New here help with thyroid results please - Thyroid UK

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New here help with thyroid results please

Stacey775 profile image
15 Replies

Thyroid peroxidase antibody 844.5 (<34)

Thyroglobulin antibody >1000 (<115)

TSH 59.5 (0.2 - 4.2)

Free T4 10.1 (12 - 22)

Free T3 3.6 (3.1 - 6.8)

Symptoms list

Joint pain

Feeling cold

Hair loss

Puffy eyes

Weight gain

Joint stiffness

Low stamina and concentration

Fatigue

Breathlessness

Thankyou

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Stacey775 profile image
Stacey775
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15 Replies
Stacey775 profile image
Stacey775

Taking 25mcg levothyroxine and diagnosed 2012

SeasideSusie profile image
SeasideSusieRemembering

Stacey775 Am I right in thinking you've been on a higher dose of Levo before?

Has it been changed a few times?

Did your doctor reduce your dose or did you?

Because of symptoms or test results?

What were the results that prompted the reduction to 25mcg?

Has anyone told you that your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's?

Have you had the following tested

Vit D

B12

Folate

Ferritin

Full blood count

Iron panel

If so can you please post the results.

I could write a very long reply, but it will be easier if you could answer those questions first :)

Stacey775 profile image
Stacey775 in reply to SeasideSusie

Always been on 25mcg levothyroxine

I didn't know I have Hashimotos

Vitamins and minerals have been tested and I supplement

SeasideSusie profile image
SeasideSusieRemembering in reply to Stacey775

Stacey775 Your GP hasn't got a clue leaving you on 25mcg Levo for 5 years. You should have had regular retests and increases every 6-8 weeks until your symptoms improved. 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. You need to go and see your GP and ask for an icrease and point out the following

From thyroiduk.org.uk/tuk/about_... > Treatment Options

According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

Booklet written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist. It is published by the British Medical Association for patients. Available from pharmacies and Amazon for about £4.95. It might be worth buying, highlighting the relevant section to show your GP in support of an increase in Levo.

Also -

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

Email louise.roberts@thyroiduk.org for a copy, print it and highlight question 6 to show your GP in support of an increase in Levo.

**

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...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

**

Please post your results and what supplements/dose you're taking.

Stacey775 profile image
Stacey775 in reply to SeasideSusie

Thanks GP has been testing my thyroid every 6-8 weeks and this is not the first time my results show hypothyroid

I will post vitamin and mineral levels now

Nanaedake profile image
Nanaedake

So how often has your doctor been testing your thyroid? And how long has your TSH been this high? You have thyroid antibodies so you have Hashimotos thyroiditis and with your TSH where it is you must feel terrible.

Stacey775 profile image
Stacey775 in reply to Nanaedake

GP has been testing thyroid every 6-8 weeks

TSH was last high a year ago

Nanaedake profile image
Nanaedake in reply to Stacey775

Ok, so your GP is monitoring the progress of your thyroid condition, that's good. You are now very hypothyroid and 25mcg is not going to be anywhere near enough so you need to book an appt with your GP to get a new prescription. There are new NICE guidelines which your GP should follow. Most people feel better when their TSH is around 1.0 or a little lower so you need to increase your levothyroxine dose and see how you feel. Some people need to increase slowly but it's something you can discuss with your GP.

cks.nice.org.uk/hypothyroid...

SlowDragon profile image
SlowDragonAdministrator in reply to Stacey775

Has your TSH ever been at lower part of range - ideally below one?

Stacey775 profile image
Stacey775 in reply to SlowDragon

Hi never been below 1

Stacey775 profile image
Stacey775

Ferritin 61.2 (30 - 400)

MCV 77.5 (80 - 98)

MCH 28.2 (28 - 32)

MCHC 384 (310 - 350)

Haemoglobin 120 (115 - 150)

Red blood cell 4.45 (3.8 - 5.3)

White cell count 6.12 (4 - 11)

Iron 10 (6 - 26)

Transferrin saturation 12 (10 - 30)

Folate 2.8 (4.6 - 18.7)

Vitamin B12 194 (190 - 900)

Vitamin D total 56.3 (50 - 75 suboptimal)

Taking 800iu vitamin D on prescription

5mg folic acid

210mg ferrous fumarate once a day

SeasideSusie profile image
SeasideSusieRemembering

Stacey775

Ferritin 61.2 (30 - 400)

210mg ferrous fumarate once a day

For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. You can help raise your level 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...

MCV 77.5 (80 - 98)

MCH 28.2 (28 - 32)

MCHC 384 (310 - 350)

These results suggest iron deficiency anaemia. Please ask your GP why he isn't following the guidelines for treatment of iron deficiency anaemia.

NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines)

cks.nice.org.uk/anaemia-iro...

How should I treat iron deficiency anaemia?

•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).

Treat with oral ferrous sulphate 200 mg tablets two or three times a day.

◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.

◦Do not wait for investigations to be carried out before prescribing iron supplements.

•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.

• Monitor the person to ensure that there is an adequate response to iron treatment.

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 2.8 (4.6 - 18.7)

Vitamin B12 194 (190 - 900)

5mg folic acid

Were you checked for signs of B12 deficiency before you started folic acid? Check now b12deficiency.info/signs-an... With your level that low I'd be very surprised if you don't have any. However, taking folic acid masks signs of B12 deficiency so think back to before you started. You should post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc Quote your Folate, B12, ferritin, iron deficiency information plus any signs of B12 you may have had or still do experience. You may need testing for Pernicious Anaemia and you may need B12 injections. Whatever they advise, discuss with your GP.

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."

Folate should be at least half way through it's range.

**

Vitamin D total 56.3 (50 - 75 suboptimal)

Taking 800iu vitamin D on prescription

The recommended level, according to the Vit D Council, is 100-150nmol/L.

Your GP wont be able to prescribe a higher dose, but 800iu is nowhere near enough to raise your level, it is hardly a maintenance dose for someone with a reasonable level.

I suggest you buy some D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 8 weeks, then reduce to 5000iu alternate days, and retest 3 months after starting.

When you've reached the recommended level 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

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.

Stacey775 profile image
Stacey775 in reply to SeasideSusie

Thanks been taking the 800iu since 2013 on prescription and GP told me to continue taking it and I will ask GP about checking me for pernicious anaemia also why my folate is deficient and why he is not treating my iron deficiency properly

SlowDragon profile image
SlowDragonAdministrator

Your antibodies are extremely high because you have been so under medicated for so long

this is Hashimoto's, (also known as autoimmune thyroid disease). About 90% of hypothyroidism in UK is due to Hashimoto's.

Hashimoto's very often affects the gut, leading to low stomach acid, low vitamin levels and leaky gut.

Low vitamins that affect thyroid are vitamin D, folate, ferritin and B12. Important to test these. If they are too low they stop Thyroid hormones working.

Follow SeasideSusie excellent vitamin advice to get levels up. Plus you must get dose increased in 25mcg steps, testing after 6 weeks after each dose increase.

But 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 can slowly lower antibodies, improving symptoms

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

Other thing that can help heal gut lining is Bone broth

thyroidpharmacist.com/artic...

SlowDragon profile image
SlowDragonAdministrator

Very few GP's understand Hashimoto's. Often completely unaware why gut is affected, or how to improve

You need to read and learn as much as possible.

Getting vitamins to very good levels and healing the gut is key, usually strictly gluten free plus increases in levo in 25mcg steps to get TSH to lower end of range.

Thyroid UK, home to this support group is good place to start. Plus reading posts on here too.

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