Thyroid Blood Tests – What’s in a full Thyroid Blood Panel?

Thyroid Blood Tests – What’s in a full Thyroid Blood Panel?

The TSH – Thyroid Stimulating Hormone test is also known as the TFT blood test.
Although this is called the Thyroid Function Test (TFT) it only tests for the one hormone.

This hormone is a secretion from the Pituitary hormone and not your Thyroid.

It is a messenger hormone and its release is stimulated further upstream by another hormone from the Hypothalamus called the Thyrotropin Releasing Hormone TRH.

The release of TRH is caused by the lack of hormone being detected in the body.

Once the Thyroid has been stimulated it will excrete from its’ stores of hormone. Mainly T4 and some T3 will be released into the blood stream.

Thyroxine, T4 is a combination of a small protein molecule, amino acid, of Tyrosine attached to 4 mineral molecules of Iodine.

Once the T4 is released into the blood stream it circulates the body. A molecule of Iodine will be cut off from the T4 by an enzymes called deiodinase. It then becomes the active hormone T3 or changed again by different deiodinase into T2 or the alternative of RT3 – Reverse T3.

RT3 or Reverse T3, is the mirror image of Active T3 and it is this hormone that will block the activity of the active T3. RT3 is commonly elevated in times of stress or too much medicated Thyroxine.

There are three Thyroid antibodies to test for:

Thyroperoxidase Antibody, TPOab

Thyroperoxidase is the enzyme that takes hydrogen peroxide that is made in the Thyroid cell and breaks it apart into Oxygen and Hydrogen. The Oxygen is then used to turn the Iodide into Iodine before it attached to the Thyroglobulin prior to the formation of T4. As you can imagine, if there are antibodies involved in this process with Hydrogen Peroxide involved there will be excessive inflammation and toxic damage. That is why TPOab is considered most aggressive and damaging of the Thyroid gland.

ThyroGlobulin Antibody, TGab

The Thyroglobulin is a large protein molecule that is made within the Thyroid cell and becomes the backbone on which the newly made T4 and some T3 are attached. This protein molecule takes the hormones from the central colloid reservoir back to the external cell wall where the Thyroglobulin is dissolved and the T4 and T3 are released and excreted into the blood stream. The antibodies will work against this protein molecule.

Thyroid Receptor Antibodies, TRabs

The TSH attaches itself to the Thyroid Receptors on the external cell wall. This in turn stimulates the production of the Thyroid hormones. If these receptors are over stimulated then the production of Thyroid hormone increases such in the case of Graves disease where there are too much Thyroid hormone sent around the body.

If you’d like to know more about this or other topics, you are welcome to join my free membership on face book. Thyroid, Metabolic, Hormone Harmony Hub. 

I’d love to see you there

Inspiring Wellness

 

Beth 

Why will my Dr only test TSH?

Why will my Dr only test TSH?

Many of my clients come to see me who have seen their Dr time and time again as they are suffering from the symptoms of having low thyroid hormone.  It is partially frustrating for them, that after pathology is completed with me, they find out they have Thyroid Antibodies pointing to the auto-immune disease, Hashimotos.

So why don’t the Dr’s test more than the TSH?

Medicare is your answer.  The Dr’s are bound by specifics and it not their fault.

For the costs of a test to be covered on Medicare they have certain rulings around what test will be covered.

For Thyroid there are a few different rulings:

 

Item 66716

For Thyroid, this ruling states 66719: TSH quantitation

Thyroid function tests (comprising the service described in item 66716 [above] and 1 or more of the following tests – free thyroxine, free T3, for a patient, if at least 1 of the following conditions is satisfied:

(a) the patient has an abnormal level of TSH; [See Rule 9 below – it says “outside the normal reference range”]

(b) the tests are performed:

(i) for the purpose of monitoring thyroid disease [it has been previously diagnosed] in the patient; or

(ii) to investigate the sick euthyroid [a normal thyroid that is affected by an illness or accident] syndrome if the patient is an admitted patient; or

(iii) to investigate dementia or psychiatric illness of the patient; or

(iv) to investigate amenorrhoea [when you don’t get a period] or infertility of the patient;

(c) the medical practitioner who requested the tests suspects the patient has a pituitary dysfunction;

(d) the patient is on drugs that interfere with thyroid hormone metabolism or function (Item is subject to rule 9)

 

Rule 9:

Thyroid function testing

9. (1) For item 66719: abnormal level of TSH means a level of TSH that is outside the normal reference range in respect of the particular method of assay used to determine the level.

