Hypothyroid: need help in my lab results

[ummosama]

Three years ago, a few months after the birth of my 8th child, I started putting on weight and was exhausted all the time with aches and pains. I had recently moved to Pakistan from the UAE during that time.Have had gestational diabetes during all my pregnancies and had to take insulin shots upto 26 units in the last two pregnancies but blood sugar returned to normal after delivery. have had obesity problems for long time now but my weight returned to my usual 72kg after delivery .but around this time I started to keep gaining weight for no reason and had put on 15kgs in these three years reaching upto 87 kg last June.

As it had been suggested by my gynae dr during pregnancy, I got TSH tested a few months after the pregnancy and found out that my results were as follows

Serum TSH 63.64 (0.4-4.2) too high!!!

Serum T3 1.22 (1.08-3.14)

Serum T4 3.34 (5.5-11.0)

I saw an endo and she started me on 100mcg levothyroxine. took my levo for 2.5 yrs but have always been forgetful and used to miss my meds sometimes. Anyway TSH kept bouncing in and out of range ( average 8uIU/ml) and about a year later got self tested for Vitamin D and was too low at 9 ng/ml and asked a doc and got myself on 50,000IU weekly for maintenance after monthly shots for 3 months.

Then, in July 2014, I saw an endo in UAE and had started reading up on thyroid issues and obesity. He did some bloods as I recommended some too and consequently, he upped my dose to 150mcg levothyroxine daily and to continue Vit. D3 50,000 IU weekly. He asked to repeat serumcortisol, am, after a few months and to get a thyroid ultrasound for baseline status.

Results

Cortisol, serum, am 5.7ug/dl (4.20-38.40)

HbA1c 6.3% (5.7-6.4) (prediabetes range)

TSH 17.8 (0.4-4.6)

Vitamin D 50.9 (30-80)

have been taking the 150mcg dose of levo and weekly vitamin D and a good multivitamin supplement quite diligently and now I recently saw an endo here in Qatar (where I have recently settled) and showed him the results of the blood tests I had self-ordered in Pakistan in Oct 2014 since it is cheaper and no need for a doc to order it there.

(sorry did not go off meds 24hrs before testing since didnt know it affects results so these are on 150 mcg levo)

Here are the results done in Oct, 2014

Anti TG 10.5 ( <4.11 IU/ml) High?

Anti TPO 2.05 ( <5.61 IU/ml)

Free T3 3.55 (2.10-4.40 pg/ml)

Free T4 1.20 (0.8-2.7 ng/dl)

serum T3 1.76 (1.08-3.14 nmol/L

serum T4 8.4 (5.5 11.0ug/dl)

TSH 0.005 (0.4-4.2 uIU/ml)

B12 254 (206-678 pg/ml) (at lower end of range)

Ferritin 18.61 (10-120 ng/ml) (at lower end of range)

Folic acid 15.7 (2.6-12.2 ng/ml) (had folate deficiency all my adult life so supplement)

magnesium 2.11 (1.6-2.6 mg/dl)

potassium 4.3 (3.6-5.1 mEq/L)

Well, he only looked at my TSH which he said was suppressed and which according to him was the very very sensitive indicator of thyroid health. He didn't even look at my other results even though I tried to show him. He briskly brushed aside any concerns about T4 to T3 conversion or not getting relief from symptoms or inflammatory triggers and how to avoid them. In his opinion, there was no need to find the cause of my hypothyroidism since it didn't change anything in the meds and you cannot avoid anything to control an autoimmune disease. (is he right? ). He refused to support me in trying NDT and since it is not even available in Qatar even as a prescription med so there was no question of him giving me a prescription.

The only thing he did do for me was that he prescribed my levo and ordered some labs and the Ultrasound my previous endo had suggested and that too on my insistence.

Here are the results

Cortisol, am 10.30 (4.3-22.70 ug/dl)

HbA1c 6.1% (6.0- 7.0) (pre diabetes range) decreased from 6.3

TSH 0.01

Lipids

Cholesterol, total 5.84 (0.00-5.18 mmol/L)

Trig 0.74 (0.30-1.51 mmol/L)

HDL cholesterol 1.43 (1.03-1.55 mmol/L)

LDL cholesterol 4.07 (0.00-3.30 mmol/L)

The Ultrasound result says something like thyroid has coarse nodular texture, with ill defined nodules of around 3mmand the conclusion says "signs suggestive of chronic thyroiditis"

The most important result of my internet research to find a solution for my thyroid and obesity issues and to avoid becoming diabetic soon was to stumble upon the low carb high fat diet (LCHF) and it has worked wonderfully to reduce my weight and I have lost 10 kg in the past 5 months. So my lipid profile should be seen in the light of the high fat diet I am on, which alters the lipids in most people in a similar way. I don't have any previous lipids results to compare. On the other hand my hypothyroid symptoms have not improved and other than the extreme exhaustion that lifted when I had initially started levo 3 years ago, I feel that other symptoms have persisted eg brain fog , aches and pains, dry and thin nails and hair, diminished eyebrows, difficulty in losing further weight, cold feet but warm hands and my basal body temperature is still quite low ranging from 35.5-35.9 * C. This recent endo doc thinks that these symptoms are not due to thyroid insufficiency but due to my vit d deficiency. Taking Vitamin D has definitely made the persistent pain in my leg and back miraculously disappear but not these above symptoms.

I have a family history of diabetes and hypothyroidism.

I have been very active all my life, running around taking care of my kids and other responsibilities, although not proper exercise. However, these past three years I have had to slow down considerably and wish that I could be my old self again. I am also undergoing peri menopause at age 46.

