TSH 0.027 mIU/L (0.27 -4.20)
FREE THYROXINE 10.9 pmol/L (12.00 -22.0)
TOTAL THYROXINE(T4) 74.7 nmol/L (59.00 -154.00)
FREE T3 4.39 pmol/L (3.10 -6.80)
There's room for your to increase your dose of NDT if you don't feel optimally medicated, as long as FT3 stays within range.
THYROGLOBULIN ANTIBODY 457.000 IU/mL (0.00 -115.00)
THYROID PEROXIDASE ANTIBODIES*62.1 IU/mL ( 0.00 -34.00)
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 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...
VITAMIN B12 194 pmol/L (140.00 -724.00)
FOLATE (SERUM) 5.72 ug/L (2.91 -50.00)
Do you have any signs of B12 deficiency b12deficiency.info/signs-an... If so you should post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc/posts
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."
Sublingual methylcobalamin lozenges are what's needed if you wish to self supplement, along with a good quality B Complex to balance all the B vitamins and help raise your folate level which should be at least half way through it's range.
25 OH VITAMIN D 49 nmol/L (50.00 -200.00)
According to the Vit D Council, the recommended level is 100-150nmol/L. You could buy some D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 8 weeks then retest. Once you've reached the recommended level you'll need a maintenance dose which may be 2000iu daily (may be 5000iu alternate days, may be less), 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.
FERRITIN 54.2 ug/L (13.00 -150.00)
Ferritin needs to be at least 70 for thyroid hormone to work, recommended is half way through range and I've seen it said that for females 100-130 is best.
You could buy some iron tablets, in which case you'd need to retest after 3 months and keep an eye on it as too much iron is as bad as too little. If you use tablets then take each one 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.
The easiest way to raise your level is by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...