9. (2) Except where paragraph (a) of item 66719 is satisfied, the amount specified in the item is not payable in respect of a pathology service described in the item unless the pathologist who renders the service has a written statement from the medical practitioner who requested the service that satisfies subrule (3).

9. (3) The written statement from the medical practitioner must indicate:

(a) that the tests are required for a particular purpose, being a purpose specified in paragraph (b) of item 66719; or

(b) that the medical practitioner who requested the tests suspects the patient has pituitary dysfunction; or

(c) that the patient is on drugs that interfere with thyroid hormone metabolism or function.

So, that is why you won’t get more out of your Dr because he is scripting for you for tests that will be paid under Medicare. So they are doing as much as they can within Medicare boundaries.

It may be more convenient (cost and time effective) to get a full thyroid profile done through a functional practitioner.  This saves your Dr having to justify and conform to Medicare’s ruling and saves you time of two Dr’s visits plus your time off work to do so – one for the initial appointment and the second to go back for the results before you are able to take action on them with your functional practitioner. 

If you’d like to know more about this or other topics, you are welcome to join my free membership on face book. Thyroid, Metabolic, Hormone Harmony Hub. 

I’d love to see you there

Inspiring Wellness

 

Beth  

Reference:

Medicare Benefits Schedule Book

Category 6
Operating from 1 January 2019 

http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/1E8EDDDB20264E41CA2583610081D914/$File/201901-Cat6.pdf

 

 

 

 

Iron Pathology

Iron Pathology

Iron itself is not the most accurate test as it fluctuates with food intake and inflammation. So it is tested with other blood values for a comprehensive assessment.

 

Iron

Is the amount available in the blood for the body to used. Remember this maybe caused by direct blood loss, whether that be monthly or abnormal bleeding inside the digestive system – stomach by ulcers, NSAIDS, intestines by hookworm, and large bowel by tumours, ulcerative colitis and haemorrhoids.

Or you may not be having enough iron in your diet or unable to absorb it due to low stomach acid or the use of Ant-acids.

 

Transferrin

Tells us how hungry your cells are for Iron and we can think of this like an Iron Taxis

High levels may indicate that the cells are looking for more Iron and have the Iron Taxi’s at the read and waiting to be filled with Iron.

A high transferrin may indicate:

  • Iron deficiency
  • High Oestrogens
  • Using the OCP
  • Pregnancy
  • Hypothyroidism
  • B12 or folate deficiency
  • Acute liver disease

Low Levels of the Transferrin are usually because there is a drain on the supply, just like at midnight when you want a Taxi home and there are none available.

  • Chronic inflammatory and liver disease
  • Malabsorption
  • Malignancy
  • Kidney disease
  • Thyrotoxicosis
  • Steroid therapy
  • Haemochromatosis       

 

Transferrin Saturation (%)

Shows the amount of Iron that is going to the tissues and it’s like the number of passengers in each Iron taxis (Transferrin).  This should between 10-50%. The closer to 50% the is result is the better. 

Ferritin

Is your iron stores.  The optimal result is 100 to 150.  This is also affected by inflammation.  Think of this as the Iron at the depot waiting for a taxi

Low levels maybe from the same as low levels of Iron as they are draining the Iron stores.

Reasons for a high level of Ferritin is:

  • Iron overload like genetic haemochromatosis
  • Fatty liver
  • Alcohol
  • Liver disease
  • Malignancy
  • Renal failure
  • Thyroiditis
  • Anorexia
  • Blood infusion

As mentioned, Iron levels and Ferritin can be affected by inflammation, so it is always a good idea to have a C-Reactive Protein (CRP) test done at the same time as your Iron to double-check that you are getting the right information before an accurate assessment can be made.

 

Pathocize (exercise for your pathology)

Ensuring you have good levels of Iron, check for anyone with haemochromatosis in your family. This can be masked while still having your menses and is revealed during menopause.

