Blood test results - help please

[Karisma853]

Hi, I have had the following results back from a blood test done last week. I have included reference ranges as well as results.

Vitamin D: 43.6 nmol/L (anything above 75 nmol/L normal)
(Vitamin D2: <6.0 nmol/L and Vitamin D3: 43.6 nmol/L)

Free T3: Not done
Free T4: 15.6 pmol/L (12-22)
TSH: 4.6 mIU/L (0.27-4.2)

I have 2 results for Ferritin as per below:

Ferritin result 1: 21 ug/L (30-400)

Ferritin result 2: 22 u/gL (30-400)

Anti-TPO Antibodies: 41 kIU/L (<34)

Folate: 4.1 ug/L (4.6-16.7)

Vitamin B12: 363 ng/L (180-900)

Plasma Viscosity: 1.64 mPa.s (1.50-1.72)

Glucose (Fluoride): 4.9 mmol/L (<10.1)

So there you have it. Also I can appreciate the receptionists aren't medically trained or educated, but to be told by one of them I had a high plasma glucose - only for me to go through the results and find that it wasn't high at all - did put me under an excessive amount of worry.

No celiac profile and no autoimmune profile - not sure why that is even though this was arranged to be done.

So I take it I do have Hashimoto's?

I was told my antibodies were lower than before, but the test I had done at that time just said "thyroid antibodies 84 kIU/L" - it could have included TPO as well as TG, surely? And if the TPO antibodies have lowered, why is that?

Also although my usual GP has ordered these tests for some reason one of the doctors I've been seeing (who has said antibodies are irrelevant in a hypothyroid patient by the way) has been getting in on the act as he ordered the TSH and FT4 to be done as well as Ferritin hence the 2 results for Ferritin. Why is he intervening?

Thanks for your help

Jo xxx

[Karisma853]

Sorry, I am still more than happy to receive guidance,  I simply meant I would like an endo to go back to my doctor and explain to them to look after me better at their end, is all.

Past experience with other doctors about this has not fared well with me.

Jo xxx

[Karisma853]

Hi Niko, thanks for taking the time out to reply to me.

My doctor did test me for celiac but I'm yet to hear back about this result - it was ordered and 5 phials of my blood were taken for the previous test so a lot of my blood's been taken from me. From the printout there is no inclusion of an autoimmune profile or celiac.

I did pile on the gluten for the celiac test and I found that as I ate more I experienced more diarrhea.

With the Raynaud's, the nurse practitioner diagnosed me by looking at my toes (which were bordering on turning purple), looked at me and said, "you have Raynaud's." So there you go. No cold water tolerance test and I have no other medical history that would point to it. No family history either.

As long as the endocrinologist gives me a name to my illness I would be fine with that, but because I'm chiefly hypothyroid with a handful of hyper symptoms the doctors don't really know what to do with me.

Thanks

Jo xxx

[TheLightSeeker]

Hey Jo.
I'm at work but have just a couple minutes.
Gluten intolerance would verified by specific tests, however, I strongly recommend you take take the "plunge" and go gluten free for several weeks.
If the experienced improvement is significant, you will be highly motivated
to stay gluten free, regardless of any medical test results and technical stuff!

Raynaud's could be easily verified by a clinical examination, cold water tolerance test and medical history.

Endocrinologists, if they adhere to their "established" protocols may be of  little help.
Keep me posted and I will give you my opinion.
In the new year sometime I will be taking specialized training in this field
but so far, even with my existing knowledge,without intending to brag,
I'm able to give more accurate and useful information, than most doctors.
Cheers!
Niko

[Karisma853]

Hi Niko, thanks for getting back!! I will stay in touch I promise - things have been busy for me myself as I've feeling too poorly to get out of bed some days and I've also been away on holiday a couple of times just to get away. And to top it all my jobseeker's allowance (dole money) didn't go through so I've been having to take trips down to the city centre and sort that all out!

Sorry, I will explain everything a bit better as a lot has happened with all of this. I can post everything again in this reply:

November 2011: TSH - 5.2 (0.2-4.2)
FT4 - 16.48 (12-22)

The front of my neck swelled up after this test.

February 2012: TSH - 2.2 (0.2-4.2)
FT4 - not done as TSH in normal range

January 2013: TSH - 0.69 (0.27-4.2)
FT4 - not done as TSH in normal range
Thyroid antibodies - 84 kIU/L (no range, no specific antibody)

May 2013: TSH - 22 (0.27-4.2)
FT4 - 10.9 (12-22) -- meds at 25mcg, then 50mcg and then 75mcg

August 2013: TSH - 4 (0.27-4.2)
FT4 - not done as TSH in normal range -- meds at 125mcg

November 2013: TSH - 4.3 (0.27-4.2)
FT4 - 15.3 (12-22)
FT3 - 5.5 -- done privately (3.1-6.8)

So there's a lot of fluctuation in these results and I haven't been on the new dose for very long.

I found it a bit odd that even though I'm within range for B12 it's still considered low. So I'm in the lower range for normal? I know that my doctor would go through my results and just say my B12 levels are normal.

I will be put on Vitamin D supplements by my doctor when I see her in a couple of weeks (I'll be on holiday tomorrow for the whole week) and I've been referred to an endocrinologist in my area.

So with the celiac test, have I not heard back about that because it's come back normal and I've got gluten intolerance instead? It'd make sense since if I eat a bit of gluten I get constipated and if I eat a lot more than that I get diarrhea! Not an ideal thing to have to talk about but it does happen!

