Hypo blood test results have left me more confused - Thyroid UK

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Hypo blood test results have left me more confused

LeighJames profile image
13 Replies

Following on from my previous blood work done on hospital admittance, approx 2 weeks ago, which said my TSH was at 29.18, my Gp sent me for a whole host of tests, most of which have now come back. (Note there have been no changes to any of my medications during this time)

Understanding the results is not easy as I am unsure of all the "ranges" and I cant get in to see my GP for a few weeks now. (Ive had to obtain most of the results over the phone). However, one of the ones that seemed to concern her most was my Vit D level. (I have been told it should be 50-90ng/ml to be considered normal but Im not sure if my result is ng/ml or nmol/l)

I am more puzzled by how my TSH has changed so dramatically in the space of 2 weeks, with no changes made to my medication.

These are my current test results:

TSH: 16.4 (down from 29.1, two weeks ago, but still obviously still an issue here)

TPOab: 92 (notes say - indicative of autoimmune issue - See Endo)

FT4: 13.7 - Dont understand this one but apparently it was tested in 2015 with a result of 19.

VIT D: 21.9

FERRITIN: 15 (I believe UK normal is 12 to 150 ng/mL for females)

The next two were done 2 weeks ago at the hospital and for reference I have included them, as it was suggested, by some forum members, that they are worth getting checked. I didnt know they had been included in a full blood work up until I saw my GP last Wednesday.

Vitamin B12: 255 (Normal values 200 to 900pg/mL)

Folate - Normal (I think this was 4, but I know its within the 2-20ng/ml range that is classed as normal in UK)

So Question 1,

Can time of day, relative to drugs taken versus blood test, have an impact on the results?

For example: (Times are approximate)

Medication taken at 9am : Bloods taken at 5pm : TSH 29.18

Medication taken at 9am : Bloods taken at noon : Results 16.4

Question 2,

Based on the 'Vitamin' results, would anyone here consider taking some B Vit supplements, Folic Acid, and Iron? Although "normal" I seem to be at the low end of the range on all of them. Alternatively, would you just try to boost your natural intake through foods you eat?

Ive been googling ideal foods within the different groups but for the most part I already eat a lot of the foods listed.

Suggestions welcome !!

For Reference:

I am female, aged 42, 'morbidly' obese, with multiple health issues including Fibromyalgia, Osteoarthritis, Major Depressive Disorder, Raynauds and more.

Diagnosed with hypothyroidism at the age of 18, my medication has steadily increased from 25mcg to current dose of 325mcg since then. Only ever taken levothyroxine. Never been offered anything else.

Last saw Endo 3 yrs ago, who, at that time, advised I may be considered for alternative meds if my thyroid function were to screw up again. (I saw him then because of a similar TSH result, which led to an increase of my meds from 300 to 325mcg).

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LeighJames profile image
LeighJames
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13 Replies
SlowDragon profile image
SlowDragonAdministrator

So your high TPO antibodies confirm you have autoimmune thyroid disease also called 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. If they are too low they stop Thyroid hormones working.

With Hashimoto's it is very likely hidden food intolerances can 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.

We have to heal the gut in order to absorb vitamins and also the Levothyroxine too

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

chriskresser.com/why-changi...

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

Low stomach acid can be an issue

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

thyroidpharmacist.com/artic...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Yes your vitamins are all far too low I will add SeasideSusie here - she's the vitamin supplements expert

See lots of her replies on how to improve and what you need

Eg

healthunlocked.com/thyroidu...

LeighJames profile image
LeighJames in reply to SlowDragon

Thank you for the great response. Waiting to hear on Coeliac test, although I have been told it isn't always a fool proof means of testing as you need to have a significant intolerance issue for it to show on the test. Thankfully my wonderful GP is very understanding and knew why I was asking for the test and agreed it was worth trying.

I have had gut issues / leaky gut syndrome in the past, which resulted in me suffering with urticaria for 2 years. After 18 months of elimination dieting we discovered I was reacting to any food that contained additives and preservatives, and MSG was borderline allergy levels. I've been much better in the last 6 years, with no urticaria flare ups, and I am still careful about what, if any, "preserved" foods I eat and avoid MSG all together.

I wish the UK produced and sold foods to the same standards as they do in France. I always feel so much better when I am there on holiday. 2 weeks over there reminds me just how crappy some of the food in the UK is (unless you have a lot of money or can grow your own). Eating organic / raw here is just too expensive for me. As someone with other health issues (mobility included) shopping fresh every few days, and preparing every meal from scratch isnt possible. I get my shopping delivered once a week and have to hope that everything has a reasonable use by date. Limited budget makes it hard to eat 'clean' all the time.