Please help me understand what is going on and how can I help myself to regain my health. I donot want to go back to the last endo I visited, with the latest labs, so I have booked an appointment with another endo and will see how it goes. In the meanwhile, I want to try out the natural dessicated thyroid, Thyrogold and waiting to receive it.

Also, is there any support group in this region and if anyone can guide me to a natural health holistic or integrative doc or functionalist here in Qatar, UAE or Pakistan to help in my issues with a whole body approach.

Desperately in need of guidance.

Any help will be highly appreciated.

Looking forward to hearing from any of you

Thanks in advance!

P.S. Sorry for the long post( just had to cry out my frustration to someone)

[shaws Administrator]

Welcome to our forum

I am sorry you've had a problem for a long time and many women after giving birth develop a problem with their thyroid gland.

You do have to take your thyroid hormones daily. The result if we don't we can develop other more serious diseases such as heart, etc.

A higher cholesterol is indicative of hypothyroidism which usually reduces when on an optimum of medication. I am sure Thyro-gold will help with this, plus your weight reducing. Weight gain is a clinical symptom of hypothyrodism and isn't only due to eating the wrong foods as many doctors think and I am glad you have been able to reduce it. It is because our metabolism is slow that we don't burn the calories off.

I am not too good at bloods but a member who knows will respond. I will say your B12 is too low and you should supplement with sublingual B12 methylcobalamin which you can buy through Amazon.

healthunlocked.com/thyroidu...

It must be methylcobalamin B12 and not Cyanocobalamin.

Best wishes

[Clutter]

Welcome to the forum, Ummosama,

Apart from taking thyroxine daily make sure you take it with water on an empty stomach, one hour before, or two hours after food and drink, 2 hours away from medication and supplements and 4 hours away from iron, vitD, calcium and oestrogen.

Your thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's) which is the cause of your hypothyroidism. They are not very high and you may find that adopting a glute-free diet helps with reducing attacks on your thyroid gland and antibodies. The ultrasound scan report that 'coarse nodular texture' is detected is consistent with autoimmune attacks on the thyroid gland. Small nodules are common and aren't usually of concern unless they grow.

I don't agree with the endo ascribing your symptoms to vitamin D deficiency. They are typical hypothyroid symptoms, often due to low FT3. Some members have recently reported good results with ThyroGold which does contain T4 and T3 although it isn't clear how much.

TSH 0.01 is suppressed which is to be expected on 150mcg thyroxine. Your previous results were skewed by taking thyroxine prior to the blood draw but that wouldn't affect FT4 much and yours is a little low, less than half way through range, which can make conversion of T4 to T3 difficult. Your FT3 looks good, in the top third of range but may have been inflated by the dose you took prior to testing. Improving your vitD will aid T4 to T3 conversion.

Your ferritin is very low and this contributes to musculoskeletal pain, fatigue and low energy. Optimal is half way through range. Supplement Ferrous Fumarate and take each tablet with 500mg-1,000mg vitamin C to aid absorption and mitigate constipation. Good iron levels aid absorption of thyroxine but iron must be taken 4 hours away from Levothyroxine.

B12 is low. Supplement 5,000mcg methylcobalamin sublingual lozenges, spray or patches daily for 4-6 weeks then cut back to 1,000mcg daily and take a B Complex vitamin to keep the other B vitamins balanced. You can slightly reduce your folate supplement as you are over range. Excess is excreted in urine but there's not much point paying to pee out supplements.

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

[ummosama in reply to Clutter]

I feel so relieved just talking to people who are or have been in the same boat and are so forthcoming in sharing their wisdom and generous in their advice. I can't thank you all enough.

I am now waiting to get my Thyrogold and will have to check my supplements and rethink how to adjust meds and my routine.

[Clutter in reply to ummosama]

Ummosama, thyroid meds should be taken an hour before or two hours after food and drink and supplements usually are taken during, with or immediately after food if that helps. You can post a question saying how much thyroxine you are taking and ask what is the equivalent amount of ThyroGold members recommend.

[greygoose]

He sounds like a typical endo - proves that the problem is international! To reduce antibodies, you need your TSH suppressed. If the gland is not working, the antibodies Don't attack. And lots of people find that gluten-free, paleo diet and/or LDN lower antibodies. So, he was totally wrong on that score! Glad you're not going back to him.

Do not worry about your cholesterol. Cholesterol is necessary for the body and doesn't cause heart attacks! Besides, it has little to do with what you eat, it's mainly made in the liver. And those with the highest cholesterol live longest!

What do you mean 'proper exercise'??? There's no such thing. Everything you do, every singal bodily function is 'exercise' - walking, housework, cooking, looking after your children, breathing, digesting, converting T4 into T3, etc - in the sense that it uses up calories. But, as you have seen, calories are irrelevant, because you've been eating lots of fat which has the highest amount of calories, and you've lost weight!

I suppose you mean you haven't been going to the gym, or anything like that. But going to the gym is hardly natural. Our ancestors didn't go to the gym. In fact, that could make you feel worse, because you not only use up your calories - which are needed for so many other functions - but you use up your T3. And you haven't got enough! So, Don't worry about 'proper' exercise. lol

You say you want to understand what is going on. Well, you have Hashimoto's disease, which is slowly killing your thyroid. That's basically it. But, of course, the fact that it's killing your thyroid brings on all sorts of other problems. Get your T3 level up and a lot of them will sort themselves out. Get your vits and mins optimal and a lot more will disappear. But Don't be too disappointed if you Don't get very much help from doctors - especially not endos - because they haven't got a clue what's going on!

Hugs, Grey