Need help with bloodwork interpretation

Hormones
1

Hi,

I have had symptoms of being excessively fatigued, nearly intolerably cold hands/feet in winter, joint pain, complete inability to lose weight despite 1500 calorie diet and working out 5 days per week at the gym, headaches, and more for several years.  I have been telling my doctor for years as she gets on to me about my weight and cholesterol that I am TRYING, but nothing is working.  I am using the diet and exercise plan she gave me, I have a personal trainer at the gym, I keep food diaries etc.  She has tested my thyroid several times (partially) though it always comes back as within the normal lab ranges.  Because I still feel horrible and can't lose the weight, I requested a referral to an endocrinologist though she felt this unnecessary.  The endocrinologist used the bloodwork my doctor had ordered a month prior and said that due to a mild anemia pattern he would test my iron and thyroid antibodies.  He said that given my TSH has steadily rose in the past few years and my free T4 level had fallen, he would put me on a low dose of thyroid medicine for 3 months to see if I improved.  When his new bloodwork came back that he ordered, he had his nurse call and say that iron levels and thyroid antibody levels were normal, therefore I had no thyroid problem and did not need to return to his office or any thyroid medication.  I was quite upset because he told me prior that he thought I would benefit from a trial of the medicine and then completely dismisses me without being able to discuss the change in our plan!  At any rate, he also failed to order an updated free T4 as the one in my chart was from one year ago!  I have also never had Free T3 or any of the other tests done.  Please help me by looking over my lab results and let me know if this is worth trying to find another endocrinologist or Primary Care Doctor or if you have any other suggestions.  Thank you in advance for any help or insight you can provide! 

TSH:

2013- 2.34

2014- 2.99

2016- 3.51  (reference range: 0.27-4.20)

Free T4:

2014- 0.75 (Range:  0.65-1.40)

2015- 0.65  

Thyroid Peroxidase Antibodies:

2016-  6.0 (Range: <9)

Thyroglobulin AB:

2016- <1 (Range: < or = to 1)

Iron Tests: (All done last week)

Ferritin- 104 (Range: 13-150)

Iron- 101 (Range: 37-145)

Iron Binding Capacity- 330 (Range: 255-450)

% Saturation- 31 (20-50%)

Vitamin D:

2015- 17  (Range: 30-100)

2016- 29 (This is with me taking 2000 IU of D3 per day)

Various other Lab results:

2016- Anion Gap- 20 (Range: 12-20)

2015- Anion Gap- 11 (Range 12-20)

2016- RBC- 3.8 (Range: 3.9-5.03)

2015- RBC- 3.99

2014- RBC- 4.10

2016- Hemoglobin- 11.9 (12.0-15.5)

2015- Hemoglobin- 12.4

2014- Hemoglobin- 12.9

2016- Hematocrit- 36 (35-45%)

2015- Sodium- 134 (Range: 136- 145)

2016- Sodium- 137 (Range: 136-145)

I know that is a lot of info, but does it ring a bell for any patterns or anything that you can see?  I really don't know if I should try again or accept the endocrinologist' assessment as is.  I am tired of being so tired and working on my weight and cholesterol only to have no change at all.

Thank you for your time.

2

Hi, I have a couple if comments that may help. Firstly, do get your vitamin B12 and folate levels tested. People are often low in this anf being so will give you a type of anaemia ans symptoms such as being fatigued and cold.

Another idea is ask to see a haematologist. An endocrinologist specialises in hormones, a haematologist specialises in blood related disorders. The reason I'm suggesting this is because of the slow gradual deterioration in many of your blood test results and that some of them are at the bottom of the range or just below.

Do let us know what you decide to do and how you get on.

3

Hello Christina

My name is Shelly and I am a nurse in the USA.  I have Hashimoto's thyroid disease .

I will disuss the abnormal results  here:

 VIT D  Needs to be a tad higher  some people take 3000 IU or higher.  VIT D   goes low as we age. We do not make enough from Sunlight after age 30 or so. You can add more VIT D foods in your diet.  Low D makes you tired also.  I also take 2000IU but some need more than that.

HGB -Hemoglobin needs to be a bit higher  so take a Multiviatmin w/ iron and that will help & so will some red meats and Liver is loaded with iron. Spinach is also.

It will help you make more RBC's and it takes 3 week to make new RBC' s. Low HGB & RBCs makes you tired so do eat more iron foods.

