TSH & CBC Results Consultation

[saikatde]

My mother (age: 55+ yrs) is a patient of Hypothyroidism. She had Goiter earlier, for which she had undergone surgery in Jan, 2000. She currently has to take one tablet of Eltroxin 50mg daily. Recently she had a TSH test, which shows a value of 4.38, where normal lab range is 0.27 - 4.2. She has done same TSH test last in Oct, 2007 where the value was 3.01, while the lab reference range was up to 6. In 2006, her TSH value was 3.66 in a lab, where reference range was up to 6. Since currently her TSH level is a little higher than normal, our doctor advised her to take 1.5 tablets of Eltroxin 50mg daily, instead of one tablet.

Couple of months back she had a fever with cough. As advised by doctor, we have done her CBC tests, results of which are mentioned below -
Haemoglobin : 12.1 (Range 12.5 - 16.00)
Packed cell volume : 37.3 (R 37-47)
RBC Count : 4.17 (R 4.2 - 5.4)
Mean corpuscular volume : 89 (R 78-100)
Mean corpuscular haemoglobin : 29 (R 27-31)
Mean corpuscular haemoglobin concentration : 32.4 (R 32-36)
Total leukocyte count : 8900 (r 4000 - 10500)
Neutrophils : 74% (R 40 - 75)
Lymphocytes : 18 (R 20 - 45)
Eosinophils : 03% (R 01 - 06)
Monocytes : 05% (R 02 - 08)
Basophils : 00% (R 00 - 01)
Platelet count : 1.5 lakh/cu.mm (R 1.5 - 4.5)
ESR : 88 mm/hr (R 0 - 30)

Recently we have again done her few tests, results of which are mentioned below -
Current haemoglobin : 11.4 (R 12 - 16)
Current ESR : 29 mm (R < 30 mm 1st hr)

She recently developed a high BP (160/110), for which medication (Olsar 40mg tablet) has been started. Also, she has osteoporosis due to vitamin-D deficiency (around 14 ng/ml), for which she is taking medicines (vitamin-D, potassium & phosphorous tablets) as per advice of an orthopedic doctor.So as an overall review, is there anything to worry about & does she need any further check up or treatment ? Is this high BP (160/110) a result of vitamin-D deficiency (14 ng/ml) or there could be some other reasons behind ?

[Barb135]

Blood pressure can vary from one time to another and there are a variety of things that can cause high blood pressure.  Is your mother's blood pressure always that high or is it sometimes lower?

Has your mother's entire thyroid been removed?

Is TSH the only thyroid test your mother is getting?  She should also be getting the Free T3 and Free T4 tests.  FT3 and FT4 are the actual thyroid hormones and are the best tests for determining dosage requirements.

[Red_Star]

Low haemoglobin is associated various diseases and conditions including hypothyroidism. Has free T4 and free T3 levels been tested to make sure they are in optimal range?

[Red_Star]

Did the blood pressure start after vitamin D supplements?  Low magnesium is one cause of high blood pressure.

Excerpt from Know the Importance of Taking Enough Magnesium with Your Vitamin D...

"Vitamin D, just like all other nutrients, works in harmony with several other nutrients to perform its many functions. Most importantly, vitamin D requires and 'uses up' magnesium to convert from supplements or sun into its active form in the blood. As such, it is a big mistake to simply take large doses of Vitamin D without taking the need for magnesium into consideration."