hello, for quick reference I am a 32yr old female, diagnosis of t2 diabetes and PCOS.
After annual diabetes MOT at the GP earlier this week, my thyroid bloods have come back “abnormal” and have an appointment next week and another blood test booked in 6 weeks. I just wanted to check whether these numbers look like Grave’s/hyperthyroid of other causes as I’m struggling to find specific ranges that would consider:
TSH- 0.04 ref: 0.38-5.33mIU/l
T3- 8 Ref: 3.8-6.0 pmol/l
T4- 19.1 Ref: 7.9-20pmol/l
For context, I had just thought maybe I was heading into an early menopause, but have been having heart palpitations around every 10 mins daily, slight vision changes, dry eyes over last year, hair falling out and hadn’t really thought much of it until now
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Levels can change a lot in 6 weeks. GP is waiting to see if levels settle back down from a transient rise or if they continue to stay elevated or rise.
There are 2 autoimmune conditions which affect thyroid & most thyroid issues are caused by either autoimmune issue.
The first, most common is autoimmune thyroiditis known as Hashimoto’s. This is where the immune system attacks thyroid. The damage releases hormones stores into circulation & levels can rise & fluctuate. Ultimately the damage causes low functioning thyroid.
The second is Graves, where the immune system causes thyroid to over produce & levels can become very high.
Do you have a way to monitor heart rate? Tracker / watch? Can be helpful.
Symtoms, particularly palpitations are common with hyper & your high FT3 is likely causes symtoms. Symtoms can very varied.
Thyroid antibodies can help determine which condition could be occurring. (GPs are unable to request all types)
Your FT4 is still just within lab range so dr is waiting to see what happens. If it remains High they will refer you to endocrinology specialist.
Levels could become in range on next test, but make sure further follow up they may drop further.
Ask for antibodies to be included on next test, do this in advance if possible. GP should be able to at least add TPO antibodies. Testing folate, ferritin, B12 & vitamin D also helpful. There are private DIY fingerprick test you can arrange if GP/Labs refuse to test.
There are 4 types of thyroid antibodies which drs can test for & they can help work out what autoimmune issue could be happening, but there are always exceptions.
Thyroid Peroxidase (TPO)
Thyroglobulin (Tg or TGab )
Thyroid Stimulating Immunoglobulin (TSI)
TSH receptor antibodies (TRAb)
TPO & TGab are highest when autoimmune Hashimotos is present
TSI & TRab are highest when Graves is present.
But there is an overlap & antibodies & they can also present in either condition.
It’s often why drs don’t pay much attention to antibodies & focus on treating levels. Hopefully FT3 & FT3 levels & not just TSH levels.
I have chronically low vitamin D that is resistant to supplements, B12 was tested.
B12 is 303ng Ref: 145-914
Last Vit D in June 2024 was 22nmol/l
Hair loss could be coming from medication for T2 which is why I didn’t think much of it. It also causes weight loss, so every week for the past 4 months I’ve been losing even more weight than the week before to now losing between 5-10lbs a week (I have/had a lot to lose) which is a lot for someone who has been on the medication for 8 months so didn’t initially seem an issue either.
This has been what’s thrown me as I’ve always had higher end of “normal” TSH as above (although I’m aware in other countries it may already be considered hypothyroidism at those levels), to then see the opposite 14 months after the last is bamboozling so I will look at hashimotos. Thank you
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
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
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
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
Have been on 5000iu tablets 3 times over the last year and my body does not seem to hold it- they haven’t tested vit D for a while though so will contact.
I am not on metformin, I am only on Mounjaro 10mg. I hate to say it, but that B12 level is the highest I have had in over a decade. It is usually around 225-245 so has improved but I will look at the supplements for sure. Thank you
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test results