I will read up on those links you have given me and see how much of it I can actively incorporate into my daily routine. I have previously tried Apple Cider Vinegar, but struggled with drinking it. Need to find ways to blend it into other drinks. I have a shocking gag reflex for things that taste funny.

SlowDragon profile image
SlowDragonAdministrator in reply to LeighJames

Only 5% with Hashimoto's are coeliac but over 80% find noticeable or significant improvements by being gluten free

Only endoscopy is reliable test for coeliac and even then it's not 100%

There are more and more good gluten free options, but yes they can be much more expensive. M&S are very good - their bread especially

LeighJames profile image
LeighJames in reply to SlowDragon

Oh yes I love M&S. Did try GF once before and their range is very good. Sainsburys also offer decent range. My main issue with GF products is the amount of sugar they seem to insist on adding to everything. Have to keep searching options and alternatives. Thank You

SlowDragon profile image
SlowDragonAdministrator in reply to LeighJames

Yes most buscuits & cakes are too sweet

Sainsbury's bakewell slice is yummy

Home made museli using Sainsbury's certified gluten free oats is cheap breakfast option. Add dried fruit, nuts and seeds of your choice

SlowDragon profile image
SlowDragonAdministrator

There's no range on the vitamin D, but it's usually anything under 25 is severe deficiency, so you should be prescribed loading dose. You will need ongoing maintenance dose every day, once you get level up to about 80-100mnol/L

Ferritin needs to be around 70 to help thyroid hormones. You can eat liver once a week, very cheap and will definitely help improve levels

But going gluten free will help gut heal and vitamins less likely to fall so quickly then as well

B12 and folate are too low for thyroid, but not low enough for GP to treat. Supplementing a good vitamin B complex eg Igennus Super B complex will help

If you start taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

LeighJames profile image
LeighJames in reply to SlowDragon

UPDATE:

Vit D sups received today.

Aviticol /Colecalciferol 1000 IU / 1 twice a day.

Would you say this is a "normal" loading dose?

Gp gave me no instructions on how long I should take them for, before going back to her. Message which came via surgery admin staff was vague, but I appear to have been prescribed 50 days worth. Coincidentally, my Endo appointment is in 53 days time.

Would you advise leaving a significant time period between taking my thyroid meds and the vitamins?

SlowDragon profile image
SlowDragonAdministrator in reply to LeighJames

No 2000iu is barely a maintenance dose, especially with poor gut function

Look up your local CCG guidelines on treating low vitamin D

21.9 puts you in the severe deficiency category

Eg oxfordshireccg.nhs.uk/profe...

You also are unlikely to need the extra calcium of one GP prescribed as taking vitamin D increases calcium anyway

You could just buy your own, much better quality one, especially as with suspected malabsorption you are unlikely to get much benefit from any medication that goes via gut

Vitamin D mouth spray by "Better You" avoids gut problems as is absorbed direct under tongue

Various doses available- 3000iu probably good to start with, see how you go and double to 2 x 3000iu if no adverse affects

Also good idea to take magnesium when taking vitamin D.

Calm vitality magnesium powder is cheap and easy to use. Start on very low dose

Both these should be at least 4 hours away from taking Levo

Magnesium is best in afternoon or evening

LeighJames profile image
LeighJames in reply to SlowDragon

Thanks, reading up on the posts that SeasideSusie has commented on, and the links she has given.

I dont know if I have a gut absorption problem, its just assumption atm. Im also struggling with balancing out the needs of my medication with the concerns of gut issues.

I have a condition atm that requires anti inflams (Ibuprofen) and therefore, antacids. I know that antacids reduce the acid in the stomach, but I also know, from past experience, that without them I can end up with severe acid reflux :/ Cant win at the moment.

SlowDragon profile image
SlowDragonAdministrator

Are you sure these are only 1000iu vitamin D

This link says they are much higher

netdoctor.co.uk/medicines/d...

If so carry on and take them

LeighJames profile image
LeighJames in reply to SlowDragon

Looking at Box now. (Orange and white box, capsules are dark orange)

Says 1000 IU with instruction to take one twice daily.

That link you posted shows the brand but not the dose I have been prescribed. :/

LeighJames profile image
LeighJames

medicines.org.uk/emc/medici...

Patient leaflet in box also confirms 1000IU and says it is equivalent to 25mcg Vit D3

SlowDragon profile image
SlowDragonAdministrator in reply to LeighJames

Well I have Hashimoto's and gluten intolerance (not coeliac- confirmed by NHS DNA testing after endoscopy was inconclusive)

Anything less than 6000iu daily (mouth spray) and my vitamin D starts dropping. I also sit out in sun a lot and go away for winter sunshine

You will see hundreds turn up on here with Hashimoto's having been prescribed 800iu (standard GP dose) eventually 4-5 years down the line after never having had level rechecked by NHS, they get private tests and find they are still deficient.

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