Blood results- seeing GP tomorrow at 9am. Would love any advice!

[Kipsy]

Hi

Please see my latest blood test results. I'd appreciate any comments before I see my GP tomorrow morning. I'm currently on 75mcg of T4 and am hoping for an increase. I'm delighted my thyroglobin antibodies have come down from 724 to 543 after 4 months on a gluten free diet for Hashimoto's. I seem to be converting T4 to T3 just about ok (??) as the ratio is, I think, 4.19. It could be slightly better I think? (I've read here that 4 or below is best.)

I did these bloods at 7.40am and had TSH done at GP's the same morning at 8.35am. Interestingly, the GP's results were 2.7 for the TSH. It absolutely shows how our TSH follows a circadian rthymn. I shall try to get the next GP's bloods done a bit earlier if posssible.

I think the GP should agree to a raise in my levothyroxine as an endo wrote to her saying I'd be best with a TSH below 2 and I envisage the biggest battle will be in two mi this time when my TSH is likely to be below 2 but probably not as low as 1. I expect the GP will be reluctant to raise the dose then but hopefully tomorrow will be willing.

Huge thanks in advance for any comments e.g. If I'm right in interpreting them correctly. Written in haste- apologies

Kipsy

[Heloise]

Hi Kipsy, you've done very well and I love that you are making the effort to sort of supervise your own treatment. You definitely need an increase if those numbers are recent and you have been on the 75 mcgs. dose for a few weeks. A normal dose may be 200 mcgs. Ferritin is still too low and it is often the case since absorbing minerals is difficult. Do everything you can to raise that. I've been touting apple cider vinegar with meals (the unfiltered kind) because the acid helps to break down minerals. You could also take betaine hcl.

Once you get your FT3 upwards to 5 or over, I think you will be feeling better. I would be surprised that a dose of 75 would reduce your TSH that much but let us know.

[SeasideSusie Remembering]

Kipsy You need to improve your ferritin. A minimum of 70 is needed for thyroid hormone to work properly and conversion of T4 to T3. Also supplementing with selenium will help conversion.

From thyroiduk.org.uk/tuk/about_... > Treatment Options

According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

Book written by Dr Anthony Toft for the British Medical Association, past president of the British Thyroid Association and leading endocrinologist, and available from pharmacies and Amazon for about £4.95

Also,

Dr Toft states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

A copy of the article is available from [e-mail] print and highlight question 6 to show your GP. That should cover TSH being below 1.

[Mary-intussuception]

I agree . Even at 2.7 your TSH needs to be brought down more. I have the same problem that Endo wrote to GP my target TSH 2. Then I read on here ideally 1. Last time mine was 1.94. I think my Endo got mine down before discharging me back to GP for monitoring though.

All the best for tomorrow.

X

🐥

[Kipsy]

Thank you very much everyone for your valuable comments Heloise , SeasideSusie and Mary-intussuception . I really do appreciate your insight.

The ferritin level of 54.2 was a bit of a shock as my ferritin on 10/5/17 was 75 (same range: 13.00-150.00) so I've dropped back a lot. I think I can pinpoint why. I was supplementing with 20mg of Solgar Gentle Iron plus 20ml of Floradix daily from March 2017 until a month ago. The reason I stopped supplementing was on the advice of the Functional Medicine nutritionist I'm currently seeing. She has put me on an 8 week protocol to try to banish the SIBO, gut dysbiosis, parasite and candida that a Genova GI test showed up. She suggested I came off all my normal supplements (selenium, magnesium, zinc, iron, B12, B complex etc etc) as she said I wasn't absorbing anything anyway. To be honest, I think I need the B12 as it seems to stem anxiety and I don't want to risk not helping conversion of T4 to T3/ reduction of antibodies by not taking selenium so I've added those back in recently. I think I will now add the iron back in as I'm shocked at the reduction in ferritin. Having suffered from hair loss since I was in my 30's, (am now 48) I know how depressing that can be!