 

If you’d like to know more about this or other topics, you are welcome to join my free membership on face book. Thyroid, Metabolic, Hormone Harmony Hub. 

I’d love to see you there

Inspiring Wellness

 

Beth  

 

Inflammatory Pathology

Inflammatory Pathology

There are a couple of different markers that indicate inflammation in the body.

Erythrocyte sedimentation rate (ESR)

This is non-specific, which means that there is some chronic inflammation in the body, just what or where is an unknown. Basically the blood is shaken up and allowed to sit and it time that is measured as to how long the red blood cell sediment takes to settle. The longer it takes, the more inflammation there is. As this is not a specific measurement reasons can be varied from bacterial infections, to collagen or vascular disease, cancers and lymphoma.

CRP C-Reactive Protein

Good to find acute illness as it rises quickly 4-8 hours after any tissue damage. It becomes it’s highest at 24-72 hours and returns to normal after 2-3 days.
It depends on the result level as to interpret the results. It could be something like an upper respiratory infection, sinusitis, pneumonia, appendicitis or post operative sepsis.

While there are similarities, there are significant differences of ESR to CRP and CRP maybe low when ESR is raised in certain illness.

Basically you want both of these to be 0 because you don’t want any inflammation in the body.

Ferritin

Is your storage of Iron stores and should be at 100. It also is affected by inflammation and may be seen high in Iron rich tissues like the liver, Gut, spleen and lymph system.

Pathocize (exercise for your pathology)

Identify cause of inflammation and address illness
If a specific dis-ease is unknown and there is general inflammation it maybe dietary.
• If you do nothing else, stop eating gluten
• Remove all grains from your diet
• Reduce or cut out dairy
• Eat fresh vegetables daily
• Have fresh fruit – 1 or 2 pieces daily (make one a older variety apple)
• Consume good quality proteins and vary these during the day
• Make sure your bowels are open and you are ‘moving’ everyday
• Drink purified water and lots of it generally 35ml per kg of weight
• Breathe, get outdoors and take in some lovely fresh oxygen
• Exercise, walking, swimming, yoga, if you don’t move it, you lose it
• Stress reduction, taking time out for you, meditation
• Sleep, put in good sleep routine practices
• Supplement with anti-inflammatories like Tumeric, Fish Oil and use Probiotics

 

If you’d like to know more about this or other topics, you are welcome to join my free membership on face book. Thyroid, Metabolic, Hormone Harmony Hub. 

I’d love to see you there

Inspiring Wellness

 

Beth  

White Blood Cell Pathology

White Blood Cell Pathology

This section of Pathology is found in the Haematology below the Haemoglobin section.

White blood cells are your immune defence system. If any results are raised it means some sort of invasion – bacterial, viral, parasites or auto immune responses. There are 5 types to take a look at.

 

Neutrophils (think bacterial)

Neutropenia is having too little of these white blood cells. That opens you up to bacterial infections. It also maybe because you have just fought off a bacterial or viral attack.

Low neutrophils may be B12 or folate deficiency, hypertension, thyrotoxicosis or malignancy. Some drugs also lower these immune cells including chemotherapy.

Neutrophils may also become high (Neutrophilia). This can be a current bacterial infection, or virus like Chicken pox, a recent injury or burn, heart attack or surgery. Malignancy, smoking and vigorous exercise and some drugs like steroids, epinephrine, heparin and cytokines can raise neutrophils.

 

Lymphocytes (think viral)

Stress commonly causes low Lymphocytes (Lymphopenia), other causes may be kidney failure, AIDS, drugs or some sort of immunosuppressive therapy.

A high amount of Lymphocytes (Lymphocytosis) may reflect an infection by a virus like epstein barr virus (EBV), hepatitis, herpes and whooping cough. It may also be from smoking, some anti-depressant drugs like SSRI’s and hormone gland diseases like hyperthyroidism and addison’s disease.

 

Monocytes (think detective)

Are the largest of the White Blood Cells. They are in force when there is bacterial, parasite and Rickettsial infections. Will show high in inflammatory disorders like ulcerative colitis, Crohn’s disease and chronic skin conditions like Psoriasis.

 

Eosinophils (think allergy & parasites)

These are mainly seen as a result of drug reactions, allergy or parasitic infestations of the gut like hookworm, eczema and psoriasis.

