Help with labs please? desperate, house bound p... - Thyroid UK

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Help with labs please? desperate, house bound primarily

ratqueenxo profile image
21 Replies

Hello, could anyone please help me with interpreting labs?

I am on 25mg hydrocortisone for adrenals.

12 hours fasted, except for a tiny sip of diet coke (i wasn't thinking, i barely swallowed it though).

No meds, no biotin.

Please any advice?

TSH 3,38 mU/L Ref: 0,27 - 4,20

T4-total° 8,9 µg/dL Ref: 5,1 - 14,1

Free T4 15,6 pmol/L Ref: 11,0 - 24,0

T3 total° 2,09 nmol/L Ref: 1,23 - 3,08

Free T3 5,5 pmol/L Ref: 3,6 - 6,7 <

Reverse T3° 24,4 ng/dL Ref: 17,0 - 44,0

FTI° 8,7 index Ref: 4,8 - 12,7

Extremely cold all of the time, have adrenal and hypo symptoms, excessive fatigue,

eyebrows won't grow, puffy face, gain weight all of the time, etc

I have T3 at home and NDT after a previous functional dr prescribed me to try, but he didn't know how to treat adrenals at the time.

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ratqueenxo
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21 Replies
Jaydee1507 profile image
Jaydee1507Administrator

Are you taking any thyroid hormone at the moment? It looks like you've tried a few different types.

Have you tested key vitamins lately - ferritin, folate, B12 & D3?

What supplements are you taking and what dose are they?

Your results point to you being hypo.

ratqueenxo profile image
ratqueenxo in reply toJaydee1507

Hi, no i've never been on meds. Drs won't acknowledge me as hypo, i've even see 3 functional drs, only one acknowledged it but he couldn't treat adrenals. I will post my iron lab here sorry i forgot to include it, also my vitamin d was 19.3 and the reference range was beginning at 20 so I know I'm deficient in that. Thank you. Found my vitamin D: 25-OH-vitamin D 19,2 ng/mL Ref: 20,0 - 100,0

iron panel
SlowDragon profile image
SlowDragonAdministrator in reply toratqueenxo

how old are you

Ferritin varies with age

Female?

Pre or post menopause?

Iron results pointing to chronic illness

See table here

labtestsonline.org.uk/tests...

ratqueenxo profile image
ratqueenxo in reply toJaydee1507

Also I have a b12 vitamin test from February: Vitamine B12: 914 reference: 197 - 771

I'm planning on doing an updated one next week, thank you for your help.

I tried straight T3, and NDT(erfa) for a brief time with very little results. This was before I was on hydrocortisone albeit. I've tried taking 5mcg of t3 recently and don't feel anything. Not sure if this is good or bad.

Jaydee1507 profile image
Jaydee1507Administrator in reply toratqueenxo

Your iron & ferritin look OK.

Vit B12 you really need an active B12 test. What you have looks like a serum B12 test which is fine but the active test is more accurate.

Folate needs testing, you can get that done next week.

We use different ranges in the UK but you likely need a minimum of 3,000iu vit D. Try and get one that also contains vit K to help it go to your bones.

A word about diet coke. Its highly processed and may not be helping your fatigue. Replacing it with water might be beneficial.

ratqueenxo profile image
ratqueenxo

OK, great thank you very much. I don't drink it anymore, thank you. I've seen something about an MMA test which I will look into. Making an appt to have those tested next week, thank you

SlowDragon profile image
SlowDragonAdministrator

Free T4 (fT4) 15.6 pmol/L (11 - 24) 35.4%

Free T3 (fT3) 5.5 pmol/L (3.6 - 6.7) 61.3%

Odd results

Having Ft3 higher than Ft4

no thyroid antibodies test results?

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

ratqueenxo profile image
ratqueenxo in reply toSlowDragon

Sorry I forgot to include I do have hashimotos

ratqueenxo profile image
ratqueenxo in reply toratqueenxo

My antibodies were as follows: Anti-THYROPEROXIDASE AL 20 ref: KU/L < 34

Anti-THYROID THYROGLOBULINE AL: + 129 ref: KU/L < 115

SlowDragon profile image
SlowDragonAdministrator in reply toratqueenxo

Have you had ultrasound sound scan of thyroid

have you tried gluten free and/or dairy free diet

ratqueenxo profile image
ratqueenxo in reply toSlowDragon

Yes I'm doing both of those thank you. Is it possible I am hypo tho? I display all hypothyroid symptoms - im hopefully seeing dr Momi in a few weeks.

