blood tests

[Guest guest]

A serum ferritin of only 26 is extremely low and yes, your GP

should not be ignoring it. You need to raise this level as quickly as possible.

Ask at your local health food store to let you know which of their iron

supplements contains the most elemental iron and follow the instructions.

Whatever form of iron you decide to take, concentrate also on taking in food

supplements that have a high iron content. At the same time, take high doses of

vitamin C with any iron you take. Doctors usually prescribe Ferrous

Sulphate or Ferrous Fumerate.

What was your TSH result Kat.

Luv - Sheila

I just got a print of my recent blood tests. My

GP said everything was normal except TSH, but several other things say

'abnormal' after them.

However, of most interest to me was serum ferritin.

26 microg/L (23-300) -there is no comment on the printout

I read the PDF in the files - I wondered where the treatment pattern suggested

had come from. Should my GP be treating this even though it is within range? Or

should I get myself an over-the-counter iron supplement?

Regards,

Kat

[Guest guest]

hello kat

> I just got a print of my recent blood tests. My GP said everything was normal

except TSH, but several other things say 'abnormal' after them.

> However, of most interest to me was serum ferritin.

> 26 microg/L (23-300) -there is no comment on the printout

i would want to ask this gp why i was told everything was *normal* when x, y or

z clearly state *abnormal*...no emotion, just stick to the facts ... " i was told

x, y or z were normal but results sheet show otherwise " " could you explain the

implications of the *abnormal* results for me please? or ignore the fact that

you were told they were normal and just ask for information on the implications

of the abnormal tests. it seems like some gps are so stressed out that they

miss many easy opportunities to help their patients.

your ferritin fell within the reference range so i suppose that is why there is

no comment.

what were the abnormal tests results? what was your tsh?

trish

>

> I just got a print of my recent blood tests. My GP said everything was normal

except TSH, but several other things say 'abnormal' after them.

>

> However, of most interest to me was serum ferritin.

> 26 microg/L (23-300) -there is no comment on the printout

>

> I read the PDF in the files - I wondered where the treatment pattern suggested

had come from. Should my GP be treating this even though it is within range? Or

should I get myself an over-the-counter iron supplement?

>

> Regards,

> Kat

>

[Guest guest]

Hi Trish,

Thanks for the reply. Yes I could do that, but I'm more interested in staying

off anti-depressants at the moment.

TSH <0.01 (0.35-3.50)

Serum free T4 21 (8-21)

Serum free T3 4.5 (3.8-6.0)

I was on 200 microg/day thyroxine, and have agreed to cut to 200 and 175 alt

days as when they asked me to cut to 175 per day last spring, it was disasterous

at work. GP this time warned me I could lose my sight and I got worried and

agreed to a lesser cut, but not to the same cut as before.

Is there any/much risk to the eyes from TSH of <0.01 and therefore a diagnosis

of too much thyroxine? (last spring, my TSH was measurable, but below ramge and

it was a phone call from someone who was not a Dr and for some stupid reasong I

felt I could not discuss it with her as she was not a Dr. After 6 weeks I went

back and successfully argued for the increase again.

I googled the items not normal and they relate to kidney disease and liver

disease. but are minorly out of range. The other interesting thing is that when

I asked him for the free T4 level, he said it wasn't done but when I got the

print, which I haven't ever had before, and had a little trouble getting, there

it was and T3 too. Do they not give the GP the full list of results?

This is a long reply, sorry, but I'm a little confused at this GP.

>

> > I just got a print of my recent blood tests. My GP said everything was

normal except TSH, but several other things say 'abnormal' after them.

>

>

> what were the abnormal tests results? what was your tsh?

>

[Guest guest]

Hi Sheila,

Sorry I missed your reply earlier, here are my thyroid results:

TSH <0.01 (0.35-3.50)

Serum free T3 4.5 (3.8-6.0)

Serum free T4 21 (8-21)

I have reduced T4 from 200 per day to 200, and 175 alternate days as GP

suggested I could lose my sight and I have been quite jittery. He also told me

there was no FT4 test done. Not happy really, but got test results under

slightly false pretenses. Ooops.

Kat

> A serum ferritin of only 26 is extremely low and yes, your GP should not be

> ignoring it. You need to raise this level as quickly as possible. Ask at

> your local health food store to let you know which of their iron supplements

> contains the most elemental iron and follow the instructions. Whatever form

> of iron you decide to take, concentrate also on taking in food supplements

> that have a high iron content. At the same time, take high doses of vitamin

> C with any iron you take. Doctors usually prescribe Ferrous Sulphate or

> Ferrous Fumerate.