 

Basophils (think allergy & parasites as well)

Not as common as Eosinophils.  High levels may indicate allergic or inflammatory reactions from drugs or food sensitivities, ulcerative colitis or hormonal issues like hypothyroidism and oestrogen supplementation.

 

Pathocize (exercise for your pathology)

Look after your immune system with Zinc and Vitamin C
Reduce Stress
Look after your gut function with pre and probiotics
Note what is going on with your gut – do you need to do a parasite cleanse?
If you are having allergy type reactions you may need to look at what exposures you are having to histamines. You may need to support the histamine pathways with B3, B12 and folate.

This downloadable PDF from Swiss Interest Group Histamine Intolerance is a great reference for histamine foods.

 

If you’d like to know more about this or other topics, you are welcome to join my free membership on face book. Thyroid, Metabolic, Hormone Harmony Hub. 

I’d love to see you there

Inspiring Wellness

 

Beth  

Lipid Pathology

Lipid Pathology

What is your cholesterol like?

As the major fat going through the arteries it is super important to keep this within range.  Risks of having high cholesterol are a heart and blood vessel disease.  Arteriosclerosis (hardening of the blood vessel walls so they can no longer contract), vascular thrombosis (a blood clot in the vein going back to the heart) or stroke (where there’s a blood clot or blood vessel bursts in the brain) are diseases of the blood vessels. 

 

LDL Low Density Lipoprotein

LDL usually makes up about 80% of total cholesterol in a normal person. Having high cholesterol is seen as a risk marker for heart and blood vessel disease.  Two main reasons are that a family member has it (hereditary) and diet high in saturated fat.  It is lucky you can change the later within weeks. 

Having a low thyroid function, drinking too much alcohol or a disease of the liver or kidneys can be a reason for high cholesterol.  Also some drugs like steroids, clyclosporin can cause raised LDL levels.

 

HDL High Density Lipoprotein

I always remember this as the good cholesterol because it has a higher amount (density) of protein.  Because of this it doesn’t have much room to carry cholesterol as it returns to the liver. But the LDL Low Density Lipoprotein has a smaller protein amount and more room to carry cholesterol.  This is often called the ‘bad’ cholesterol and it takes fat into the tissues.

 

Triglycerides

Tri (meaning 3) gly (for glycerol) is the framework on which the fat is stored.  These are made from the fats and  carbohydrates that you eat. They are either used up for energy or stored in the body in fat cells.

If you have on going high triglycerides it is useful to check out the other blood results too. 

Reasons for high triglycerides can be that it is in the family and also that you are overweight.  Not having much physical activity, diabetes, enjoying a lot of fats and carbohydrates in your food and drinking too much alcohol can all cause high Triglycerides.  There maybe some other reasons like Hypothyroidism, liver, kidney and pancreatic  disease.  Pregnancy can also cause raised triglycerides. 

CVD Risk

Finally the Cardio Vascular Risk

This compares the ‘bad’ cholesterol (LDL) with the “good’ (HDL) cholesterol to give an estimate of your cardio vascular risk.  It is a ratio from fats going to the tissues and the fats back to the liver.

 

Pathocise (exercise for your pathology)

Your doctor may recommend drugs like Statins, Beta-Blockers or ACE inhibitors. Oestrogens and Selective estrogen receptor modulators like Tamoxifen, Thyroid hormones with neomycin (can result in a 25% fall in cholesterol)

Ideally get onto the right diet and remove trans-fatty acids.  These are high in deep fried/fast foods. Fill yourself with better options:

Saturated fats – are solid at room temperature, like butter and coconut oil, animal fats like lard or tallow.

Good sources of polyunsaturated fats – these stay liquid at room temperature like wild-caught fish, pasture-raised meats and eggs.

Here is a guide from https://coconutsandkettlebells.com/good-fats-vs-toxic-fats/

You may also need to take some CoQ10/Ubiquinol, particularly if you are taking Statins or Beta Blockers.

Keeping the bowels open with good amounts of fibre and stabilising your glucose levels can help.

 

If you’d like to know more about this or other topics, you are welcome to join my free membership on face book. Thyroid, Metabolic, Hormone Harmony Hub. 

I’d love to see you there

Inspiring Wellness

 

Beth  

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