Help, Can anybody interpret these results?

[helenshubby]

Can someone help me make sense of these test results? MC = Medichecks. NHS = GP Surgery, BH = Blue Horizon.

What is screaming at me over these last 6 bloods is that they are all fasting, taken around 9.00am. The very last results were based on supplementation of B12 sublingual spray 300 mcg x1 day Thorpe Basic B supplements, 400 mcg Magnesium, Vit D3 1000 iu K2 spray x 3, Zinc, Selenium and 100 mcg Levo except for first two which I think was 75 mcg.. The Blue Horizon RBC's may be suspect as it took 51 hours to get to the lab despite being 24 hour Guaranteed. CRP is high as are thyroid antibodies so Hashi's is a given.

Despite the Vit D being tripled from 1000 iu to 3000 iu it's barely moved and Red and White Cell Counts are grumbling along the bottom of the range except ferritin. (last one up due to haemolysis?). The B supplements seem to have shoved her folate to the high end of the range and her T3/T4 still suggests poor conversion. TSH is still abit on the high side. Active B12 is elevated so we have stopped the sublingual and left it to the B supplements. Selenium is raised so Helen is taking one every other day. Given Magnesium was raised she has stopped it as it was near normal in February '23 and elevated on half a daily dose. It was also going her abdominal issues with fullness & slow bowel movements but not constipation. We suspect the hashes may have been triggered by a really bad dose of chicken pox in her early twenties and slowly shown itself over the years.

I am not convinced Helen has enough RBC's or WBC's to cope with every day needs hence perpetual tiredness, sinus pain, ear pain, catarrhal mucus down throat at night, eye pain and general feeling of not sleeping, and feeling unwell despite having most bloods "in range". White Cell Count suggests Neutropenia. Platelets on the low side.

RFT's, LFTs HBA1C seem normal though she has been labelled pre diabetic but we have a pretty healthy diet and Helen has all but eliminated Dairy (Using Arlo Milk, Gluten free Bread, oily Fish) Only non Gluten/Dairy is occ Biscuit and 1 x Actimel daily. Proactively looking for dairy free chocolate/biscuits and probiotics.

Lipids are up as expected with hashi's but the TC/HDL Ratio isn't too bad and Iron doesn't look too promising either.

Copper and Zinc are at the upper end of the range but normal as is CK. The only other issue is the Random Cortisol. We have 2 x 24 hour cortisols to use but is the random reading from 0930 OK or not.

In the light of a thyroid being slowly trashed by antibodies, is there any relevance to having a thyroidectomy or does that cause more issues than it solves. Apologies for the length of this but we are getting desperate.

Anyone able to help pin point any other issues other than the need to see an endo and get put onto a slowly increasing dose of T3 and eliminate the last bits of gluten and Dairy from the diet would be be greatly appreciated. I hope this table stays as is as it's taken two days to put together. I did try to upload a pdf but that was too small to read. I can send as a csv or excel by email or PM if it will take it. Dashes mean no test done.

Date 3/8/23 10/8/23 12/12/23 8/2/24 27/6/24 13/8/24

Lab MC NHS NHS MC NHS BH

CRP 2.160(<3) 2(0-5) - 4.9(<3) 2(0-5) 1.23(0-5)

Ferritin 317(30-650) 288(23-300) - 313(30-650) 315(23-300) 365(13-150)

Serum Folate 35.3(8.83-60.8) - - >45.4(>7) 16.8(3.1-20.5) 58.60(8.83-60.8)

Active B12 >150(37.5-188) - - >150(37.5-188) - >150(37.5-150)

Vit B12 - - - - 348(187-883) -

Vit D 52.5(50-250) - - 69.5(50-250) 76(50-120) 78(75-200)

TSH 6.910(0.27-4.2) 7.68(0.35-4.94) 1.78(0.35-4.94) 3.180(.27-4.2) 1.36(0.35-4.94) 1.53(0.27-4.2)

Free T3 3.7(3.1-6.8) - - 4.3(3.1-6.8) - 4.4(3.1-6.8)

Free T4 17.2(12-22) 1 2.9(9-19.1) - 1 9.1(12-22) 15.2(9-19.1) 20.4(12-22)

T4 Total - - - - - 133(66-181)