>

> What was your TSH result Kat.

>

> Luv - Sheila

>

> However, of most interest to me was serum ferritin.

> 26 microg/L (23-300) -there is no comment on the printout

>

[Guest guest]

Hi - can someone remind me which are the best blood tests to request for checking my thyroid function please? I have a doctor's appt tomorrow

Thanks

[Guest guest]

Hi ,

I'm not sure whether you have had any tests before or not. Anyhow, the tests to

ask your doctor for are as follows:

TSH

Free T4

Free T3

If you haven't checked for autoimmune disease, you may also want to ask for a

Thyroid peroxidase antibody (TPOAb)test.

http://labtestsonline.org.au/understanding/analytes/thyroid_antibodies/glance.ht\

ml

I usually skip the dose prior to my blood test and I always try and have the

tests done at the same time of day (in my case, as early in the morning as

possible). I read somewhere that having the tests early in the day is a good

thing, but I cannot remember where I read it, but I have all my tests at about

8am and at 9am at the latest.

P

>

> Hi - can someone remind me which are the best blood tests to request for

checking my thyroid function please?  I have a doctor's appt tomorrow

>  

> Thanks

>  

>

>

[Guest guest]

Hello

You need free T3, free T4, TSH, and tests to check to see

whether you have thyroid antibodies. These are TPO and TgAb. At the same time,

ask your GP to test your levels of :

Low iron/ferritin: Iron deficiency is shown to

significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block

the thermogenic (metabolism boosting) properties of thyroid hormone (1-4).

Thus, iron deficiency, as indicated by an iron saturation below 25 or a

ferritin below 70, will result in diminished intracellular T3 levels.

Additionally, T4 should not be considered adequate thyroid replacement if iron

deficiency is present (1-4)).

1.

Dillman E, Gale C, Green W, et al.

Hypothermia in iron deficiency due to altered triiodithyroidine metabolism.

Regulatory, Integrative and Comparative Physiology 1980;239(5):377-R381.

2.

SM, PE, Lukaski HC. In

vitro hepatic thyroid hormone deiodination in iron-deficient rats: effect of

dietary fat. Life Sci 1993;53(8):603-9.

3.

Zimmermann MB, Köhrle J. The Impact of

Iron and Selenium Deficiencies on Iodine and Thyroid Metabolism: Biochemistry

and Relevance to Public Health. Thyroid 2002;12(10): 867-78.

4.

Beard J, tobin B, Green W. Evidence for

Thyroid Hormone Deficiency in Iron-Deficient Anemic Rats. J. Nutr.

1989;119:772-778.

Low

vitamin B12: http://www.ncbi.nlm.nih.gov/pubmed/18655403

Low

vitamin D3: http://www.eje-online.org/cgi/content/abstract/113/3/329

and http://www.goodhormonehealth.com/VitaminD.pdf

Low

magnesium: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292768/pdf/jcinvest00264-0105.pdf

Low

folate: http://www.clinchem.org/cgi/content/full/47/9/1738

and http://www.liebertonline.com/doi/abs/10.1089/thy.1999.9.1163

Low 

copper/zinc:http://www.istanbul.edu.tr/ffdbiyo/current4/07%20Iham%20AM%C4%B0R.pdf

and http://articles.webraydian.com/article1648-Role_of_Zinc_and_Copper_in_Effective_Thyroid_Function.html

I

have added some references to the scientific research in case your doctor tells

you that there is no connection between low levels of these minerals and

vitamins and the symptoms of hypothyroidism.

Good

luck - and when the results come back, don't forget to get them, together with

the reference range for each of the tests done and post them on the forum, so

we can help with interpretation.

Luv

- Sheila

Hi - can someone remind me which

are the best blood tests to request for checking my thyroid function

please? I have a doctor's appt tomorrow

Thanks

[Guest guest]

Thanks for my replies on the blood tests everyone

Will let you know how I get on

[Guest guest]

Hi all am a newbie.

Hypothyroid diagnosed in 1996 ....am on 150 mcgs a day of levothyroxine and a

monthly B12 injection and cipralex. Weight piling on despite a vlcd. Have asked

for full range of thyroid blood tests. Practice Nurse said only TSH will work as

others are affected by thyroxine tablets s. Any advice out there for me. Weight

gain , exhaustion and aching .....

