Results are in

[Claire67]

Can someone please explain these results to me and what action / supplements etc I should take all very confusing to me.

Biochemistry

CRP 1.60 <5.0 mg/L

Ferritin 26.6 20 - 150 ug/L

Thyroid Function

TSH H 14.59 0.27 - 4.20 IU/L

T4 Total 88.1 64.5 - 142.0 nmol/L

Free T4 12.95 12 - 22 pmol/L

Free T3 3.24 3.1 - 6.8 pmol/L

Reverse T3* 17.0 10 - 24 ng/dL

Reverse T3 ratio L 12.41 >20 Ratio

Immunology

Anti-Thyroidperoxidase abs H 424.5 <34 kIU/L

Anti-Thyroglobulin Abs 15.7 <115 kU/L

Vitamins

Vitamin D (25 OH) L 19 Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 L 187 Deficient <140 pmol/L

Insufficient 140 - 250

Consider reducing dose >725

Serum Folate L 9.56 10.4 - 42.4 nmol/L

[Jazzw]

You're still very hypo. Your TSH has come down since you started levo - are you still on 50mcg? - but nothing like enough yet, so you need a raise in dose. Your ferritin, Vit D and B12 are all woefully low and will be making you feel terrible - all need supplementing. And you have antibodies, meaning you have Hashimoto's.

Did you complain about that awful doctor who shouted at you? {hug}

[Claire67 in reply to Jazzw]

Hi there thanks for replying, yes still on 50mcg of levo they wouldnt raise it until I had these tests back (even though I had them privately done ) anyway I told the nurse who made a note about the doctor and have had it put on my notes not to see him.

I knew I still felt terrible my family think Im making a fuss but am sleeping 2 - 3 hours every afternoon, I can only work mornings (doctors note for 28 days reduced hours) and am used to working full time running about at work everything is having an impact on my life... I dont think I will be fit to up my hours from 9th Aug , so my work place is going to kick off .... its all so draining.

So what do you suggest, just go back to Doctors with results ?

[Jazzw in reply to Claire67]

Yes, definitely. I'd say you probably need your dose doubled to 100mcg - no reason why not if you're otherwise healthy (I know "healthy" is feeling a relative term at the moment!). If they do only want to give you 75mcg, perhaps suggest they prescribe 100mcg but you'll only take 75mcg for a few weeks. To be honest they should've started you on 75mcg - there was no need to start at 50mcg with someone young who had no heart problems

Poor you, I understand the work thing only too well - but remember this isn't your fault and that this is something that should be fully resolvable given time (and enough thyroid meds!).

[SeasideSusie Remembering]

Claire67 As you know from your previous posts you have Hashimoto's disease so hopefully you are following advice given and have started a gluten free diet to help reduce the antibody attacks. Your TPO antibodies are still high, but of course it is early days. Also, supplementing with selenium can help reduce antibody attacks so that is something to consider.

I see that you were started on 50mcg Levo, well you need an increase in your dose to bring your TSH down and increase your FT4 and FT3. The aim of a treated hypo patient is for the TSH to be 1 or below and FT4 and FT3 to be in the upper part of their ranges. A low THS is also supposed to help reduce antibody attacks.

Your Vit D is terribly low at 19, it should be around 100+. If not already supplementing you should get some D3 5000iu. Start supplementing 20,000 daily for two or three weeks, then reduce to 5000iu daily. Re-test after about 4 months (City Assays do it for £28, a private, fingerprick bloodspot test to do at home or ask your GP). When taking D3 you should also take K2. Vit D aids absorption of calcium and K2 directs the calcium to bones and teeth rather than arteries and soft tissues. Look for K2-MK7.

Your B12 is dreadfully low too. If not supplementing then you should aim to get that level up to 1000 which is what the Pernicious Anaemia Society recommends. You can get Jarrows or Solgar sublingual methylcobalamin lozenges 5000mcg.

When supplementing B12 you should also take a B Complex to balance the B Vits. Look for Thorne Basic B or Jarrows B Right, both contain 400mcg methylfolate which should start to bring you folate level up as that is also very low. Aim for half way through the reference range.

Ferritin, again, is very low, it needs to be at least 70 for thyroid hormone to work properly, 100+ would be better. If not already supplementing you need iron. Take iron with 1000mcg Vit C to aid absorption and help prevent constipation, and take 4 hours away from your thyroid medication.

Once your vits and mins are at optimal levels then you should feel better and your thyroid hormone should work better than it does now, but you still need an increase in your levo. Your GP should re-test 6-8 weeks after starting you on Levo and increase your dose. Re-test after another 6-8 weeks and adjust dose again, etc., until your thyroid tests are at the levels mentioned above if that is where you feel best.

[Claire67 in reply to SeasideSusie]

Thankyou for that .... all a bit daunting at the minute will pick through it tomorrow xxx