Hi new here do I have absorption problem?

[Ellie2425]

TSH 46.8 mIU/L (0.2 - 4.2)

FREE T4 10.2 pmol/L (12 - 22)

FREE T3 3.1 pmol/L (3.1 - 6.8)

Taking 200mcg levo and diagnosed 2011 with hypothyroidism thank you

[Clutter]

Ellie2425,

Were previous tests in normal range? Have you been prescribed a new medicine recently? Did you take biotin supplement or B Complex supplement prior to your blood test?

[Ellie2425 in reply to Clutter]

Hi thanks for reply yes previous results were in normal range, I have not been prescribed any other medication and I have not taken biotin or a B complex supplement before blood draw.

[Ellie2425]

Previous results

TSH 1.77 mIU/L (0.2 - 4.2)

FREE T4 15.5 pmol/L (12 - 22)

FREE T3 4.2 pmol/L (3.1 - 6.8)

[Clutter in reply to Ellie2425]

Ellie2425,

How long ago were these done?

[Ellie2425 in reply to Clutter]

Hi they were done January 2017. The ones in the thread were done June 2017.

[SeasideSusie Remembering]

Have you had the following tested

Thyroid antibodies - TPO (thyroid peroxidase) and TG (thyroglobulin)

Vit D

B12

Folate

Ferritin

[Ellie2425 in reply to SeasideSusie]

Hi yes

THYROID PEROXIDASE ANTIBODIES 257.3 IU/mL (<34)

THYROGLOBULIN ANTIBODIES 369.5 IU/mL (<115)

FERRITIN 69 ug/L (30 - 400)

FOLATE 2.6 ug/L (2.5 - 19.5)

VITAMIN B12 238 pg/L (190 - 900)

TOTAL 25 OH VITAMIN D 67.3 nmol/L

(<25 Severe vitamin D deficiency. Patient may require pharmacological preparations

25 - 50 vitamin D deficiency. Supplementation is indicated

50 - 75 vitamin D may be suboptimal, and long-term may lead to clinical effects. Advise on safe sun exposure and diet. Supplementation may be indicated

>75 adequate vitamin D)

Taking the following

3000iu vitamin D from 800iu prescribed to me

210mg ferrous fumarate 1x a day

5mg folic acid 1x a day

[SeasideSusie Remembering]

Ellie2425

THYROID PEROXIDASE ANTIBODIES 257.3 IU/mL (<34)

THYROGLOBULIN ANTIBODIES 369.5 IU/mL (<115)

This is part of the problem. Your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it.

The antibody attacks cause fluctuations in symptoms and test results. You can go from hypo to hyper to hypo again. Your current results makes it look like you are massively undermedicated. You don't say what your dose was when the January test was done, but if on the same dose you can see how the antibodies have caused such a difference in your results.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

Gluten/thyroid connection: chriskresser.com/the-gluten...

Hashi's can cause gut and absorption problems, SlowDragon has links and information about that.

**

FERRITIN 69 ug/L (30 - 400) 210mg ferrous fumarate 1x a day

You are taking the correct amount of FF. Ferritin is said to be recommended to be half way through it's range, I've also seen it said that for females it should be 100-130, and it needs to be a minimum of 70 for thyroid hormone to work.

Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.

**

FOLATE 2.6 ug/L (2.5 - 19.5)

VITAMIN B12 238 pg/L (190 - 900)

5mg folic acid 1x a day

Your B12 is far too low. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... Be aware that taking folic acid can mask any signs so you may need to think back. If you do have signs of deficiency, please post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc

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."

**

TOTAL 25 OH VITAMIN D 67.3 nmol/L - 3000iu vitamin D from 800iu prescribed to me

You're doing the right thing taking 3000iu D3 daily. The recommended level, according to the Vit D Council, is 100-150nmol/L. When you've reached this level you'll need a sensible 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

vitamindcouncil.org/about-v...

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

naturalnews.com/046401_magn...

Check out the other cofactors too.

[Ellie2425 in reply to SeasideSusie]

Hi I was taking 200mcg levothyroxine at the time

[SeasideSusie Remembering in reply to Ellie2425]

So the massive difference in the two sets of results are due to the antibodies.

We frequently see hyper swings when a member has a Hashi's 'flare' which shows as suppressed TSH and over range (sometimes massively over range) FT4 and FT3.

With a hyper swing, when the antibodies attack the thyroid the dying cells dump a load of hormone into the blood which results in the low TSH/high free Ts. A reduction in Levo would normally be made until the temporary hyper swing is over, then dose adjustment would be made again when hypo type symptoms returned.

Your previous results show normal-ish levels and your latest results show a massive hypo swing.

You are taking a fairly high dose of Levo and one would expect an increase in Levo to deal with this but what has your GP said about this result? What is he going to do about it? I dare say he doesn't understand anything about Hashi's and antibody attacks causing these swings, most of them don't. And because most endos are diabetes specialists, most of them have little knowledge of how to treat these swings either.