[Guest guest]

So,

thyroxine tablets don't affect the TSH eh!

wonder,

then,

why doctors are prescribing levothyroxine? I thought the whole idea was to

bring TSH to within the normal reference interval!

Perhaps

you should show the following to your Practice Nurse to help her update her

information and to show her the many conditions that can depress or elevate TSH

and exactly how UNRELIABLE TSH testing alone is. Even the BTA state

categorically in their 2006 Guidelines that TSH should be done TOGETHER with a

measure of free T4 - but we, the patient, and doctors who work outside of the

NHS guidelines, state categorically that free T3 should also be tested,

otherwise, how can a doctor tell whether or not their patient is suffering

with low levels of thyroid hormone secretion by the thyroid gland

or peripheral resistance to thyroid hormone at the cellular level? I

would be tempted to ask this nurse why she chooses to go against the BTA and the

Association of Clinical Biochemists Guidelines on Thyroid Function Tests 2006

and ask her what she knows, that they don't.

Take

her the long list of references below - and ask her to produce such scientific

evidence to back up her assertion that ONLY TSH is needed to test for serum

thyroid function. She is not taking into account those who's thyroid gland is

secreting the correct level of thyroid hormone that is not getting into the

cells where energy is produced. It's time we patient's started to

question our medical practitioners and challenge them with the facts - this is

the only way we are going to get through to them.

Conditions or factors that depress serum TSH are

aging, [1,2] fasting, [3-6] strenuous physical activity,[7] pregnancy,[8]

depression and anxiety disorders,[9-13] Non-thyroidal diseases: diabetes

mellitus, Cushing’s syndrome, renal failure, cancer, myocardial

infarction, AIDS, post-traumatic syndromes, chronic alcoholic liver disease,

other illnesses,[14-28] Medications: thyroid therapy, estroprogestative birth

control pills, progestogens, anti-inflammatory agents (incl. glucocorticoids

and aspirin), antidepressants, L-Dopa, bromocriptine, neuroleptica,

anti-hypertensives, antiarrhythmics (amiodarone), hypolipemic agents, IGF-1,

somatostatin, etc.[28-46] toxic foods: MSG, alcohol,[47-49] Thyroid diseases: hyperthyroidism,

Graves-Basedow disease, nodular goitre, thyroiditis, secondary or tertiary

hypothyroidism, congenital hypothyroidism,[50-53]

Factors that elevate TSH are: Neonatus, stress -

emotional arousal, cold exposure, sleep deprivation, adrenal insufficiency,

recovery from severe illness, congenital malformations,[54-61]Medications: iodine,

antithyroidea, lithium, neuroleptica (haloperidol, chlorpromazine), cimetidine,

sulfapyridine, clomifen, antidepressants (sertraline), antihistaminic agents,

cholestograhic agents, etc.[62-65] Auto-immune thyroiditis and hypothyroidism: primary,

iodine-deficient, thyroid hormone resistance[66-70], TSH-secreting tumours

(rare),[71]77). There are also many factors that depress and elevate serum TSH:

Physiological serum TSH fluctuations, [72-78]) variations in the biological

activity of TSH. [79-81] There are, of course, TSH test kit imperfections,[82-96]

Thyroid function blood test results can be

influenced by many factors, any of which should be taken into

consideration, e.g.

·

Labelling errors

·

Bacterial

contamination

·

Yeast/Fungal

contamination

·

Clotting

·

Sampling errors

·

Sample

preparation errors

·

Sample storage

errors

·

Thermal cycling

·

Antithyroid

antibodies (any)

·

Antibodies from

any other cause

·

Presence of

specific ‘toxins’ in the blood

·

Presence of

pharmaceutical drugs (interferences) within the blood

·

The method of

analysis being carried out eg radio-immune assay (RIA)

·

‘Systematic’

errors in analytical equipment or methodology

·

Composite errors

<> pre-analysis (not mentioned above)

·

MCT8 mutations

It is also known that thyroid

function tests will be normal also in patients who have a proven carcinoma. Both

the T4 and TSH value can be misleading in such cases.

Many individuals with classic symptoms of

hypothyroidism, such as low body temperature, joint pain, fatigue and

depression, are discouraged when they’re told that their thyroid hormone

levels are within the normal range. The question of whether they might be

resistant to their body’s own thyroid hormone is seldom considered. Yet,

a disease known as thyroid hormone resistance can prevent thyroid hormone from

reaching the body’s cells.

