First Post- Advice re Blood Results Please

[Buggy04]

Hello everyone,

I have read many of your posts to try and learn more since being diagnosed with Hashimotos 2 years ago. I have always been on the same dose ie 100 Levo since being diagnosed and have been reasonably well. Over the past year my weight has crept up and I have put on over 1 stone. I have recently noticed that my abdomen is more swollen, so since the weekend I have decided to cut gluten from my diet, having read that this may help. Today I got my latest blood results and my iron levels are low. I have been vegetarian for 30 years but do eat fish and shell fish. I know this is probably why my iron levels are so low. I suffer from constipation regularly and so try not to take the iron tablets the doctor has prescribed as this makes it even worse. I am a bit tired, I guess this is due to the iron and my T3 looks a bit low to me....I was wondering if you could please give me some advice on my blood results and what I can do to try and get to the optimal values so I can feel as well as I possibly can. About 18 months ago I have a course of B12 injections, but the dr won't do them again as she says I'm now 'in range', although I know it should be towards the top end. My results are

serum vitamin b12 211ng/L (150-620)

serum folate 15.5 ug/L (3.1-19.9)

serum ferritin 18ug/L (20-300) LOW

serum TSH 0.35 mu/L (0.40-5.00) LOW

serum free T3 3.55 pmol/L (2.6-5.7)

serum free T4 14.2pmol/L (9.0-19.0)

haemoglobin estimation 139 g/L (115-165)

percentage monocytes 12% (2-10) High

platelet count 204 10*9/L (150-450)

If anyone could be kind enough to give me some advice on what I should eat and take as supplements to try and get my levels to where they should be, I would be really thankful.

[Clutter]

Welcome to the forum, Buggy04.

Did your GP test intrinsic factor for pernicious anaemia? Your B12 is shocking low after having had loading injections and you should be getting B12 from fish and dairy in your diet. If PA is ruled out you should supplement high dose methylcobalamin, 5,000mcg for 6-8 weeks and then reduce to 1,000mcg. You might want to ask for advice on the HU PAS forum before supplementing.

Your TSH is below range but your FT4 and FT3 are also low. Some patients need very low or suppressed TSH in order to produce good levels of T4 for conversion to T3. Your GP should raise your dose or add Liothyronine (T3) to improve your FT4 and FT3. Read Dr. Toft's comments in Treatment Options thyroiduk.org.uk/tuk/about_... and email [e-mail] if you want to show your GP a full copy of the Pulse article when you ask for a dose increase.

Your ferritin is very low. Half way through range is optimal. Take each iron tablet with 500-1,000mg vitamin C to aid absorption and minimise constipation. If you won't take iron you need to eat a lot more iron rich food.

Monocytes aren't elevated much and if your other white blood cell count is good it won't be significant.

An increased percentage of monocytes may be due to:

Chronic inflammatory disease

Leukemia

Parasitic infection

Tuberculosis

Viral infection (for example, infectious mononucleosis, mumps, measles)

nlm.nih.gov/medlineplus/enc...

[Buggy04 in reply to Clutter]

Hello Clutter, thank you for your comments. My Dr tested me for pernicious anaemia 18 months ago when I had the b12 injections and the test was negative. I will make an appointment with gp to discuss increasing my dose of level as you suggest. Are liquid iron supplements easier to absorb than tablet form? Can I get the b12, vitc and iron supplements at the strength you suggest in a standard health food shop or is there a better place? Thanks again for your help x ps I have an ovarian cyst could that raise my monocytes level?

[Clutter in reply to Buggy04]

Buggy, I don't know whether liquid iron is better absorbed than tablets, it can stain the teeth so drink through a straw.

I don't know whether high dose methylcobalamin is available in stores but you can get it on Amazon. Please use the TUK Amazon link if you use Amazon thyroiduk.org.uk/tuk/go_sho...

[Buggy04 in reply to Clutter]

Ok will do, many thanks

[Spareribs]

Hi Buggy - well done for posting, it isn't easy.

I'm surprised you can eat seafood, a lot cannot -you are doing better than a lot of us!

Yet lots of us are low B12, it's often low stomach acid - have a looksie at the PA forum - they have much better/informed advice on low B12 & further testing - hopefully its not PA - you're not on PPIs are you? Low B12 can cause permanent nerve damage - please get that sorted asap -I really cannot comprehend how doctors start to treat this then stop, it's criminal!

I suspect you are more than 'a bit tired' - your body needs more nutrients - luckily you know this, again time to get it sorted.... especially that iron, Vit C helps.

like the gluten/coeliac test - you have to eat a ton of bread for at least 2 months - many can't do this. I suggest you read up - as you have done so far - we'll get there J

[Buggy04]

Thanks for your reply. Not too sure what PPI is ? Do you think if I asked for a referral to the hospital to see an endocrinologist that they may give me the b12 injections ?

[greygoose in reply to Buggy04]

PPIs are things that suppress stomach acid that doctors prescribe for GERD and other stomach problems. They tend to be called something Omeprazole, or something like that.

The problem is, that if you complain of stomach acid, acid reflux or anything else to do with the stomach, they prescribe them automatically without checking that you do, in fact, have high stomach acid.

Hypos usually have low stomach acid, which makes absorption of nutrients difficult. If you then start taking PPIs - as a lot of people do without realising the problem - things get worse instead of better. The symptoms of low stomach acid and high stomach tend to be similar, unfortunately.

I'm not sure that asking for an increase in levo is going to solve your problems, because you aren't converting that T4 to T3 very well - your T3 is way too low. You might try asking for some T3 to be added to your Levo, instead.

Having said that, your conversion would probably improve if you raised your iron and B12 levels. Have you had your vit D and folate tested, by the way? If you Don't want to take the iron because of the constipation - something I can well relate to! - you could try taking some magnesium, as well as the vit C. You're more than likely low in magnesium, anyway. And that will cause a host of symptoms. So, taking magnesium could well improve a lot of things, as well as the constipation.

[Buggy04]

Many thanks for the information. No I don't take PPI but will add magnesium supplements to the list..... wHen I see my go I will ask about vitD as about a year ago I had tablets to boost this, but have not been tested recently. My folate is 15 (3.1-19.9), if you could guide me in the most effective iron supplement I will try it, as since been gluten free for 1 week (early days I know) my constipation seems to have gone to the opposite extreme!!!!