McPammy profile image
McPammy

what is your cortisol 9am result or have you done a cortisol saliva test privately before starting any medication to help adrenals. My cortisol was low when I had low T3. After finally getting help privately I was prescribed T3 medication alongside my usual t4 medication (liquid). My cortisol jumped from a low 150 to 450 ( range 150-650) after increasing my T3 from a low of 8% to 85% I’m a very poor converter t4 to t3 and have Hashimotos

I was also prescribed hydrocortisone for low adrenals/cortisol before the t3 medication by a stupid NHS endocrinologist. It didn’t help me, in fact it made things worse. It just kept knocking me out not giving energy. Be sure you actually need hydrocortisone as taking adrenal medicine could damage your natural output even people on steroids can alter their natural output

ratqueenxo profile image
ratqueenxo in reply toMcPammy

Hi, my original Dr (who didn't believe I had hypothyroidism), used an old blood test which showed almost 0 morning cortisol, and very high DHEA., he informally diagnosed me with NCAH However when I've done recent(ish) blood tests without taking HC that morning it was in the mid range. I've never taken T3 before my t3 seems to have risen naturally which I'm confused at.

Is there any testing I can do now I'm on it? When I try tapering it down I do find myself getting very stressed/agitated. I do believe I needed it at the time as I also couldn't tolerate thyroid meds, and for a short time of taking it (a few weeks) i could tolerate them again.However it was short lived and now i'm wondering if it's doing more dmg than good? I also get very cold when i try to taper, crave salt excessively too. I do believe I need them but I don't have sufficient data to prove that.

Thank you

McPammy profile image
McPammy in reply toratqueenxo

You really do need a synacthen test before you mess about with any hydrocortisone treatment. I’ve had 3 of these tests all turned out adrenals functioning correctly. You firstly could do a 9am cortisol test through your gp easily. Or pay privately and order a saliva cortisol test. If your Dr said in the past your cortisol was zero I’m sure you’d be dead and you would have been seriously ill prior with addisons disease. Be extremely careful with adrenals they are your major support system for so many things. Do not mess with them unless advised by a good endocrinologist. I certainly would not take any cortisone medication without serious medical help prior and during.

Do not take T3 medication unless your bloods indicate you really need it

If hypothyroidism then always start on t4 medication and after 2 months check if you’re converting to t3 ok

If your cortisol was mid range without taking hydrocortisone that I suspect you don’t need it

ratqueenxo profile image
ratqueenxo in reply toMcPammy

It wasn't 0 but it was very low, OK thank you, would a saliva test still be valid if I'm on hc though?

I will book an appt to do a morning cortisol test, thank you.

Yes I hate them I'm basically left of my own to figure it out while on HC...I make sure not to take it past 1pm as following 1pm it instruct the adrenals to stop producing cortisol. Thank you - he was far too liberal

McPammy profile image
McPammy in reply toratqueenxo

I think anytime of the day taking hydrocortisone would instruct your own adrenals to stop making cortisol not just after 1pm.

It dangerous to mess with adrenals without proper supervision and testing by a endocrinologist

ratqueenxo profile image
ratqueenxo in reply toMcPammy

He is treating based off of a book called safe uses of cortisol. I've heard mixed things, for some people they can wean off of it following this method safely.

Either way I am seeing a new dr soon who specializes in hashimotos and adrenal dysfunction, but in the meantime I will do the blood test for his appt. Thank you very much

McPammy profile image
McPammy in reply toratqueenxo

Just be careful extremely careful you don’t want to damage your adrenals if they are working ok. You really don’t want a life time on steroids as they have bad effects

ratqueenxo profile image
ratqueenxo in reply toMcPammy

I pretty much disowned the dr who prescribed me it after he said I probably have lupus...lol he's far too crazy with easily diagnosing

McPammy profile image
McPammy in reply toratqueenxo

Be very careful

ratqueenxo profile image
ratqueenxo in reply toMcPammy

Yes thank you I'm seeing a new doctor soon.

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