The discovery of MCT8 mutations explains

laboratory discrepancies [96] e.g. cases in which the lab results didn’t

fit a particular pattern. It also explains how thyroid hormone resistance

can cause TSH to appear normal even with a low FT4. In many instances

only the TSH test is performed. If the TSH result is normal, and symptoms of

hypothyroidism are observed, tests for FT4, FT3 and T3 should all be performed.

None of these types of error are ever shown as

being part of the reference range, but they all add to the unquantifiable

‘unreliability’ of the final number that appears on a lab report;

stated to be within/outside a reference range. The labs expect, but often don’t

get, notification of antibodies found by other labs or by investigations

showing antibody activity, to enable proper screening (dilutions) for likely

errors. e.g. vitiligo, alopecia, ongoing autoimmune symptoms specific to such as

lupus, autoimmune attacks on specific organs, histology samples, haematological

examinations.[97] A search on Pubmed shows 126 such cases.

You go girl - and btw - welcome to our forum

where I sincerely hope you get all the help and support you need.

BTW, if your surgery still refuse to give you

the thyroid function tests you need (including tests to see whether you have

antibodies to your thyroid (TPO and TgAb) you can get these tested privately. Information

about 'Discounts on Tests and Supplements' in our FILES section on this forum.

Luv - Sheila

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Hi all am a newbie.

Hypothyroid diagnosed in 1996 ....am on 150 mcgs a day of levothyroxine and a

monthly B12 injection and cipralex. Weight piling on despite a vlcd. Have asked

for full range of thyroid blood tests. Practice Nurse said only TSH will work

as others are affected by thyroxine tablets s. Any advice out there for me.

Weight gain , exhaustion and aching .....

[Guest guest]

Sheila replied to this mail with a very long expose to show to my practice

nurse!!!! THANK YOU SHEILA!!!!!!!!!!!!!

Anyway when I went for my monthly B12 shot yesterday I talked to her about the

TPA and other groups and the fact that they were recommending other than the T4

tests.That there was a link between PA and Hypothroidism. She did a complete

about turn - told me to give her copies of info, that she appreciated patients

who wanted to be well informed and that she would discuss, once having read the

info, with the Dr -that I have the additional tests - and also self inject with

B12.

Watch this space !!!!

>

> Hi all am a newbie.

> Hypothyroid diagnosed in 1996 ....am on 150 mcgs a day of levothyroxine and a

monthly B12 injection and cipralex. Weight piling on despite a vlcd. Have asked

for full range of thyroid blood tests. Practice Nurse said only TSH will work as

others are affected by thyroxine tablets s. Any advice out there for me. Weight

gain , exhaustion and aching .....

>

[Guest guest]

Ian,

I had (and still have) the same problem. My TSH was 1.6 but my T4 was right at the bottom of the range like yours. I was on 100 mcg thyroxine at the time and had been for about 10 years prior to this happening.

In the end, because my doctor was saying it was not my thyroid as TSH was within range I went and had the tests done by a private laboratory. This showed that my T3 was below range.

But even when I showed my GP that the T3 was below range I was told they took no notice of T3.

So I ended up going to a private doctor who prescribed T3 for me, but it took me nearly a year to feel really well again every day, although I understand others get there quicker.

My blood tests still show a low TSH even if my T4 and T3 are low. I can only think I might have a lazy pituitary or the pituitary is getting the correct amount of T4 and T3 but the rest of me isn't.

Lilian

My blood tests came back today with the following results:TSH: 1.2 Range: 0.345 to 5.60 mlU/LT4: 7.5 Range: 7.5 to 21.1 pmol/lUnfortunately, they did not carry out the T3 test.

[Guest guest]

Why does it have to be such a fight!?

Its bad enought feeling unwell in the first place but to have to keep battling

the doctors is crazy.

Thank goodness there are groups like this to keep people informed.

It seems to me to be a case of having to find the right doctor.

Thanks

Ian

> In the end, because my doctor was saying it was not my thyroid as TSH was

within range I went and had the tests done by a private laboratory. This

showed that my T3 was below range.

>

> But even when I showed my GP that the T3 was below range I was told they took

no notice of T3.

>

> So I ended up going to a private doctor who prescribed T3 for me, but it took

me nearly a year to feel really well again every day, although I understand

others get there quicker.

>

>