Thyroid lab results-do I have a problem?

[alexL103]

Hi, I had a higher TSH in blood work I've had recently, did some more specific ones for thyroid.
TSH is 4.30 uIU/ml (range between 0.40-4.20)
Free T4 13.57 pmol/L (range is 10.00-20.00)
Free T3 6.06 pmol/L (range is 3.50-6.50)
Anti thyroid peroxid <10.0 (don't know what that result means?)
Thyroglobulin 18.9 ng/mL (range is 0.0-55.0)
My doctor said it's ok that my TSH is a bit higher and suggested to check it again in a few monthes.
Should I be concerned?

[gimel]

You need to take enough to raise your ferritin level to 70-100 and then continue as needed to maintain that level.  Of course you can also increase the iron from your diet by eating foods rich in iron.

[alexL103]

Ok, thank you!

[gimel]

I would wait while you try to get the PTH test done.  With your low ferritin you really do need to start supplementing that.  Where are you located?

[alexL103]

For how long do I take supplements for the ferritin?
I'm in Israel

[gimel]

Yes, you can use an Endo.  Just be aware that being an Endo does not guarantee a good thyroid doctor, but at least maybe you can get the testing done.  

[alexL103]

So, I went to the gynecologist today in hopes of getting a referral to an Endo (she started with all these hormonal tests) but she said she does not see any reason to go to him because everything is "working great".

I would like to start with vitamin d but as said, the low vitamid d with calcium 10 could suggest hyperparathyroidism and it could be a problem if I start taking it. Maybe I should start taking it anyway? Is that risky?

Is there any other kind of doctor that I could go to about this and that could give me the additional blood tests done? Family doctor and gynecologist don't help.

[gimel]

Sorry about the confusion over Vitamin D.  You really do need to get that suggested PTH test done before considering supplementing with D3.  If you look at the graphical data in this link I previously gave you it seems that your calcium and D levels fall in the blue zone.

http://www.parathyroid.com/low-vitamin-d.htm

So you can maybe use that graph to persuade your doctor to run a PTH test.  

[alexL103]

Can I go to an endo doctor does he engage in this kind of stuff? Family doctor will not be willing to even look at that and yell again that everything is fine

[alexL103]

By the way, you suggested I might (or not) have hyperparathyroidism because of calcium over 10 and low vitamin D, I read that increasing vitamin D levels increases calcium levels as well, so won't that be a problem?

[gimel]

There is nothing in your testing that indicates your thyroid gland is not working properly.  Any issues are most likely due to other things such as low ferritin, high/low cortisol, and low Vitamin D and B12.

[alexL103]

The one you sent is working, thank you! will start reading.

Another question I have is about why actually the thyroid is not working properly, I've seen a pretty interesting video of a doctor talking about this issue and saying that gut problems, blood suger problems, stress, brain problems and inflammatory responses are some of the things that can damage a thyroid. What do you think of that? Is that correct?

[gimel]

B12 is likely low due for the same reason as D and ferritin:  low stomach acid.

I have sent a PM with the link for you to try again..

[alexL103]

I would like to go to a doctor who is specialized in thyroid issues, the doctor I went to is just my family doctor, but she will need to give me a referral to a thyroid doctor in order for me to see him, which she probably wouldn't do. I will still try to find someone anyways.

I didn't test for B12 btw, or will it be low because of the low ferritin?

Thank you so much for all the help! I would like to do some reading but the link within the link you sent isn't working

[gimel]

Your doctor is a waste of time.  Your thyroid test results and your symptoms are clearly indicative of a problem.  It could be that you only need to get your Vitamin D, B12  and ferritin optimal and then see what the effect is and what needs to be done from there.  In order to get your D optimal I think you will need to take 3000 - 4000 IU of D3 daily.  For the B12 about 500 mcg daily should help.  For the ferritin I think you will need about 75 mg of a good iron supplement daily, along with about 500mg of Vitamin C and 250-500 mcg of Magnesium.   Some good iron supplements are ferrous fumarate, ferrous sulfate, and ferrous bisglycinate.  

