Thyroid results

[Aliona887]

TSH 3.87 (0.2 - 4.2)

FT4 10.3 (12 - 22)

FT3 2.1 (3.1 - 6.8)

TPO 87.5 (<34)

Hi new member looking to get T3 since current endo says it is dangerous for me to take but previous endo prescribed it to me with no problems. Thanks

[SlowDragon Administrator]

Can we have a bit more info so members can advise

What dose were you taking when on T3. Do you have test results from then. How long were you taking T3

How long since dose changed and what to ?

Any chance you can see the endo that started you on T3

Presumably these test results are since T3 stopped. They are extremely low. You need to increase Levo by 25mcg and retest after 6-8 weeks and likely need further increases after that

Highly likely that you now have poor gut function and low vitamins

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. Have these been tested, if not ask that they are. Always get actual results and ranges.

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. Very, very many of us here find it really helps and can slowly lower antibodies.

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

chriskresser.com/why-changi...

scdlifestyle.com/2014/08/th...

If you can't get full thyroid and vitamin testing from GP

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after.

[Aliona887 in reply to SlowDragon]

I was taking 200mcg levo and 10mcg T3, these results were done when I was on 25mcg levo. I was taking T3 for 1 year.

Dose was changed 4 months ago. Endo has discharged me from clinic.

Results when on 200mcg levo and 10mcg T3

TSH <0.02 (0.2 - 4.2)

FT4 20.3 (12 - 22)

FT3 5.3 (3.1 - 6.8)

Diagnosed 2013

[Aliona887 in reply to SlowDragon]

Other results

FERRITIN 21 (30 - 400)

FOLATE 4.1 (4.6 - 18.7)

VITAMIN B12 101.3 (180 - 900)

VITAMIN D 23.2 (<25 SEVERE DEFICIENCY)

Thanks again

[SlowDragon Administrator]

So this endo left you in 25mcg dose of Levo? And this is still all you are taking now?

If that is the case endo needs reporting for gross mismanagement.

How long since these vitamin results and has your GP seen them? What have they prescribed?

I will add SeasideSusie for detailed vitamin advice

Is there another GP you can see

Email Louise at Thyroid Uk for list of recommended thyroid specialists

[e-mail]

[Aliona887 in reply to SlowDragon]

Yes I only take the 25mcg now because endo was worried about my weight. Vitamins and minerals done 2 months ago nothingf prescribed thanks

[SlowDragon Administrator in reply to Aliona887]

You mean your not the "typical" over weight thyroid patient.

Many aren't, you can be very slight and skinny and still be extremely hypo.

Your endo obviously not a thyroid expert

You need urgent increase in Levo and significant vitamin supplements. Plus almost certainly gluten intolerant. 5% are coeliac, but over 80% of us are gluten intolerant

Is there another GP to see at the practice. Make an urgent appointment. Do you have friend or family member to go with you.

Vitamins must be improved as soon as possible

I am adding Clutter and humanbean to this post.

You must be feeling appalling. What are main symptoms

[Aliona887 in reply to SlowDragon]

That's right yes I am slight and skinny. There is another doctor I can see but there is no one to go with me to appointments. Main symptoms are pins and needles, tiredness, heavy periods, cramps, feeling cold, puffy eyes and ankles, dry skin all over legs, hair loss, eyelash loss.

[SlowDragon Administrator in reply to Aliona887]

Pins and needles is typical of low B12

Make urgent appointment with different GP

Meanwhile start improving your vitamin D, (plus magnesium). Follow advice on post linked by SeasideSusie

Wait to see GP before starting any B vitamins or testing for Pernicious Anaemia and intrinsic factor is no good

[SlowDragon Administrator]

Previous post by SeasideSusie for similar low vitamins

healthunlocked.com/thyroidu...

[SeasideSusie Remembering]

Aliona887 Vitamins and minerals done 2 months ago nothing prescribed thanks

Have a read through my reply below, see a different GP to get treatment sorted, then I suggest you seriously think about reporting the GP who has ignored these results, he has been extremely negligent.

FERRITIN 21 (30 - 400)

As your ferritin is below range, you need an iron panel and full blood count to see if you have iron deficiency anaemia. If these have already been done, post the results please.

For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. As your level is below range, ideally you need an iron infusion so ask for one, but you may only be prescribed the tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours.

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.

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...

**

FOLATE 4.1 (4.6 - 18.7)

VITAMIN B12 101.3 (180 - 900)

You are folate and B12 deficient. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... Please go to the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc Quote your B12, Folate, Ferritin results, plus iron deficiency information if you have any. Also quote any signs of B12 deficiency you may be experiencing. I think you may need testing for Pernicious Anaemia (I'd be surprised if you don't prove positive for it) and you will probably need B12 injections for life.

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 needs to be at least half way through it's range.

Please don't underestimate how serious your B12 result is. Please watch the first part of the first film in this link and then realise just how negligent your GP has been and what damage he could very well have caused you b12deficiency.info/films/

**

VITAMIN D 23.2 (<25 SEVERE DEFICIENCY)

You are severely deficient and need loading doses of D3. Check NICE treatment summary for Vit D deficiency:

cks.nice.org.uk/vitamin-d-d...

Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the guidelines and prescribes the loading doses. Once these have been completed you will need a reduced amount (not the 800iu you will probably be prescribed) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose which may be 2000iu daily (not 800iu), 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.

[Aliona887 in reply to SeasideSusie]

Hi and thanks complete blood panel and iron panel were done, doctor didn't explain what results meant. I only got printout from the surgery.

Red blood cell count 4.45 (3.8 - 5.8)

White cell count 6.12 (4.0 - 11.0)

MCV 76.1 (80 - 98)

MCHC 385 (310 - 350)

MCH 27.8 (28 - 32)

Haemoglobin estimation 120 (115 - 150)

Platelets 254 (150 - 400)

Iron 9.1 (6.0 - 26.0)

Transferrin saturation 15 (10 - 40)

[SeasideSusie Remembering in reply to Aliona887]

Aliona887

MCV 76.1 (80 - 98)

MCHC 385 (310 - 350)

MCH 27.8 (28 - 32)

This is enough to suggest iron deficiency anaemia and now you have something else to complain about your GP's negligence.

See 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.

I would still ask for an iron infusion to deal with the low ferritin, I'm not sure how much difference, if any, that will make to the iron deficiency anaemia.

You really do have a GP that should be in a different job, he doesn't seem to be able to understand test results or know what to do about deficiencies. I hope the next one you see is more on the ball and that you get the treatment you need and start to feel better.