Are you under an endo? If not I would ask for an urgent referral to one who specialises in thyroid. If you email [e-mail] she has a list of thyroid friendly endos but you would need to see who is in your area and then ask for feedback from members as you don't meant to see one who is useless regarding Hashi's.

[Ellie2425 in reply to SeasideSusie]

Hi I received a letter from my endo saying I should be taking 200mcg of levothyroxine and he has questioned my compliance. The GP has said because the endo is dealing with my medication he is not getting involved with adjusting my dose.

[SeasideSusie Remembering in reply to Ellie2425]

We frequently hear of Endos/doctors questioning the patient's compliance, and even accusing them of abusing their medication (usually when they're in a hyper phase). This is because they don't understand the nature of Hashi's and the fluctuations it causes.

If you were taking the same dose of Levo when both tests were done, and you were compliant with regularly taking your Levo, then you can see yourself how the results are massively different not due to your Levo but due to a Hashi's hypo phase.

You need an endo who specialises in thyroid and who has full understanding of Hashi's.

Your results currently show undermedication as the aim of a treated hypo patient 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. How do you actually feel?

Did you check the signs of B12 Deficiency?

[Ellie2425 in reply to SeasideSusie]

Hi I was taking the same amount of levo when both tests were done and I have been taking it every day.

Symptoms I have are

Difficulty swallowing

Weight loss

Hair loss

Anxiety

Depression

Fatigue

Insomnia

Heavy periods

Muscle weakness

Muscle spasms

Pins and needles

Dry skin

Loss of appetite

Irregular periods

Puffy eyes

Puffy face

I have had a look at the signs of B12 deficiency and most of them I have.

[SeasideSusie Remembering in reply to Ellie2425]

"I was taking the same amount of levo when both tests were done and I have been taking it every day."

Then there doesn't seem to be any other explanation than a Hashi's swing and you are going through a very hypo phase.

**

"I have had a look at the signs of B12 deficiency and most of them I have."

You now need to take advice from the PA forum. Further investigation may be required, you may need to stop the folic acid until they've been done - check that with them.

**

Some of your symptoms seem to be due to Hypo, some due to low nutrients. I have already mentioned the recommended levels for ferritin and Vit D above. Folate should be at least half way through it's range and we say on this forum that B12 should be no lower than 500 to avoid neurological problems, and that top of range is best.

[Ellie2425 in reply to SeasideSusie]

Posted on PA forum an hour ago thanks

[jgelliss in reply to SeasideSusie]

GREAT INFORMTION SeasideSusie . Very valuable . Thank you .....

[Ellie2425]

List of B12 deficiency symptoms

Tinnitus

Tremor

Paresthesia - numbness, tingling and pain

Confusion / disorientation

Weakness of legs, arms, trunk

Impaired vibration - position sense

Abnormal reflexes

Unsteady or abnormal gait / falls

Ataxia (Neurological disorder affecting balance, coordination and speech)

Balance problems

Difficulty walking

Dizziness

Restless legs

Visual disturbances

Forgetfulness, memory loss

Dementia / intellectual deterioration

Paralysis

Impaired fine motor coordination

Muscular spasticity

Bladder or bowel incontinence

Impaired pain perception

Nocturnal cramping

Disturbance in taste and smell

Confusion/disorientation

Psychosis

Hallucinations

Memory loss

Delusion

Depression

Suicidal ideation

Mania

Anxiety

Paranoia

Irritability

Apathy

Personality changes

Violent/aggressive behaviour

Schizophrenic symptoms

Sleep disturbances

Insomnia

Changes in taste, smell, vision, and sensory/motor function which can be mistaken for psychiatric problems

Anaemia

Macrocytosis (large red blood cells)

Hyper segmented neutrophils

Generalised weakness, fatigue

Breathlessness

Pallor / jaundice

Chronic fatigue

Vascular Problems

Orthostatic hypotension

Postural hypotension (low blood pressure when standing, which can cause fainting and falls)

Postural orthostatic tachycardia

palpitations

Occlusive vascular disorder

Transient ischemic attacks (TIAs, or 'mini stroke')

Female

Infertility

Recurrent miscarriage

Abnormal PAP smears

Intrauterine growth retardation

Loss of appetite/weight loss or anorexia

Epigastric pain (poor digestion, bloated feeling after eating small or normal sized meals

IBS - Irritable bowel syndrome

Constipation

GERD - Gastric reflux disease - ulcers / mouth ulcers

Giardiasis

Pancreatitis

Decreased stomach acid

Gastropareisis

SIBO Small intestinal bacterial overgrowth

Dry cracked corners of the mouth

Premature greying

Glossitis - swollen / sore tongue, geographic tongue

Fainting/light headedness

Osteoporosis

Fractures

Increased susceptibility to infections

Poor wound healing

Malnutrition

Skin hyper pigmentation and hypo pigmentation

[SeasideSusie Remembering in reply to Ellie2425]

As mentioned, take advice from the PA forum.

[Ellie2425 in reply to SeasideSusie]

Posted on forum an hour ago