Thyro-

globulin

a/b 38.8(0-115) - - - - 123 (<115)

Thyroid

Per-

oxidase

a/b. 415 (0-34) - - - - 434 (<34)

Hb - 125(120-150) - 119(115-165) 125(120-150) 126(120-160)

HCT - 0.382(3.6-0.46) - 0.363(3.8-5.8) 0.38(0.36-0.46) 0.444(0.35-0.47)

RBC. - 4.24(3.8-4.8) - 4.11(3.8-5.8) 4.23(3.8-4.8) 4.22(3.8-5.8)

MCV. - 90(83-101) - 88.4(80-100) 90(83-101) 105.2(88.1-98)

MCH. - 29.5(27-32) - 28.9(27-32) 29.6(27-32) 29.9(27-33)

MCHC. - - - 327(320-360) - 284(300-350)

MPV. - - - - - 9.8(7-13)

Red Cell

Distribution

Count. - - - - - 14.8(11.5-14.4)

Nucleated

RBCC. - 0.1(0-0.1) - - - -

WCC. - 4.3(4-10) - 4.5(3-11) 4.2(4-10) 3.8(3-10)

Neutrophils - 1.9(2-7) - 2.4(2-7.5) 1.99(2-7) 1.9(2-7.5)

Lymphocytes - 2.02(1-3) - 1.6(1.5-4.5) 1.76(1-3) 1.53(1.20-3.65)

Monocytes. - 0.24(0.2-1) - 0.3(0.2-0.8) 0.31(0.2-1) 0.3 (0.2-1)

Eosinophils - 0.1(0.02-5) - 0.2(0-0.4) 0.14(0.02.0.5) 0.08(0-0.4)

Basophils - 0.0 (0-0.1) - 0.1(0-0.1) 0.01(0-0.1) 0(0-0.1)

Platelets. - 237(150-410) - 257(150-450) 241(150-410) 241(150-400)

Date 3/8/23 10/8/23 12/12/23 8/2/24 27/6/24 13/8/24

Urea. - 5.2(2.5-7.8) - 4.1(2.5-7.8) 7.2(2.5-7.8) 5(2.5-7.8)

Creatinine. - 88(45-84) - 84.5(55-100) 83(45-84) 81(45-84)

eGFR. - 61(60) 65 67(>60)

Bilirubin. - - - 7.7(<22) 11(<21) 8(<21)

ALP. - - - 114(30-130) 105(30-130). 113(30-130)

ALT. - - - 14(<34) 15(<34) 18(<35)

GGT. - - - 16(<38) 16(<38) 15(5-36)

Total Protein - - - 71(60-80) 68(60-80) 73(60-80)

Albumen - - - 44(35-50) 43(35-50) 44(35-50)

Globulin. - - - 28(19-35) 25(21-35) 29(19-35)

HBA1C. - - - 36(20-41.999) 42(<48) 39(20-42)

Tot. Chol. - - - 5.86(<5) 6.5(3.6-5) 6.89(0-5.0)

LDL Chol - - - 3.82(<3) 4.6(0.4-3) 4.4(<3))

Non HDL Chol - - - 4.59(<4) 5.16(?) 5.18(<4)

HDL Chol. - - - 1.27(>1.2) 1.34(>1.2) 1.7(>1.2)

TC/HDL Ratio - - - 4.61(<6) 4.9(<4 or 5?) 4.03(<4)

Triglycerides - - - 1.69(<2.3) 1.4(0.5-1.7) 1.7(<1.7)

Uric Acid. - - - 308(140-360) - 242(140-360)

Iron. - - - 14.6(10-30) - 16.4(5.8-34.5)

TIBC. - - - 48.6(45-81) - 54 4(45-81)

UIBC. - - - 34(13-56) - 37.3(24.2-70.1)

Transferrin Sat.- - - 30(25-45) - 30.5(20-50)

Calcium - - - - 2.35 2.29(2.22-2.55)

Serum Adj

Calcium Conc - - - - 2.31(2.2-2.6) 2.22(2.22-2.55)

Inorganic

Phosphatase - - - - 1.1(0.8-1.5) -

Magnesium. - - - 0.93(0.7-1) - 1.1(0.7-1.0)

