Advice on Blood Work Please

[Timmersby]

Hi all, I am new to this forum, although I have been lurking for quite some time ! I was diagnosed with Hashimotos around two years ago and since then have been under the care of a very empathic and caring Endocrinologist. Despite my last test results appearing to be within normal ranges, I am still feeling incredibly lethargic, my hair is still falling out, my skin incredibly dry, and I'm lacking in motivation, enthusiasm and energy.

Accordingly I would really value the group's expertise and experience in reviewing these results and providing me with your thoughts and feedback. If you think my most recent results suggest I am within optimal ranges, then I need to investigate my symptoms further.

Jan 15 - Two Years since Initial Diagnosis - Prescribed 50mcg Levothyroxine

FT3 - 3.89 (2.8 - 7.1)

FT4 - 13.79 (12 - 22)

TSH 1.75 (0.27 - 4.2)

Anti TG 989 (0 - 115)

November 15 - Prescribed Novothryal 100 (100mcg Levothyroxine and 20mcg Liothyrine) due to low FT3

FT3 - 2.7 (2.8 - 7.1)

FT4 - 13.3 (12 - 22)

TSH 2.28 (0.27 - 4.2)

Anti TG 719 (0 - 115) After being gluten-free for 6 months and taking 100mcg Selenium per day

January 16 - After being on Novothryal 100 (100mcg Levothyroxine and 20mcg Liothyrine) for 2 months

FT3 - 5.4 (2.8 - 7.1)

FT4 - 15.00 (12 - 22)

TSH 1.150 (0.27 - 4.2)

Anti TG 580 (0 - 115)

Thank you in anticipation of your advice.

Best regards,

Tracey

[Clutter]

Timmersby, Jan TSH, FT4 and FT3 are quite good but could be better. An extra 25mcg Levothyroxine would raise FT4 which in turn should raise FT3. Alternatively another 10mcg T3 will raise FT3.

It's worth checking ferritin, vitamin D, B12 and folate as they are often low/deficient in Hashi/hypothyroid patients which can cause musculoskeletal pain, fatigue and low mood, similar to hypothyroid symptoms.

Thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). 100% Gluten-free diet can help reduce symptoms and antibodies.

chriskresser.com/the-gluten...

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

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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Timmersby in reply to Clutter]

Thank you Clutter for taking the time to get back to me and for your advice regarding dosage. I will do as you suggest and see if that can help resolve some of my lingering symptoms. I have been gluten free for about 8 months now, so I guess that is what is helping to lower my antibodies, so will continue that regime, along with taking the selenium each morning.

You are quite correct with regards to those other issues being related to my Hashi's - my Vitamin D level was extremely low this time two years ago (8 with range of 30-70) and I was prescribed 10000iu per week to help raise it - it is now in the normal range thankfully.

I should have also mentioned that I had a surgical menopause when I was 42, including the removal of both ovaries, and despite being on HRT for the past 10 years, had never had my vitamin D levels checked. This was a real problem as I now have osteopenia all through my body, with a couple of areas borderline osteoporosis - even though I was taking calcium tablets and on HRT, my body could not metabolise it due to my dangerously low vitamin D levels.

I assumed that because I grew up and lived in Australia, that I would be getting plenty of Vitamin D - how wrong I was.

January 16 Results

Vitamin D 42 (30-70)

Ferritin 72.60 (10-160)

I didn't have folate or B12 tested in my Jan 16 blood work but i will ask at my next test.

Thanks again for your advice, and feedback - sincerely appreciated.

[Clutter in reply to Timmersby]

Timmersby, high SPF, covering up and avoidance of sun means many Australians are likely to be vitD deficient. Ferritin looks okay, halfway through range is optimal.

I also have mild osteopenia in the hip and lumber spine which I think is due to early menopause <42. I took HRT for a couple of years but stopped it after adverse press coverage suggested the bone health benefits were outweighed by other risks. I was severeley vitD deficient in 2013 and have been supplementing since then to maintain levels around 100 nmol/L which is in the UK replete range 75-200nml/L.

[Marz in reply to Timmersby]

drmyhill.co.uk/wiki/Osteopo...

Timmersby - I have read that the most up to date research suggests that calcium is not well absorbed when taken in tablet form. VitD naturally improves the uptake of calcium from the gut - then you need to take VitK2 to ensure the calcium goes to the bones and the teeth and does not remain in the arterial system.

As you will see from the above link there are many other supplements required to prevent osteoporosis - magnesium being important too. Low B12 is also implicated in bone issues. You need a level of around a 1000 and do not allow it to go below 500.

Calcium is involved in osteoclasts - which are involved in the breaking down and dispersal of old bone in the body. It does not help the rebuilding of new bone

Good levels of T3 are also needed.....

[Timmersby in reply to Marz]

Thank you Marz - you have inspired me to do more reading and research on this issue. I truly appreciate you taking the time to provide your advice.

