Hi I have high thyroid antibodies TPO 803.5 (<34) TG 258.3 (<115) and had my dose reduced from 150mcg levo to 100mcg but my free T4 was 20.3 (12 - 22) and free T3 4.2 (3.1 - 6.8) and TSH 0.01 (0.27 - 4.20) and I continue to have symptoms endo says are not thyroid related - tiredness, muscle spasms, heavy periods, weight gain, hair loss, feeling cold, yellow tinge to skin. Advice appreciated. Thyroid bloods already commented on.
August 2017
Ferritin 44 (30 - 400) taking 1 iron tablet a day since Feb 2017
MCV 78.2 (80 - 100)
MCHC 386 (310 - 350)
MCH 27.5 (28 - 32)
Haemoglobin estimation 119 (115 - 150)
Haematocrit 0.40 (0.37 - 0.47)
Platelets 251 (150 - 400)
Iron 8.3 (6.0 - 26.0)
Transferrin saturation 16 (10 - 30)
Red blood cell count 4.46 (3.80 - 5.80)
White cell count 7.13 (4.00 - 11.00)
Folate 2.3 (2.5 - 19.5) Taking 5mg folic acid since November 2016
Vitamin B12 203 (190 - 900)
Total 25 OH vitamin D 38.8 (25 - 50 deficiency. Supplementation is indicated) Taking 800iu vitamin D since 2015
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Laura_C
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Ferritin 44 (30 - 400) taking 1 iron tablet a day since Feb 2017
MCV 78.2 (80 - 100)
MCHC 386 (310 - 350)
MCH 27.5 (28 - 32)
You are being treated for low ferritin but your iron deficiency anaemia, which is suggested by the other results, has been ignored. You should see your GP, tell him that those results appear to suggest iron deficiency anaemia and ask to be treated appropriately.
See NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines)
•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.
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...
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Folate 2.3 (2.5 - 19.5) Taking 5mg folic acid since November 2016
Vitamin B12 203 (190 - 900)
As your B12 is very low, did your GP check for signs of B12 deficiency before starting the folic acid? Folic acid can mask the signs of B12 deficiency. Check now b12deficiency.info/signs-an... You should post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc You may need testing for Pernicious Anaemia and you may need B12 injections. See what they say then discuss with your GP, but don't start the folic acid until you've had further investigations.
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.
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Total 25 OH vitamin D 38.8 (25 - 50 deficiency. Supplementation is indicated) Taking 800iu vitamin D since 2015
800iu is going to take forever and a day to raise your level, you need far more. It's unlikely that your GP will be able to prescribe more than 800iu so I suggest you buy your own D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 8-10 weeks then reduce to 5000iu alternate days. Retest 3 months after starting this dose. When you've reached the level recommended by the Vit D Council - which is 100-150nmol/L - 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
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
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