Sodium - 142(133-146) - - 142(133-146) 143(133-146)

Potassium - 4.1(3.5-5.3) - - 3.9(3.5-5.3). -

CA125. - 16(0-35) - - - 15 (<35)

C opper - - - - - 18.10(12.24-23.72)

Zinc. - - - - - 15.66(10.7-17.5)

Selenium. - - - - - 2.61(0.75-1.48)

Random Cortisol 0930. - - - - 320(106-507)

CK. - - - - - 95(28-192)

Date 3/8/23 10/8/23 12/12/23. 8/2/24. 27/6/24 13/8/24

[helenshubby]

I am adding this as the spacing on this table has not worked out at all.

table

[HealthStarDust in reply to helenshubby]

You may wish to add the page with the results for the magnesium and selenium etc.

I’m sorry Helen is so unwell. I can relate and ever trying to figure out what I can do. Sometimes, it seems to me some people have more straightforward thyroid disease that responds to treatment be that levithyroxine, added T3, or NDT and others don’t.

[helenshubby in reply to HealthStarDust]

Magnesium & selenium were only marginally over hi range Just notices 2nd page didn't print. Must go now as have trip to Stanmore from Norwich tomorrow with neophyte driver.

[helenshubby in reply to HealthStarDust]

What Iron results we have are in my initial listing but repeated Hera along with selenium, magnesium etc. Dates alongs the bottom. Dashes indicate test not done on the date it represents:

Iron. - - - 14.6(10-30) - 16.4(5.8-34.5)

TIBC. - - - 48.6(45-81) - 54 4(45-81)

UIBC. - - - 34(13-56) - 37.3(24.2-70.1)

Transferrin Sat.- - - 30(25-45) - 30.5(20-50)

Calcium - - - - 2.35 2.29(2.22-2.55)

Serum Adj

Calcium Conc - - - - 2.31(2.2-2.6) 2.22(2.22-2.55)

Inorganic

Phosphatase - - - - 1.1(0.8-1.5) -

Magnesium. - - - 0.93(0.7-1) - 1.1(0.7-1.0)

Sodium - 142(133-146) - - 142(133-146) 143(133-146)

Potassium - 4.1(3.5-5.3) - - 3.9(3.5-5.3). -

CA125. - 16(0-35) - - - 15 (<35)

C opper - - - - - 18.10(12.24-23.72)

Zinc. - - - - - 15.66(10.7-17.5)

Selenium. - - - - - 2.61(0.75-1.48)

Random Cortisol 0930. - - - - 320(106-507)

CK. - - - - - 95(28-192)

Date 3/8/23 10/8/23 12/12/23. 8/2/24. 27/6/24 13/8/24

[SlowDragon Administrator]

Only non Gluten/Dairy is occ Biscuit and 1 x Actimel daily. Proactively looking for dairy free chocolate/biscuits and probiotics.

Definitely ditch the daily Actimel taking a non dairy alternative

And loads of dairy free/gluten free sweet treats available.

Vitamin D, try increasing to 4000iu or 5000iu daily

Perhaps increase levothyroxine by 25mcg per WEEK

split as extra 12.5mcg x 2 days

Retest in another 8 weeks

[helenshubby in reply to SlowDragon]

But T4 on BH results was quite high. Helen can't get to see GP til at least 1/10! Awful. And I have an appt at Stanmore tomorrow. Getting worse and more info coming out of the wood work about something that may have happened some time ago. Not good either.

I despair of the Medical Profession. Not helped by loss of Bro in Law last Sept 11, Dad 29/3 and Mum 13/8!

[grumpyold in reply to helenshubby]

What an awful time you are both having. Sympathies for the loss of your loved ones.

I, too, despair of the medical profession. I have Hashi's. On Levothyroxine alone My FT4 levels used to be considerably above range whilst my FT3 was just 5% within it. I was gluten free, dairy free and trying to eat kimchi, kefir etc to bolster my stomach acid as well as taking highish doses of magnesium citrate. All my other vits and minerals looked good.

The game changer for me, was adding T3. Tired of banging my head against a brick wall I went rogue and ordered it myself, without my GPs knowledge . As you can't get an appointment for so long, if I were you, I would simply take matters into my own hands and try it. (I appreciate this may not be the route you wish to take.)