[Timmersby in reply to Clutter]

Clutter, would you suggest splitting the dosage as I increase ? Take the combined tablet in the morning, and the additional 25mcg T4 or 10mcg T3 at night for example ?

Thanks !

[Hidden in reply to Timmersby]

Timmersby,

Depending on what you increase will determine the best time to add the additional meds.

T4 has a long half time so can be added to the meds you take already.

T3 has a short half life and many members benefit from splitting the dose to encourage a more even level of available hormone through out the day.

You can split the dose two or even three times but remember to take away from food and other meds.

Flower

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Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

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[Timmersby in reply to Hidden]

Thank you Flower for taking the time to read my post and offer advice and guidance.

I really appreciate it !

[faith63 in reply to Timmersby]

you could add t4, but if it were me, i would add t3. T3 is the active hormone and a small increase of levo.will not necessarily all convert to t3, but will probably just raise your ft4 level, which doesn't help symptoms, but t3 should. I would work on bringing your hashi's under control. I am using the functional medicine approach to get rid of this evil disease!

[Timmersby in reply to faith63]

Thank you Faith - that sounds like very sound advice !

I'm broadly following a Paleolithic eating plan to try and ease my Hashi's symptoms and supplementing with Selenium but if there are any other supplements and / or strategies that you have found beneficial, I would be most grateful for that kind of feedback.

[Hidden in reply to Timmersby]

Timmersby,

High TPOAb's & inflammation will make any auto immune disease worse and must be reduced.

I have suffered high TPOAb's and have found supplementing Curcumin & Resveratrol to be huge in reducing inflammation. They work together by supporting “regulatory T cells” which regulate the activity of TH-17, TH-1, and TH-2. An imbalance in these is what causes the allergy/intolerance responses and results in inflammation.

Other sups to consider are fish oils containing high omega-3, vitamin D3 & vitamin A.

Flower

Curcumin & thyroid

naturalendocrinesolutions.c...

Curcumin reduces inflammation

ncbi.nlm.nih.gov/pubmed/126...

…………………………………………………………………………………

Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

…………………………………………………………………………………

[Timmersby in reply to Hidden]

Hi Flower, I am taking Pradaxa for pulmonary embolism & DVT risk (both of which I have had), and understand from my haematologist that Tumeric/Curcumin is contraindicated when taking anti-coagulants. However, I have not heard of Resveratrol - must do some reading and see whether it might be useful by itself or whether it would only be best when used in conjunction with Tumeric ?

Thank you so much for getting back to me - this group is collectively such an amazing resource !

[Marz in reply to Timmersby]

Do you know your level of Homocysteine Timmersby - when raised it is more indicative of strokes/clots etc. Can be easily brought down with a good B Complex....

[Timmersby in reply to Marz]

I have Factor V Leiden thrombophilia Marz which is the cause of my predisposition towards clotting. I have not heard of the test for Homocysteine, however I will certainly speak with my Haematologist during my next appointment and do some more reading during the meantime.

Thank you very much for this interesting advice.

[Marz in reply to Timmersby]

Oh dear that does complicate things for you. Am afraid I do not know about the Factor V Leiden. I just know that the only way to lower Homocysteine is naturally with a GOOD B Complex and a TCM - all natural. When they looked into blocked arteries they found homocysteine along with cholesterol. They found a drug for cholesterol but could not patent the natural cure for Homocysteine. When you lower the latter then the cholesterol also reduces. Well in my case it did

[faith63 in reply to Timmersby]

Read this and do what he says.. this is what i am doing..

drhyman.com/blog/2010/07/30...

i was tested for and have leaky gut, like all autoimmune people do. It was stool testing..icky! I am replacing lost bacteria and enzymes with supplements and have had the food sensitivities testing done and follow that. I cannot eat oats, walnuts and swiss cheese...odd. So a paleo diet, would be okay except you still may be eating what you are sensitive too.

I am on more supplements because my urine shows abnormal neurotransmitter readings..like serotonin and dopamine etc..

I have replaced my missing sex hormones, starting in 2011.

I am nearing month 4, of a 6 month protocol, with little improvement, but have been really stressed. Unfortunately have developed, what can only be described as fibromyalgia..which i am not sure really exists. It is all part of having low metabolic rate and abnormal hormone levels. My cortisol is low and i have not addressed it, except for the supplements, but need further testing.

My doctor didn't mention continuing selenium, i guess because it is not addressing the root cause for the autoimmune disease.

[Timmersby in reply to faith63]

Thank you once again for taking the time to reply Faith and providing such interesting and comprehensive advice.

I will most certainly investigate the information contained on the website you recommended.

Hugely grateful for your support

[faith63]

also, t3 has a half like of 1.5 days, so you can take it all at once.

[Timmersby in reply to faith63]

Thank you Faith