Help with blood test results and symptoms please

[RuthNelson]

Hi,

I have hashimotos, and had a hemithyroidectomy just before Xmas. Before the operation I had been described as sub-clinical hypothyroid, with a TSH of around 2.

Since the operation I been suffering from pins and needles and a feeling of slight breathlessness, which mostly comes on in the evening or at night, but can happen during the day too. In the evening it seems to be often accompanied by an unnatural feeling of tiredness, so that I go to sleep early, but then wake up after a couple of hours. Since the operation I also regularly experience a globus sensation, that gets worse with exercise. I suffer from hot flushes, but that might be the menopause, and my eyes can get quite dry.

I am gluten- free and have been taking Vitamin D3 and iron/ B vitamins for the last few weeks. I stopped my iron/b vitamins a week before my blood tests, which were taken at 8.30am after fasting.

I am not taking levothyroxine or other thyroid medication.

Results are;

TSH: 4.22 range 0.3 -4.2 milliunit

Free T 3 4.2 range 2.4 to 6 pmol/l

Free T4 11.3 range 9-23 pmol/l

Folic acid 11.3 range > 2.7 ug/l

Ferritin 34 range 20-300 ug/l

B12 445 Range 160-800 ng/l

Vitamin D 63.7 range 50-150 nmol/l

Would be grateful for any interpretations and recommendations of what to discuss with the GP.

[SlowDragon Administrator]

All your vitamins are poor, especially ferritin

No doubt as direct result of low thyroid levels

You need two separate blood tests with TSH over range at least 6 weeks apart

Work on improving low vitamin levels by supplementing

Book second test early morning, ideally before 9am, only drinking water between waking and test

Exactly what vitamins are you taking

[RuthNelson in reply to SlowDragon]

Thank you for your reply, I had my TSH taken just after my op 10 weeks ago and it was 4.23.

I have been taking;

D3 400iu Healthspan tablets once a day.

1x Iron complex Healrhspan elite per day, which has 14mg iron, 1.4mg B2, 1.4mg B6, 2.5ug B12, 80mg Vit C, 1mg Copper.

Also Meno Multi capsules x 2 per day

Vitamin C (As Calcium Ascorbate), Calcium (As Citrate And Ascorbate), Magnesium (As Citrate), Vitamin E (Natural D-Alpha-Tocopherol), Niacin (As Nicotinamide, Vitamin B3), Pantothenic Acid (As Calcium Pantothenate, Vitamin B5), Riboflavin (Vitamin B2), Thiamine (As HCl, Vitamin B1), Vitamin B6 (As Pyridoxal-5-Phosphate), Protease (10,000 Hut/G), Beta-Carotene (Dunaliella Salina Algae), Choline (As Bitartrate), Inositol, Zinc (As Citrate), Manganese (As Citrate), Paba (Para Amino Benzoic Acid), Amylase, Lipase, Folacin (Folic Acid), Vitamin A (As Acetate), Boron (As Sodium Borate), Chromium (As Picolinate), Selenium (Methionine As L-Selenomethionine), Biotin, Vitamin B12 (As Hydroxycobalamin), Vitamin D3, Capsule Shell: Hydroxypropyl Methylcellulose.

And D Flamm tablets x 2

Turmeric Powder

Olive leaf

Ginger root

Quercetin

Hops

Black Pepper extract

I have only started these in the last few weeks, and have felt worse since laying off the iron tablets before the blood tests, although that might be a coincidence.

I don’t think that the bloods mean that I need Levothyroxine necessarily?

[SlowDragon Administrator in reply to RuthNelson]

So 400iu is tiny dose vitamin D

Suggest you look at vitamin D mouth spray

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Too much Vitamin D is toxic

Test twice a year

healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to RuthNelson]

I don’t think that the bloods mean that I need Levothyroxine necessarily?

See how thyroid levels look once all four vitamins are at good levels

Vitamin D at least over 80nmol

Ferritin over 70

Serum B12 over 500

Active B12 over 70

Folate near top of range

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Multivitamins never recommended on here, usually too small a dose to improve significantly

But at least there’s no iodine in it

[RuthNelson in reply to SlowDragon]

Thank you very much, Slow Dragon.

I don’t think I’ve had my active B12 tested ever.

Is folate the same as folic acid? There was no top end of the range given here.

Is there a ferritin supplement and a magnesium supplement that is recommended on here?

[SlowDragon Administrator in reply to RuthNelson]

Active B12 test only available privately

NHS always test serum B12

B12 below 400 too low

Aiming for B12 over 500

Folate = folic acid on test results yes

Folic acid range will probably be 2.7- 20

Some folic acid range are 8-60

Difference between folate and folic acid

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements

thyroidpharmacist.com/artic...

[RuthNelson]

Thank you; will keep an open mind re whether symptoms are thyroid related or not.

[SlowDragon Administrator in reply to RuthNelson]

Get Full thyroid and vitamin retest BEFORE booking any consultation