Help with results please

[Luckystar]

Hi I am new I am a 27 year old female and I have been taking Levothyroxine for 4 years and T3 for nearly 2 years. I still continue to have symptoms of underactive - fatigue, muscle cramps, dry skin, constipation, heavy and short periods, dry eyes, deafness, ears ringing, cold intolerance, depression. Could anyone please feedback regarding results/symptoms? Thank you

Jan-2017 (125mcg Levothyroxine/10mcg T3)

TSH 2.40 (0.2 - 4.2)

Free T4 15.7 (12 - 22)

Free T3 4.3 (3.1 - 6.8)

Thyroid peroxidase antibody 285 (<34)

Thyroglobulin antibody 398.5 (<115)

[SeasideSusie Remembering]

Luckystar Some of your symptoms are indicative of low nutrient levels. Have you had the following tested? If so please post the results with their reference ranges, if not please ask for them to be tested:

Vit D

B12

Folate

Ferritin

Also, you have high antibodies which are positive for autoimmune thyroid disease aka Hashimoto's. Hashimoto's isn't treated, it's the resulting hypothyroidism that's treated. The antibody attacks will eventually destroy your thyroid. You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

Gluten/Thyroid connection - chriskresser.com/the-gluten...

Supplementing with selenium, 200mcg daily, and keeping TSH suppressed also helps reduce antibodies.

Hashi's information:

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

Your TSH is too high and your free Ts too low. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges if that is where you feel well. That applies to being treated with Levo alone. Add T3 into the mix and FT4 tends to be lower in range.

You need an increase in your thyroid meds. An increase in your Levo will raise FT4 and should, by conversion if it's good enough, raise FT3. An increase in your T3 will raise your FT3 level.

[Luckystar in reply to SeasideSusie]

Thanks SeasideSusie for your reply, I will post vitamin and mineral results. I am meant to be under active monitoring for an iron infusion done last year but haematology unit has discharged me. I will post them here if ok. Whenever Levothyroxine is increased my T3 level drops so I would feel better if my T3 was upped instead.

[Luckystar in reply to Luckystar]

Serum folate 2.5 (4.6 - 18.7)

Serum ferritin 14 (15 - 150)

Serum vitamin B12 196 (180 - 900)

Total 25 OH vitamin D 17.4 (<25 severe vitamin D deficiency. Patient may need pharmacological preparations) I take 800iu vitamin D

[SeasideSusie Remembering in reply to Luckystar]

Oh my goodness Luckystar it's no wonder you feel tired!

Ferritin is dreadful. It needs to be at least 70 for thyroid hormone to work, preferably half way through range and best for females is 100-130. Presumably your iron infusion raised your ferritin level. Once up it needs to be maintained, either by a maintenance dose of iron or by eating liver regularly. You need to get that back up ASAP. Speak to your doctor and ask him to address it. He must know that haematology has discharged you, in which case he should be keeping an eye on your level. The sort of yo-yoing you're experiencing ie iron infusion>level increases>no maintenance>level drops is quite common I believe but no good for your health. It happened to my brother. You need to maintain a good level once you've achieved it. Speak to your GP and let us know what he says.

B12 is low in range and Folate is well under range. Please take these results over to the Pernicious Anaemia Society forum here on Health Unlocked for their advice. Further testing will probably be advised, for Pernicious Anaemia, and you possibly need B12 injections but definitely need folic acid or folate supplement. However, supplementing before testing is not advised, and folate should be addressed before B12. Get the advice from the PA forum then go and speak to your GP. Come back and let us know what he says.

healthunlocked.com/pasoc

Vit D This is severely deficient. Speak to your GP about loading doses of D3, followed by a maintenance dose. Recommended level is 100-150nmol/L but your GP will only want to see it in range. Come back and tell us what he says and we will point you in the right direction if his treatment is inadequate. Also, when taking D3 it is important to take it's co-factors, which your GP wont know about. We will advise about those when we know what he is going to do.

An increase in T3 would seem to be the best idea for you. But improving your nutrients to optimal level will go a long way in helping your thyroid hormone to work better.

[Luckystar in reply to SeasideSusie]

Ok I see my GP later to discuss the results because I called haematology and asked what the consultant plans to do since I had ferritin fall down far enough to require infusions. The receptionist said I had been discharged because there was no haematological disorder present and there was no mention of active monitoring post-infusion in the letter I have received. I will go to the pernicious anaemia forum after I spoken to the GP.

[SeasideSusie Remembering in reply to Luckystar]

It would be a good idea to see what advice the PA forum gives you before speaking to your GP. They are experts and will tell you what the correct procedure/treatment is. Then if your GP doesn't offer the correct testing or supplements, you can tell him you've taken advice from the Pernicious Anaemia Society and they suggest.......

[Gambit62 in reply to SeasideSusie]

loitering from the PAS forum.

Luckystar - it looks like you have multiple vitamin and mineral deficiencies - now these could be dietary but I suspect you are quite careful about your diet - and that points to an absorption problem - likely candidates are: PA, ceoliacs, crohn's, drug interactions.

Ferritin is actually a protein that binds to iron so can be an indicator of an iron deficiency - sorry if SeasideSusie covered that already - next step would be a full blood count to see what is going on with your red blood cells - which is where things could get confusing as iron deficiency will tend to make cells smaller but both folate and B12 deficiency tend to make red blood cells larger and rounder so mix the two and things can get very difficult to interpret.

Things to be aware of in relation to interpreting serum B12 test - normal range is set in such a way that going by results alone will result in missing 25%-30% of people who are B12 deficient (but picking up 5%-10% of people who aren't so needs to be looked at in the context of symptoms. One classic symptoms is the enlarged and rounder red blood cells mentioned above but this isn't among the first symptoms for about 30% of those who are B12 deficient so there are some dangers in using this as a criterion for ruling out B12 - back to symptoms.

Unfortunately the symptoms overlap with a number of other conditions and as you are definitely folate deficient (and folate and B12 work together) that's going to make unravelling just B12 impossible.

If there is a possibility of B12 deficiency and you have neurological symptoms or quite low B12 then the B12 deficiency should be addressed 24-48 hours before starting folate supplementation (small risk of nerve damage if done the other way round and a bigger risk if the folate deficiency is treated without the B12 deficiency being treated).

Please resist the temptation to supplement B12 and folate until you have exhausted the possibilities of getting a diagnosis of deficiency as supplementation makes getting a diagnosis nigh on impossible unless you are very lucky and hit on a doctor with an interest and back-ground in B12. Please do join the PAS forum for support on getting a diganosis.

Try to get your GP to investigate what could be causing the absorption problems, unless you are certain that it is all down to diet.

[SeasideSusie Remembering in reply to SeasideSusie]

Luckystar I hope you've seen the reply by Gambit62 (immediately above) who has much more knowledge than I have.

It's come in reply to my message, just don't want you to miss it as there is so much important information there

[Luckystar in reply to SeasideSusie]

Hi yes I will go to PA forum now because I have full blood count results as well.

[shaws]

I have read research which states that when on T4/T3 combination usually the T3 part is too low. The recommendation was a 3:1 basis. Go to page 80 and the top left-para.

tpauk.com/images/docs/reduc...

[Sugarplumb61]

Hello,

All your symptoms are common place with having a under active thyroid.

I suggest you take a little more t3. like me you may not convert T4 to T3.