Roseway Labs have their own prescriber. Many members on here are now sourcing their T3 from them, me included. Their website is very comprehensive. Feel free to DM me if you need to. I don't want to overstep the mark and put more info into the public domain than is permitted.

[SlowDragon Administrator in reply to helenshubby]

Stress and grief could be contributing

Possibly depression too?

[helenshubby in reply to SlowDragon]

We have gone to 5-6000 iu daily Vit D

[FallingInReverse]

Random thoughts.

* what have your recent efforts been on t3? It is bottom of range and it seems an obvious place to look. But I’m sure you have that on your list?

* Have you got a full iron panel to share?

* Keep in mind magnesium tests are useless as way less than 5% circulates in the blood. We do assume everyone is deficient and benefits from the standard dose.

[helenshubby in reply to FallingInReverse]

Helen changed to Magnesium citrate as the other stuff was giving her all sort of gut sluggishness. She’s stopped all Magnesium for the time being to see if she can get rid of the obvious fullness but it’s not showing much sign of movement. This was on half the daily recommended dosage. I don’t think she will be comfortable going back on the.citrate for its laxative effects until she loses some of the current fullness. Suggestions?

[FallingInReverse in reply to helenshubby]

Have a read of this: healthunlocked.com/thyroidu...

Particularly the article link in the main post with an overview for types and options : drjockers.com/best-magnesiu...

If she has sluggish gut (if that means constipation) then you should likely look elsewhere for what’s causing it. Magnesium at its core has a common side effect of the opposite… diarrhea… some types more than others - as you are seeing with the citrate. But you say she has fullness, and stopping the magnesium didn’t help, which makes sense as it’s unlikely to be the cause.

But also - as DD explains below - her t3 is a very obvious suspect here. Are you nit doing anything to address that?

Lastly, increasing ferritin (especially as (CRP goes down) should be looked into with a full iron panel.

[DippyDame]

I suspect these results are key -

Free T3 3.7(3.1-6.8) - - 4.3(3.1-6.8) - 4.4(3.1-6.8)

For good health every cell in the body must be flooded with T3 by way of a constant and regular supply

The T3 must reach the nuclei of the cells where it attaches to T3 receptors and finally becomes active and can fulfill it's purpose

FT3 is the most important lab followed by FT4, this is frequently overlooked.

Her T4 to T3 conversion is poor ( high FT3 with low FT3

100mcg levo is not an adequate dose

Suggest an increase to 125mcg levo and retest after 6 weeks

If FT3 remains low then adding T3 should help

We aim to have FT3 approaching 75% through the ref range

Helen's latest FT3 result is only 35.14% through he ref range so far too low for good health

She needs to see an endo who will prescribe T3 based on her poor T4 to T3 conversion and consequent low FT3, or failing that source a private supply as many of us have been forced to do.

Her Vit D is too low....aim for at least 100

Her thyroid antibodies are high which means her Frees may fluctuate from time to time as the failing thyroid dumps hormone in the serum, raising Free levels which will eventually fall back again. A gluten free diet usually helps

Increase her FT3 and I suspect she will start to improve but it's not necessarily a quick fix so patience is important

Wishing Helen well

[klr31]

Neutropenia seems common with us hypothyroid sufferers. I have it too.

Karen

[Topsy33]

Just a thought but, did Helen stop all vitamin B complex for around a week before testing?

The Biotin in B complex is sometimes implicated in unexpected results.

[helenshubby]

we were pushed by BH for an appt. We managed almost 96 hours. Their literature stated Biotin needed only to be stopped for 72 hours.

[Jazzw]

Hi Helenshubby

The B supplements seem to have shoved her folate to the high end of the range… Active B12 is elevated so we have stopped the sublingual and left it to the B supplements.

Happened to notice that MCV is high—which can often indicate LOW vitamin B levels.

So that got me wondering. It means the red blood cells are big—macrocytic. If it’s not Vitamin B issues, then it could be the hypothyroidism but the thyroid function tests seem to be improving.

Has she had a liver function test?

[helenshubby in reply to Jazzw]

LFT's are listed in my first post and seem OK

[Jazzw in reply to helenshubby]

Sorry—I missed that!

Then it’s a bit of a puzzle.