I still think you need to check cortisol.  If you are interested enough to do some reading, have a look at this link.  Also, within the link there is a link to a paper on diagnosing and treating hypothyroidism.  I recommend reading at least the first two pages, and then any more that gives you some useful info.  You could also give a copy of the whole paper to your doctor to try and change her mind, but I am doubtful of any progress there, so you need to find a different doctor that will be willing to do more testing and give you a better diagnosis.  

http://www.medhelp.org/user_journals/show/2019570/Diagnosing-Treating-Hypothyroidism-A-Patients-Perspective?personal_page_id=12021

[alexL103]

Also didn't give the full blood work for my mom (I asked here a question for her too) saying there's no need for it all :/

[alexL103]

I'm not from the US unfortunately

[gimel]

Your doctor is wrong on so many things.  

Where are you located?

[alexL103]

So I just came back from the doctor, here's what she said:
About Vitamin D- She said it's always going to be low in blood tests (that doesn't even make sense) because it only produces in the sun, but people try not to be exposed to the sun too much because it's harmfull to the skin so thats the outcome (totally contradicting herself, because last time she said just sit in the sun). She said if I really want to I can take suppelment of 1000 units.

About the ferritin- She said it's within norm even though it's on the very low scale of the norm and there's nothing that could be done.

About the thyroid- She completley denied everything and said to just check TSH in a few monthes. She also refused to give me a request for blood work on cortisol and PTH, and said if the vitamin D is low the PTH will be high.

I have no idea what to do right now, she denies everything and doesn't even give me do more blood work :/

[alexL103]

Ok I will go to back to the doctor next week, thank you very much!

[gimel]

Okay, in summary then I suggest that you get tested for the PTH, and  morning serum cortisol.  Also suggest that you supplement the low ferritin to bring it up to 70.  That should not cause any problem with your iron level.  Be aware  that when supplementing with iron you should stop for several days before a blood draw to test ferritin and iron again.  That prevents false high results.

[alexL103]

The iron test that was high was in 2012, I mentioned it because about a year before I took iron supplements and I think the high iron was because of them.

Calcium was 9-10 at the last 4 years from whar I see.

Iron was 93.9 (range 40-145) and ferritin 12.9 in the tests I did this week.

[gimel]

What were the recent iron  and ferritin test results?

[gimel]

You mentioned a ferritin and % sat test recently, but when was the iron test done taht you said was high?  

For calcium 10 is kind of the level at which they become concerned if it is a regular result from a number of tests.   I think you can see that in the chart in the link I gave you.

[alexL103]

I don't remember how much iron I took nor how much vitamin C was in it.

Ok I will talk to my doctor about the supplements and additional blood work, will definitely start on the vitamin D at least.
But if my iron is fine now (yet ferritin low) will taking supplements take the iron to a too high of a level?

[alexL103]

And why is it bad the calcium is over 10? It is within range

[alexL103]

Do i have to test the iron and ferritin again? Just did them a few days ago

[gimel]

How much iron were you taking, by the way?  How much Vitamin C was in it?

Those reactions are not unusual when starting on iron supplements.  It can usually be avoided by taking adequate Vitamin C and magnesium along with the iron.  

I don't really understand how you could have serum iron at top of range, and ferritin at the bottom of its range.  If you look at the following link it shows a matrix of various disease conditions that correlate with various test results for iron, TIBC, % saturation and ferritin.  There is none that show a high iron with a low ferritin.  So, I'd suggest that you get those tested again.  A low ferritin could be contributing to your symptoms.  Along with that don't forget a morning serum cortisol test.  

With a continuing calcium over 10, along with a low Vitamin D level, I suggest that you look at this link about how those two conditions could be an indication of hyperparathyroidism.  So I suggest that you also get a Parathyroid Hormone (PTH) test done just to rule it in or out.  

http://www.parathyroid.com/low-vitamin-d.htm

[alexL103]

Also the iron I took was already with vitamin C in it.

[alexL103]

First diarrhea for the first days/week then constipation and some nausea.
And yes I find it strange too but these were the results, I have all lab tests for the last 6 years in my medical account in the computer. They were taken in 2012, iron 151.7 (range 40-145) and ferritin 12.1 (range 10-291).

Do you mean calcium result back then or now? If then it was 10.16 (range 8.50-10.50). If now it's 10.11.

[gimel]

Please explain the "really bad" that you experienced with iron supplements.  Was it constipation?  Also I can't understand how you could have low ferritin but too much iron.  Doesn't compute.  Do you have the lab test results?

What was your calcium test result?