Thyroid, B12, folate, Vit D and Adrenal results help please

[Danifox6]

My recent thyroid screen reads as below, if anybody can help me in really simple terms as my brain fog is horrendous at the moment and concentration zero, that would be very much appreciated. Maybe in terms of if T3 would be beneficial and if so why, are my thoughts (but i could be wrong). I have tested positive for the DI02 gene too. I am currently taking 125 and 150 thyroxine on alternate days. I am stage 3 adrenal fatigue. Thank you.

THYROID STIMULATING HORMONE 0.469 mIU/L 0.27 -4.20

FREE THYROXINE 16.63 pmol/L 12.00 -22.00

TOTAL THYROXINE(T4) 110.1 nmol/L 59.00 -154.00

FREE T3 4.2 pmol/L 3.10 -6.80

REVERSE T3 *27 ng/dL 10.00 -24.00

REVERSE T3 RATIO *10.13 15.01 -75.00

THYROGLOBULIN ANTIBODY *788.400 IU/mL 0.00 -115.00

THYROID PEROXIDASE ANTIBODIES*100.4 IU/mL 0.00 -34.00

Vitamin B12 328.2 pmol/L 140 - 724

Folate (serum) 3.32 ug/L 3.89 - 26.80

25 OH Vitamin D 43.05 nmol/L 50.00 - 200.00

[Nanaedake]

You have autoimmune thyroid disease otherwise known as Hashimotos. You can tell this from your high antibodies result.

Have you recently felt unwell? Were your last blood tests very different from this? With Hashimotos, thyroid levels can fluctuate and therefore blood tests can vary.

There are a lot of people on this forum that can tell you a lot about Hashimotos but what do you already know?

[SlowDragon Administrator]

You have high reverse T3 - possibly due to adrenal issues

You probably need less T4 and addition of T3 instead

Reading you other post you have homozygous DIO2 gene, so you really need T3

Your antibodies are very high. Are you absolutely strictly gluten free?

What supplements do you take?

Levels of vitamin D, folate, ferritin and B12 are very important

Do you avoid all soya too, including soya lecithin

[Danifox6 in reply to SlowDragon]

I had antibodies of 170 went gluten free and they shot up to 500 plus. I take no supplements at present as I am just getting am all round picture first. If I have the gene why does that mean I need t3 please ? Does it prevent conversion? Sorry I only function about 3 hours a day so it's a lot to take in. I also just added my adrenal and hormone results if that helps.

[SlowDragon Administrator in reply to Danifox6]

The increase in antibodies after going gluten free may have been coincidental. Gluten only seems to influence TPO antibodies. Was it TPO antibodies that went up or TG?

TG antibodies seem to go up if TSH rises

I would seriously consider strictly gluten free again for at least 3-6 months

Has anyone considered if you might have PCOS? Your testosterone is high. This might be due to PCOS

PCOS also linked to gluten intolerance

paleoforwomen.com/causes-of...

Or high testosterone may be due to your Hashimoto's not being resolved.

Yes basically research suggests that having DIO2 gene variation means we need T3 to help brain function correctly. The DIO2 gene variation is apparently fairly common within the population, (about 40% test positive) but if you have inherited from both parents then you may be even more affected, than only having from one parent.

"commonly inherited variation in the DIO2 gene is associated both with impaired baseline psychological well-being on T4 and enhanced response to combination T4/T3 therapy, but did not affect serum thyroid hormone levels.”

thyroiduk.org.uk/tuk/testin...

With Hashimoto's we very often have very low vitamin levels

Essential to get vitamin D, folate, ferritin and B12 tested. Always get actual results and ranges. Post results on new post when you have them

If these are too low then you can't use thyroid hormones.

Once you have these you might want to consider seeing a recommended thyroid specialist. But unlikely to be NHS one that will consider sex hormones and cortisol levels too.

Email Louise at Thyroid Uk for list of recommended thyroid specialists

Louise. [e-mail]

[Danifox6 in reply to SlowDragon]

Yes I had those tested I just added them too !

[humanbean]

Your Free T4 is 46% of the way through the reference range. This probably needs to be in the top third or quarter.

Your Free T3 is only 30% of the way through the reference range. This also needs to be in the top third or quarter for most people to feel well. There are always exceptions though - top third or top quarter of the range suits many people but some people are happy with lower levels. But I'm sure that 30% of the way through the range is too low for everyone with hypothyroidism.

Despite these rather low numbers your TSH is only 5% of the way through the reference range.

You may have central hypothyroidism, because your body should be pushing out more TSH than it is to get the low levels of Free T4 and Free T3 a bit higher. But if your pituitary or hypothalamus is not working at full efficiency you won't have enough TSH being produced.

With central hypothyroidism thyroid treatment cannot be monitored by TSH, it must be monitored by Free T4 and even more importantly, by Free T3 levels. It is Free T3 levels which determine the number and severity of your symptoms, and since yours is too low this will be creating lots of symptoms for you.

You would have to ask for a referral to an endocrinologist for investigation of possible central hypothyroidism. However, since your TSH, Free T4, and Free T3 are all in range I think your request would probably be refused. If this did happen it would be a shame because the pituitary and hypothalamus control a lot more hormones than just TSH, and if one of the hormones is low there is a good chance that others will be too.

I think your best bet is to try and buy T3 online and self-treat. Ask for help on this in a new post.