me you didn't understand what I was talking about? I could have explained. You didn't say you wanted to know if you should be on thyroid hormone replacement. And I cannot guess how much you know about thyroid before posting, you have to tell me.
As I understood your post, you just wanted your results analysed. So that's what I did. I would have told you that whilst your thyroid hormone levels are slightly low, you are not yet hypo. And no doctor would diagnose you as such on those results.
I'm sorry you didn't understand what I told you, but I wasn't working with the full facts, was I. I wish you'd said.
I did reply to you 5 days ago, you must not have seen it and I was really keen to get some explanation hence me posting on here again:
in reply to greygoose
5 days ago
Thanks for the analysis - I'm a newbie round here, though so could you let me know what all this means? Am I hypothyroid? Or is this something I can tweak with a change of diet/vitamins or do I need meds? Can't imagine my GP will be interested as the results seem within range...
No, I didn't see it. I have the impression there are quite a few responses I never get to see because the alert system is so erratic. My apologies.
No, you're not hypo at the moment. But you could be heading that way. But your GP will only be interested in the TSH, I'm afraid. They're pretty ignorant when it comes to thyroid.
You certainly do need to tweak your nutrients! But that probaby won't make much difference to your thyroid results. On the other hand, low nutrient levels do cause symptoms, so optimising them might make you feel better in some ways.
Brief thyroid 101:
TSH is a pituitary hormone. When the pituitary senses there's not enough thyroid hormone in the blood, it raises the TSH to stimulate the thyroid to make more.
The thyroid hormones are T4 and T3. T4 is basically a storage hormone that doesn't do much until it is converted into T3. T3 is the active hormone and it is needed by every single cell in your body to function correctly. And, when it is low, all sorts of nasty symptoms can arise anywhere and everywhere in your body and brain.
People who don't have any sort of thyroid problem are called 'euthyroid'. Usually a euthyroid TSH is around 1, never over 2, and you are technically hypo when it gets to 3. But the NHS like it to go over 10 before they will diagnose!
People who are hypo tend to have high TSH and low FT4/3.
People who are hyper - Graves' Disease - have very low/suppressed TSH and very high FT4/3. To know if you have Graves' you need your TSI and TRAB tested. (Pretty certain that is not your case. )
However, it doesn't always follow that pattern.
If you have Autoimmune Thyroiditis - aka Hashi's - where your immune system slowly destroys your thyroid, you can swing between hypo and mildly, temporarily, hyper. To know if you have Hashi's, you need your TPO and Tg antibodies tested.
And, then, there is a condition called Central Hypo, where the fault lies with the pituitary (Secondary Hypo) or the hypothalamus (Tertiary Hypo) rather than with the thyroid itself (Primary Hypo). With that you will have low TSH and low FT4/3.
The reason we calculate the percentages through the range is so that we can compare results from different labs. Because different labs can have different ranges. If you are euthyroid, your TSH will be around 1, as I said, and FT4 and FT3 around 50% through the range - whatever the range - with the FT3 slightly lower than the FT4.
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Blood results
Fatigued with anxiety
Thyroid Test results 
T3 and T4 results
