I've now received my lab results from Medichecks and list them below. I'd be extremely grateful for some guidance on steps I should take that will relieve the symptoms I have:-
BACKGROUND
Diagnosed with CFS/ME in 2005, then Hypothyroidism in 2006. Now taking 125mcg Levothyroxine. Current age: 66.
ONGOING SYMPTOMS
Weight gain of 40 kilos, unable to lose weight despite an optimum, calorie controlled diet and daily exercise.
Heat intolerance and profuse sweating on mild exertion. Joint and muscle pain needing weekly [self-funded] physiotherapy sessions to keep mobile.
THYROID FUNCTION
TSH = 0.612 [0.27-4.20]
FT4 = 20.7 [12.00-22.00]
TT4 = 97.1 [59.0O-154.00]
FT3 = 4.08 [3.10-6.80]
RT3 = 26 [10. 00-24.00]
RT3 RATIO = 10.22 [15.01-75.00]
THYROID ANTIBODIES
TGAB = <10 [0.00-115.00]
TPOAB = 849 [0.00-34.00]V
VITAMINS
B12 = 328.9 [140.00-724.00]
Folate = 8.8 [3.89-26.80]
25 OH Vit D = 106.3 [50-200]
INFLAMMATION MARKER
CRP-HS = 3.5 [0-5]
IRON STATUS
Ferritin = 111.9 [13-250]
Thank you very much for any recommendations you can give me.
Written by
papi11on
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TSH and FT4 are actually in a good place. FT3 is rather low in range for such a good FT4. It shows that your conversion of T4 to T3 isn't particularly good. Good conversion takes place when FT4:FT3 ratio is 4:1 or less, yours is 5.07 : 1
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RT3 = 26 [10. 00-24.00]
RT3 RATIO = 10.22 [15.01-75.00]
Your rT3 is over range and your ratio is low. I've not seen that ratio for rT3 before, I think it usually says >20. Anyway, you can see that yours is far too low, it should be over 20.
These results mean that instead of converting to enough T3, you are producing rT3. The usual way to clear rT3 is to go on to T3 only for a few weeks to reduce it, then go back onto Levo and, if needed for poor conversion, the addition of T3. Your GP, and even an endo, may not know anything about this so you will have to do some research and decide what you want to do.
Your TPO antibodies are high so you are positive for autoimmune thyroid disease, aka Hashimoto's. This is where the antibodies attack and gradually destroy the thyroid. Hashi's isn't treated, it's the resulting hypothyroidism that is. You can help reduce the antibodies, and therefore hopefully the attacks, by adopting a strict gluten free diet which has helped many members enormously. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
B12 and Folate work together. Both are too low. B12 below 500 can cause neurological problems. Recommended is very top of range, even 900-1000. You can supplement with Solgar sublingual methylcobalamin lozenges 5000mcg. Finish the bottle then get the 1000mcg dose ones as a maintenance dose.
When taking B12 we need a B Complex to balance all the B vitamins. Thorne Basic B is a good one and contains 400mcg methylfolate which will help raise your low folate level. Folate should be at least half way through it's range.
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25 OH Vit D = 106.3 [50-200] - recommended levlel lis 100-150nmol/L so this is fine.
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CRP-HS = 3.5 [0-5] - this is fine
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Ferritin = 111.9 [13-250] - this needs to be at least 70 for thyroid hormone to work, and 100-130 is best for females. Yours is in a good place. Do you supplement? It needs maintaining so eating liver once every week or so is a good idea.
Thank you SO much for your comprehensive reply and for giving me much-needed direction on next steps I can take. I can't tell you how relieved I am that my symptoms aren't all in my head. I'll study all the information in the links you've given me and order the supplements. A 1000 thanks for your time and guidance.
TSH is low and FT4 is high in range but FT3 is quite low in range which indicates you are not converting T4 to T3 well. Reverse T3 (rT3) is high and may be due to unconverted T4. Advise is usually to reduce Levothyroxine dose and add in some Liothyronine (T3) to compensate and if that doesn't work to switch to T3 only for 3-4 months. It is very difficult to get T3 prescribed on the NHS and your GP may need recommendation from a NHS endocrinologist before s/he can prescribe. If you can't get it prescribed on NHS you can buy European or Mexican T3 which is quite affordable.
Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.
There is a view that there can be B12 deficiency when B12 is <500. You could supplement 1,000mcg methylcobalamin with a B Complex vitamin to improve folate.
My grateful thanks for adding to the invaluable information given by Seaside Suzie above. I think it's so kind of you to give me a clear path to do more in helping myself feet back to being me. Appreciated more than words can say. THANK you!
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