bluepurple Are these GP tests? If not, have you shown them to your GP and what has been said?
Ferritin 12 (15 - 150)
If GP results, did you have an iron panel and full blood count done as well? If not you need to ask for one to see if you have iron deficiency anaemia.
Ferritin needs to be at least 70 for thyroid hormone to work, and half way through range is best, although I have seen it said that for females it should be 100-130.
Ideally, because of your below range ferritin, you need an iron infusion so ask for one, but you may only be prescribed tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours.
If you are given iron tablets then take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds (if and when taking it) and two hours away from other medication and supplements as it will affect absorption.
If you are diagnosed with iron deficiency, the treatment is for Ferrous Fumarate 1 tablet 2 or 3 times a day. For low ferritin it is 1 tablet once or twice a day, but try and get the iron infusion first.
Folate 2.6 (4.6 - 18.7) Vitamin B12 153 (180 - 900)
This is appalling. Please go over to the Pernicious Anaemia Society forum here on Health Unlocked for further advice.
Do you have any signs of B12 deficiency b12deficiency.info/signs-an... (I would be very surprised if you haven't)
You are folate deficient with below range B12. I'm guessing you need testing for Pernicious Anaemia and you might very well need B12 injections. Please post on the PA forum and quote your Folate, B12 and Ferritin results, iron deficiency information if that has been diagnosed, also any signs of B12 deficiency. Don't wait, do it now 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."
That's good enough for me and I keep mine around 1000. Sublingual methylcobalamin lozenges are what's needed to supplement B12 yourself along with a good B Complex to balance all the B vitamins.
Vitamin D total 38.3 (25 - 50 deficient)
Unfortunately, you are too high for the NICE guidelines to class you as Deficient whereby they would treat with loading doses intitially. You could ask your GP but don't be surprised if you're only prescribed 800iu D3 daily. If you are, buy your own supplements as follows
and take 10,000iu daily for 4-6 weeks then reduce to 5000iu daily.
When you've reached the level recommended by the Vit D Council - which is 100-150nmol/L - 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
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
Check out the other cofactors too.
Thyroglobulin antibodies 289.3 (<115)
Thyroid peroxidase antibodies 91 (<34)
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 swing from hypo to hyper and back to hypo when these 'Hashi's Flares' take place.
When the antibodies attack, the dying cells dump a load of thyroid hormone into the blood and this can cause TSH to become suppressed and Free T4 and Free T3 to be very high or over range. You may get symptoms of being overmedicated (hyper type symptoms) to go along with these results that look as though you are overmedicated. Unless a GP knows about Hashi's and these hyper swings, then they panic and reduce or stop your thyroid meds.
The hyper swings are temporary, and eventually things go back to normal. Test results settle back down and hypo symptoms may return. Thyroid meds should then be adjusted again, increased until you are stable again.
Your results of
TSH 47.8 (0.2 - 4.2)
Free T4 10.3 (12 - 22)
Free T3 4.0 (3.1 - 6.8)
indicate a very hypo swing at the moment. What dose of Levo are you on? Have you had it reduced recently? Was that because you were apparently overmedicated with suppressed TSH and high free Ts? That would have been a hyper swing as described above. If that did happen, and your Levo was reduced, then you have now swung in the other direction and have become very hypo. You urgently need an increase in your Levo to bring your TSH down and free Ts up.
The aim of a treated hypo patient generally 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 when on Levo only.
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.
Gluten/thyroid connection: chriskresser.com/the-gluten...