I've been diagnosed with hypothyroidism for over 2 years, I'm on 150 of Levothyroxin, it was first identified after the birth of my daughter. I also have other hormonal issues as I have a prolactinoma (tumour on the pituitary gland which is non malignant and managed through tablets). After joining this group I got the following tests done - I'm seeing my consultant next week. Could you please advise what this means and what I should do/ ask for from him?
TSH - 0.925 (0.27 - 4.20)
Free Thyroxine - 20.3 (12 - 22)
Total T4 - 121 (59 - 154)
Free T3 - 5.38 (3.10 - 6.8)
Thyroglobulin Antibodies - 443 (0 - 115)
Thyroid peroxidase antibodies - 27.5 (0 - 34)
B12 - 199 (140 - 724)
Folate - 3.44 (2.91 - 50)
Vit D - 57.4 (50 - 200)
CRP - 0.8 (0 - 5)
Ferritin - 67.1 (13 - 150)
Thanks so much for your help.
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Jrouseuk
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Sorry, but we need the ranges - the results are meaningless without them. Can you edit your post and put them in, please? Just click on the downward-facing arrow at the bottom of your post.
Jrouseuk For proper interpretation of your test results, the reference ranges are needed, eg
TSH: 0.925 (0.2-4.2)
If you edit your post and add the ranges members will help. Click on the down arrow V below your original message, choose Edit, make the changes, then click the big green button Edit Response.
Two obvious ones to start with are your Thyroglobulin antibodies are very high over range confirming autoimmune thyroid disease aka Hashimoto's and your B12 is very low.
Adopting a strict gluten free diet can help reduce the antibodies, as can supplementing with selenium L-selenomethionine 200mcg daily and keeping TSH suppressed
These results suggest that your current dose is good. Conversion of T4:T3 is good with a ratio of 3.77 : 1 (good conversion takes place when ratio is 4:1 or less). Do you feel well on this dose?
Thyroglobulin Antibodies - 443 (0 - 115)
Thyroid peroxidase antibodies - 27.5 (0 - 34)
As mentioned previously, high antibodies confirm Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results. As mentioned, being strictly gluten free and supplementing with selenium can help reduce the antibody attacks. Also, check out the links given previously, you need to learn about Hashi's because most doctors know precious little about it and how it can cause fluctuations, they tend to dismiss it and say it's of no importance then blame any symptoms or fluctuating test results on something else, often accusing the patient of abusing their medication!
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B12 - 199 (140 - 724)
Folate - 3.44 (2.91 - 50)
This is a problem. Both folate and B12 are far too low. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... . If so then please post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc
Folate should be at least half way through it's range and B12 at the top of it's range. I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:
"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."
And an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
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Ferritin - 67.1 (13 - 150)
This is just about bordering on OK. Ferritin needs to be at least 70 for thyroid hormone to work, recommended is apparently half way through it's range but I have also read that females should aim for 100-130. Rather than supplement with iron tablets, you can increase your ferritin by eating liver regularly, maximum 200g per week due to it's high Vit A content, and include lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
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Vit D - 57.4 (50 - 200)
This is too low. Replete is 75-200 and the Vit D Council recommend 100-150nmol/L. Your GP/endo wont do anything about this level so my suggestion would be to buy your own D3 softgels like these bodykind.com/productsearch/... and maybe take 4000-5000iu daily for 8 weeks, reduce to that amount alternate days for a month then retest. Once you've reached the recommended level (100-150) then you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
There are important cofactors needed when taking D3
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
Wow thanks very much - this is all just incredible to me, having been diagnosed for 2 years and no one has ever said any of this to me. You asked me how I felt on my dose. I guess I feel fine but I cannot lose weight. I'm careful with my diet and exercise between 4-6 times per week. However, I regularly get virus infections which will be like the flu and it will put me out of action for 3-6 weeks each time. I guess this is the antibodies?
I'm also considering having another baby and I'm terrified about all of the above and the impact it might have on an unborn baby if levels aren't right so thats why I want to speak to my endo about it all. I'm hoping he's going to be receptive.
Have posted on the other forum as you mentioned. I've got no idea what that all means so will have a look through the various links.
I'm careful with my diet and exercise between 4-6 times per week.
Exercise depletes T3 and we need good T3 level for weight loss to happen. Your FT3 isn't bad at all, but if you maybe cut back on any hard exercise, concentrate more on gentle exercise, maybe that will help.
However, I regularly get virus infections which will be like the flu and it will put me out of action for 3-6 weeks each time. I guess this is the antibodies?
I don't have Hash's so can't say if this is connected. However, I'd do all you can to boost your immune system. I have to be very careful of infection because of my lung disease so I make sure I do everything possible to have as healthy an immune system as I can. I take a minimum of 2000mg Vit C daily in divided doses, (recommended as a general good thyroid/adrenal support), I take a garlic supplement every day (I prefer the liquid form Allimed as it has better bioavailability than capsules), during the winter months I take a homeopathic flu preventive - oscillococcinum - one per month from October through to April - I haven't had as much as a cold for as long as I can remember, maybe 20 years (and I don't have the flu jab). If I do feel I have any type of virus infection I use Oil of Oregano capsules temporarily and that helps.
Hashimoto's affects the gut, very often leading to low vitamin levels. When these are too low then thyroid hormones struggle to work
As you have Hashimoto's then hidden food intolerances may be causing issues, most common by far is gluten. Changing to a strictly gluten free diet may help reduce symptoms and eventually start to lower antibodies. Very very many of us here find it really helps and is essential to be gluten free
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