opinion on test results please

[MiriamD]

Hi, I had a thyroid plus blood test via Medi checks and got results today. I have been feeling really exhausted ,gained so much weight over last couple of months, losing eyebrows, always cold etc but my results do not seem very conclusive. I’ve been feeling so rubbish I was convinced they would be much worse than they appear to be.

I am not currently taking meds as although I’ve had antibodies since 2018 I’ve been managing through diet, no gluten and alternative remedies including homeopathy. However

because symptoms have worsened over last few months again I’ve been contemplating going the medication route but now not sure I would even be offered a prescription. I’ll put results below and would really appreciate anyone’s thoughts on how to interpret them. Lat thing to say I had the test at 2 pm which I now see is later in the day than recommended but I fasted beforehand,

TIA

Miriam

Results

TSH. 2.49 (range is 0.27 - 4.2 )

FREE T3. 4.6 (range 3.1 - 6.8 )

FREE THYROXINE. 14.9 (range 12 - 22 )

THYROGLOBULIN ANTIBODIES

153 (range 0 - 115 )

kIU/L

THYROID PEROXIDASE ANTIBODIES

11.8 (0 - 34 Range)

[TiggerMe]

Did you get any result for ferritin, Vit D, folate and B12?

Edit.... As you tested late it would be worth requesting tests from your GP and booking an early slot

[J972 in reply to TiggerMe]

MiriamD says the test was done fasting at 2pm, so chances are TSH would’ve been higher if done before 9am.

[TiggerMe in reply to J972]

Doh 😬

[MiriamD in reply to TiggerMe]

Yes I did, pls see in my reply below to Cornwaller

[Sparklingsunshine]

If you could test again, preferably around 9am, fasting except water your TSH could well be higher and its the TSH GP's look at. Also avoid taking any supplement with biotin in for several days before hand. Biotin can interfere with thyroid blood tests assays.

Biotin is often found in hair, skin and nail formulations or B complex vitamins. Your FT4 looks lowish in range so you could be on your way to going hypo.

[Cornwaller]

Hi. I'm not a doctor but your symptoms appear consistent with hypothyroidism and your blood work especially t3 and t4 are pretty low and your antibodies high which are also consistent with hypothyroidism. Interestingly your tsh is not as elevated as might be expected; nonetheless a trial of levothyroxine would seem appropriate to see if your symptoms improve.

Further testing of b12 and other vitamins would be worthwhile because if one auto immune condition is present there is an increased livelihood of another.

Whether an actual doctor with a white coat and condescending manner would concur is probably less clear.

Best wishes

[MiriamD in reply to Cornwaller]

Thank you for quick response - kicking myself about the timing of my test now as would have preferred the TSH levels to confirm how I’m feeling and wondering if this is a contributing factor. I do take supplements for B12 and ViT and stopped before the test, but only 24 hours beforehand. the results are below

FERRITIN 80.3. (Range 30 - 332)

FOLATE - SERUM 32.1. ( nmol/L > 7 )

VITAMIN B12 - ACTIVE 150 (range 47.5 -187)

VITAMIN D. 102. (Range 50 - 250)

I think you are probably right that unless the TSH is more elevated I won’t get much help from a doctor. I have previously been told from blood tests that I have NAFLD so was reluctant to only take thyroxine in case it was a conversion problem. In your opinion -( I know your not a doc ) wld I be better with a T3 supplement as well?

[Cornwaller in reply to MiriamD]

I don't know if you would be better with t3 as well. Your results don't show any clear evidence of a conversion problem albeit you probably can't 100% rule it out either.

As you note I'm not a medic, however, you might consider of an initial trial with t4 as a reasonable and well trodden starting point and see how you are symptom wise after eight weeks and do a blood test too. Then you can evaluate the way forward. Hopefully you can find a medic who understands hypothyroidism and can help you with this journey. Additionally the lovely people here will always give you their thoughts.

Best wishes

[SlowDragon Administrator]

Retest including vitamin D, folate, ferritin and B12

Either via GP or Medichecks

Always test early morning, ideally before 9am and only drinking water between waking and test

What vitamin supplements are you taking

Stop any vitamin supplements that contain biotin 5-7 days before test

[Oatlove in reply to SlowDragon]

Hi - should you not take thyroxine before a blood test? I normally take mine at 7am an hour before food or drink.

[Sparklingsunshine in reply to Oatlove]

No you should leave 24 hours after your last dose of Levo. Otherwise you can get falsely elevated FT4 levels. Take it after your blood test.

[MiriamD in reply to SlowDragon]

Thank you for quick response - kicking myself about the timing of my test now as would have preferred the TSH levels to confirm how I’m feeling and wondering if this is a contributing factor. I do take supplements for B12 and ViT and stopped but only 24 hours before hand these were the results in the same blood test

FERRITIN 80.3. (Range 30 - 332)

FOLATE - SERUM 32.1. ( nmol/L > 7 )

VITAMIN B12 - ACTIVE 150 (range 47.5 -187)

VITAMIN D. 102. (Range 50 - 250)

[SlowDragon Administrator in reply to MiriamD]

So retest again in in few weeks

Stop vitamin B complex 5-7 days before test

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

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

Test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)