Also I have Raynaud's Phenomenon diagnosed by a nurse practitioner at my former practice, but I thought an immunoassay (autoimmune profile) would have shown it up?

I had my glucose (fluoride) tested as well. Not sure if that's the same as the HbA1c test? Well, when I went to the surgery on Tuesday the receptionist I spoke to said this result was high - which made me panic as I knew a high HbA1c result meant I could have diabetes! And diabetes is rife in my family history! It turns out my glucose was at 4.9 (less than 10 is normal) but I did not fast for this. Should I have been fasting for this? I wasn't told to at the time these tests were ordered and I wasn't told to prepare at all.

The info about the gluten resembling the TPO - I actually didn't know about that before! So - not saying that I would - but if I happen to eat more gluten that would increase the TPO antibodies?

I went gluten free for a week and had a significant reduction in symptoms - the constipation has still not fully come back and I was on this diet over 2 months ago. I guess that means something...

Thanks

Jo xxx

[TheLightSeeker]

Sorry, accidentally it submitted! lol!
Stay in touch (I'm pretty busy these days at work, but mid january I should have a bit more time).

Cheers!
Niko

[TheLightSeeker]

Hi Jo. I'm afraid I missed your message somehow.
Red_Star has given you some great info and definitely your B12 levels
are low and you should look into supplementing with sublingual MethyloCobalmin (NOT cyanocobalamin!) asap.

Another thing I want to point out is :
Most hypothyroid sufferers have gluten intolerance and don't even know it!
The gluten molecules resemble the TPO (Thyroid Peroxidase - an enzyme necessary for the signalling Thyroid hormone production) molecules and thus the immune system in its response against gluten, attacks the TPO in the Thyroid also! Forgive me if I have mentioned this to you in the past.
Going gluten free might be something you could consider as a test, but please take note that the effects of gluten may stay in the body for a long time, so do not expect any visible results in just a few weeks, but if you experience improvement earlier, consider it a blessing!

I hope things work out for you!
Stay in touch! (I'm

[Karisma853]

Ok, thanks for this info.

[Red_Star]

In Japan and Europe, the lower limit for vitamin B12 is around 550 pg/mL. The range on the lab report may not be a healthy range.  My lab lists the lower limit for vitamin D at 50 nmol/L. Yet another dodgy lab range. :) Vitamin D council recommend vitamin D levels to be between 125 - 200 nmol/L.

I can't say what your antibody levels would of been with your earlier test results but TSH can fluctuate with Hashimoto's thyroiditis. Excerpt from the book - Why do i still have thyroid symptoms? when my lab tests are normal by Dr Kharrazian...

"Hashimoto's Disease and "Normal" Lab Results

Jan - TSH 4.5
Feb - TSH 0.08
Mar - TSH 2.3
April - TSH 3.8
May - TSH 8.7
June - TSH 7.4
July - TSH 1.6

One reason hypothyroidism goes misdiagnosed is because a person with Hashimoto's can present with normal TSH. This graph illustrates the monthy TSH levels of a person with Hashimoto's who is receiving no treatment. As the autoimmune condition fluctuates, TSH levels vary wildly. Using standard lab range of 0.45 - 4.5 this person would fail to be diagnosed. During the month of March the patient's TSH even falls within functional range 1.8 - 3.0. That's why also testing for immune antibodies and evaluating symptoms and history are so vital."

[Karisma853]

Hi Red_Star, thanks for your reply.

I've had this diagnosis hanging over my head for so long and I just want to be absolutely certain that I am in the early stages of Hashimoto's by explaining my case a little bit more:

November 2011 - TSH: 5.2 (0.2-4.2) FT4: 16.48 (12-22)

Around about 2 months after this test, the front of my neck swelled up. I assumed it was an upper respiratory tract infection so I did not see a doctor about this and took cold and flu remedies to help it go away. This swelling took 3-4 weeks to go down.

February 2012 - TSH: 2.2 (0.2-4.2)

January 2013 - TSH: 0.69 (0.27-4.2) Thyroid antibodies: 84 kIU/L (not sure which ones and no range given)

May 2013 - TSH: 22 (0.27-4.2) FT4: 10.9 (12-22) I was put on thyroxine at 75mcg after this result.

August 2013 - TSH: 4 (0.27-4.2) Ferritin: 15 (30-400) My thyroxine was increased to 125mcg after this result.

November 2013 - TSH: 4.3 (0.27-4.2) FT4: 15.3 (12-22) FT3: 5.5 (3.1-6.8)
My thyroxine was increased to 150mcg after these results.

Does that mean that during the earlier abnormal thyroid function tests my antibodies would have been higher? Also my doctor never mentioned my B12 was low as it's within range, but she's going to be putting me on Vitamin D supplements.

Thanks

Jo xxx

[Red_Star]

You look to be in the early stages of Hashimoto's thyroiditis. TPO antibodies may fluctuate with autoimmune thyroid disease. The top three deficiencies found with hypothyroidism are vitamin D, iron (ferritin is the most sensitive lab test for iron deficiency), and vitamin B12.

Your vitamin B12 is too low in the range. Research has shown vitamin B12 deficiency may occur at 500 to 600 pg/mL (ng/mL).  Without adequate vitamin B12, folate becomes trapped in an unusable form.