Heloise- I have apple cider vinegar with the mother at home and am going to start straightaway! Would you recommend a tablespoon in a little water immediately before eating or is that too much?

Thank you again everyone. The GP I saw at my first 6 week review after diagnosis was happy to leave me on 50mcg of levo when my TSH dropped to 3 point something (can't lay my hand on the exact figure) and I had a bit of a battle get g an increase to 75mcg so I'm not looking forward to tomorrow's appointment but hopefully the endo's letter will help. I seem to have bought every thyroid book apart from the one mentioned by Dr Toft- it sounds like a good investment and I will order it.

Thank you once more,

Kipsy

[SeasideSusie Remembering in reply to Kipsy]

Kipsy, to help your ferritin level, start eating liver regularly, maximum 200g per week. This raised mine from 35 to 91 without any iron supplements (I couldn't tolerate them). Also eat lots of iron rich foods.

As for apple cider vinegar, don't jump in at one tablespoonful, it will be a shock! Start with one teaspoonful in a cup/mug of honey sweetened water (unless you like the acidic taste) and build up gradually. I have built up to one tablespoonful in a small mug of water. You could actually sweeten it with blackstrap molasses, that contains some iron.

[Kipsy in reply to SeasideSusie]

Thank you so much SeasideSusie . I would be utterly in the dark without this forum and all I have learned from you wonderful people. The first thing I do every morning is read my newsfeed from Healthunlocked as it is addictive!

Liver...the idea turns my stomach but yes, I think it's time to try it! My wise old mum says calves liver tastes ok. I will research if it has enough iron compared to other kinds.

And thank you re the advice concerning the amount of ACV.

[humanbean in reply to Kipsy]

Lamb's liver has the mildest flavour, in my opinion, and pig's liver has a very strong taste. Ox liver is somewhere in between.

[SeasideSusie Remembering in reply to Kipsy]

I've not tried calves, I eat lamb's liver. Lots of ways to cook it, and of course you can 'hide' it in things like cottage pie, casserole, bolognese, curry, etc,

[Kipsy in reply to SeasideSusie]

Luckily I'm having an online groceries delivery tomorrow anyway...chicken liver has been ordered this time! Thanks ladies. X

[Angel_of_the_North in reply to Kipsy]

I think you'd prefer lamb's or ox liver - it feels more like meat. My cat loves chicken liver and it is really slimey.

[Kipsy in reply to Angel_of_the_North]

Ooh thank you! I must admit I was quite relieved when Sainsbury's failed to deliver the chicken livers this morning! Will investigate lambs liver next! Thank you.

[Angel_of_the_North in reply to Kipsy]

I must add that I don't eat it myself as I'm veggie and am just going on the texture and appearance of what I get for the cat - lamb kidney is quite good for B12 and other B vitamins BTW and isn't too slimey if you get it from Sainsbury's deli/butchery counter rather than the pre-packed stuff from Tesco.

[Kipsy in reply to Angel_of_the_North]

Thanks! Great advice x

[Heloise in reply to Kipsy]

I don't even measure any longer but it's somewhere between a teaspoon and a tablespoon. It has helped with insulin resistance, it adds probiotics and kills certain bacteria in the lower gut. I think it's great.

We've had a wonderful summit which I have mentioned in my posts if you look at my profile. If you are on Facebook Shivan Sarno has some repeats of the interviews. I didn't know that much about Sibo an your doctor is wonderful to have spotted it. It affects 45% of the people.

[Kipsy in reply to Heloise]

Thanks very much Heloise!

[Kipsy]

Quick update- saw a locum GP yesterday who suggested a raise of levo from 75 to 100mcg without any arguing. How nice for a change! She even said 'let's have a quick look then' when I mentioned I had my medichecks BT results with me. Shame she's only a locum & is leaving- we could do with more like her! She even agreed that TSH of nearer to 1 can be beneficial, especially to women looking to conceive apparently.