The rest are okay blood values. That is good about your thyroid as it is normal.

Shelly

4

I'm a licensed nursing assistant and from what I can Dee it looks as if all of your levels except your vitamin d looked within the Normal range..even if something is slightly elevated usually it can have something to do with the beginning/ end of menstrual cycle or starting of menopause. Hormones can fluctuate somewhat pretty regularly and uusuallywe don't even realize it.. some times you may feel more tired than usual or have hot flashes or other tale tale signs that something isn't right with your levels.. most doctors don't want to start hormone therapy unless absolutely necessary because of the increased risk of cervical cancer and other serious side effects. SaMe with thyroid therapy.. unless the levels are extremely elevated they prefer to try other forms of treatment prior to starting.. it is frustrating..I am a 28 year old female and my t4 is 23 normal range is 300-400 and my doctor won't put me on estradiol( low dose hormone replacement) because of the risk.. I feel at times like I'm not being herd and I'm not the one in control of my health issues.. the hyperthyroidism and thyroid issues go hand in hand..usually you get one with the other because unlevel hormones will trigger other problems.. if you can somehow get this doctor to treat the hormones you can almost guarantee that the thyroid issues will even out with time and the proper diet.. I know the struggle of going through this, sometimes the symptoms are almost to much to bear and for me it has triggered shortness of breath and extreme anxiety.. all of which are normal side effects of low Hormones..I have the opposite of you , hypothyroidism and I can't gain any weight.. I have dropped so much that I feel unhappy and unhealthy.. I also have low hormone levels, low vitamin d and and a blood disease that causes an overproduction of iron in my blood so they gave to drain a Half pint or so every month.. it has been difficult. If your not happy with your health care provider or the answers or lack thereof that you received you have the right to another opinion.. Also check into different homeopathic alternatives too.. if your vitamin levels are still not on Trac with the supplements it could be because without the proper food intake of vitamin rich foods is is extremely hard for the vitamin d to be enough on its own.. make sure your diet is full of healthy foods.. sunlight is very important to vitamin d absorbson 15 minutes a day for a week might be a good way to boost those levels.. I know it difficult to not want answers and help right away.. maybe trying some natural resources would be beneficial to you .then after a trial period you can always go back and get 're tested.. please know I'm not a doctor..all this information is based on what I learned from nursing school and from my personal experience.. I hope you find the help you need.

5

You seem to have a LOT in common with MANY people in the UK, getting full thyroid tests on the NHS is often a major challenge and being that bit under par you get dismissed very easily. What usually happens at the Public Health lab is the other tests are not even carried out unless one or other is fully under the range, even if the GP specifically requests it to be done.

Vitamin D is (still!) well under optimal levels, (that word NORMAL is a curse! Forget about it, you want things to be OPTIMAL) but I would not suggest suppmenting the bigger amounts you probably need unless you also supplement vitamin K2 - NOT vitamin K (search for info!) as it has a bad habit of affecting Calcium transport and it can migrate from the bones into the bloodstream, not the best a good idea!

There is a lot of info (I won't post the web site address as it usually ends up putting this post in a long moderation queue), but there is a site for Thyroid UK which has a lot of help for the likes of you (and me!!) You are far from alone sadly, and most Endocrinologists are pretty lousy when it comes to helping unfortunately. There are some however that have a far better track record.

Something going on with that Sodium level and anion gap levels too... when one of the blood electroytes is very low as yours is it is often the case that other blood electrolytes (eg. calcium or  Magnesium or Potassium may be less than optimal too so well worth having those checked too. it is VERY common in any case for Magnesium levels to be low, in fact more common than not.

To be sure thyroid is optimal,(even if you get thyroid replacment) the right vitamins and minerals have to be in place, if you search: Role of Vitamins and Minerals in Thyroid Disease, you will see the thyroid  uk page that gives more info, and there is a alot of other info out there on it too.

Unfortuinately if you are not an easy stereotypical thyroid case in the UK you won't find getting sorted anything like as easy as it SHOULD be! The only way out is to educate yourself and find out as others have done to remedy this common situation.

6

Hi,

​Like Barbara, I was going to suggest Vitamins/Minerals to try. I have been keeping UAT at Borderline for 10 years with Vitamins/Minerals/Kelp and Diet. 

​Now i am over borderline and fighting to stay off Thyroxine as I struggle to take Synthetic drugs of any kind. I am worried by all the side effects you read about on this site, especially as i have no symptoms at present.