Can anybody please help with my latest thyroid ... - Thyroid UK

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Can anybody please help with my latest thyroid results?

Amyflood246 profile image
13 Replies

hello! So I have been monitoring my thyroid now for a couple of years since I did an at home test with medichecks in 2023 and my TSH was 4.24 and my tpo antibodies were positive at 80 something… In the last year and a half I’ve done 3 tests and my TSH has been swinging between 1.6 and 4 and my TPO antibodies have been between 33 and 80… I have not been to the GP yet as was told they wouldn’t do anything until my TSH was at 6 or higher… is it definitely under active rather that over active? And does it definitely look like I have a thyroid problem or could this just be normal for my thyroid because I thought it would have been more out of range consistently by now…Here are my latest results from yesterday! Thanks

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Amyflood246
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SlowDragon profile image
SlowDragonAdministrator

Have you also got recent vitamin D, folate, ferritin and B12 results

What vitamin supplements are you taking

What symptoms do you have, if any

Are you on gluten free diet and/or dairy free diet

Amyflood246 profile image
Amyflood246 in reply toSlowDragon

I follow the VIT D protocol and I’m in a good range with that. I am b12 deficient so I am on injections and have been for a couple of years… my folate is above 20 because I take daily folic acid to support my b12 injections… My ferritin is 123 but haven’t had a full iron panel done for about a year and I have a feeling that my ferritin is high due to inflammation so I need to get an iron panel done and no I’m not on gluten free or dairy free x

SlowDragon profile image
SlowDragonAdministrator in reply toAmyflood246

You might be better taking good quality daily vitamin B complex, one with folate in (not folic acid) rather than just folate

This can help keep all B vitamins in balance

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need separate methyl folate couple times a week

Post discussing different B complex

healthunlocked.com/thyroidu...

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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 if last test result serum B12 was below 500 or active B12 (private test) under 70:

Amyflood246 profile image
Amyflood246 in reply toSlowDragon

I take a vitamin b complex too but take a break every 3 months because of the b6… I actually took a break from the 5mg folic acid for a few months and ended up severely deficient again and only just managed to get it back up now. What about the thyroid issues that I mentioned? How do the vitamins relate to thyroid? Thanks x

SlowDragon profile image
SlowDragonAdministrator in reply toAmyflood246

Free T4 (fT4) 14 pmol/L (12 - 22) 

Ft4 only 20.0% through range

Free T3 (fT3) 4.3 pmol/L (3.1 - 6.8)

Ft3 only 32.4% through range

TSH is sluggish responding to low thyroid levels, which is quite common with Hashimoto’s because thyroid levels hop around so much

Low vitamin levels are result of low thyroid levels

Maintaining GOOD vitamin levels and trialing Gluten Free/ Dairy Free

And retest again in 2-4 months

Amyflood246 profile image
Amyflood246 in reply toSlowDragon

Great thank you. Wasn’t sure of the correlation between thyroid and vitamins x

greygoose profile image
greygoose

So have you been having your blood draw consistently at the same time of day?

TSH levels depend a lot on how efficient your pituitary is, what time of day you have the blood draw, and your FT4/3 level. At the moment, your Frees are a bit on the low side:

FT4: 14 pmol/l (Range 12 - 22) 20.00%

FT3: 4.3 pmol/l (Range 3.1 - 6.8) 32.43%

But nothing that would attract the attention of a doctor. However, you must feel terrible!

But, as you have Hashi's, these are going to jump around a bit so it's difficult to catch them all just at the right time.

That said, it does look like your pituitary is a bit sluggish - and TSH moves slowly, anyway, so that's another complication - and one of the so very many reasons why diagnosis/treatment should not depend on the TSH! But that's the way it is, I'm afraid. And with you TSH you have at the moment, it's not going to get you a diagnosis.

Amyflood246 profile image
Amyflood246 in reply togreygoose

Yes between 9 and 10am. Is there anyway I could end up being overactive rather than under active with these results? And also you say my pituitary is a bit sluggish am I looking at a problem with that too?

greygoose profile image
greygoose

Absolutely not, no. A TSH over 2 means that your thyroid is struggling to make enough hormone for your needs, it certainly couldn't over-produce.

HOWEVER, you do have Hashi's. And that means that periodically your immune system is going to launch an attack on your thyroid to try and destroy it. And when that happens the dying cells release their stock of of thyroid hormones, that have previously been produced, into the blood causing levels of FT4 and FT3 to rise sharply to what could be misconstrued as hyper levels by unknowledgeable doctors. But the levels are hardly likely to be high enough to suggest Graves' - if you know Graves' - and are only temporary. Eventually the excess hormone will be used up/excreted and you will go back to being hypo. This is often called a Hashi's 'hyper' swing, because that's what it's doing, swing backwards and forwards between hypo and false 'hyper'. But this is not the same as having hyperthyroidism because the thyroid is not over-producing thyroid hormone consistently.

Difficult to say for the pituitary problem because we don't have enough information. At this moment, the TSH does not correspond to Free levels, one would expect it to be higher. But, as I said, the Free levels are likely to jump around due to the nature of Hashi's, and as the TSH moves more slowly it has difficulty keeping up. You need to keep track of it, in relation to the Free levels, to see if there's a pattern building up. Which I know isn't easy to do. Have you had your early morning cortisol tested? That could be a clue, because just as the thyroid relies on the pituitary TSH to make hormone, the adrenals rely on the pituitary hormone ATCH to stimulate them to make cortisol. But even that would be inconclusive. You would need pituitary testing to know for sure, and that's difficult to get because only an endo can do it.

Amyflood246 profile image
Amyflood246 in reply togreygoose

this is very helpful thank you!

So could I be like this for another few years yet before I end up truly hypothyroid?

I have had my 9am cortisol checked and it was on the low end of the range in my opinion at 271. Its like a minefield the lot of it and with my b12 deficiency causing so many nasty symptoms I don’t know if any of them are actually thyroid related x

greygoose profile image
greygoose in reply toAmyflood246

It is complicated. But doctors think it's simple because they don't know the half of it!

There's no knowing how long it will take for your Free levels to get low enough to show 'truly hypo' - in my opinion you are now, but I'm not a doctor! I suppose we ought to call it something like 'medically-hypo', or 'doctor-approved hypo'. :(

B12 deficiency symptoms can mimic hypo symptoms, it's true, but with those levels, I'm pretty sure some of yours must be due to thyroid.

Amyflood246 profile image
Amyflood246 in reply togreygoose

Yes most probably! I have noticed that my hair has turned very coarse over the last couple of years, my skin especially on my face has gotten very dry and sensitive and also the heels of my feet get that dry that they crack open in painful sores. I’m quite intolerant to the cold and I am gaining weight (but I also don’t live the healthiest of lifestyles either) and I know those can all be symptoms of thyroid but as you say there is so much overlap in symptoms between different conditions x

Bearo profile image
Bearo

I obtained a prescription for Levothyroxine well before my TSH got particularly high. It was over 4 for several years so I kept pushing for it to be retested. Of course I kept seeing different doctors and eventually one gave me a prescription, just to shut me up, I think.

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