Results advice please

[Kristine1990]

New here not yet diagnosed thank you

TSH 60.7 (0.27 - 4.20 mIU/L)

Free T4 10.1 (12.0 - 22.0 pmol/L)

Free T3 3.2 (3.1 - 6.8 pmol/L)

Thyroid peroxidase antibody 503.5 (<34 IU/mL)

Thyroglobulin antibody 357.3 (<115 IU/mL)

Ferritin 12 (30 - 400 ug/L)

Folate 1.6 (2.5 - 19.5 ug/L)

Vitamin B12 103.5 (180 - 900 pg/L)

Vitamin D total (25 OH) 23.3 (<25 nmol/L severe deficiency)

[SeasideSusie Remembering]

Kristine1990 Has your GP seen these results? If so what has he said? If not you need to make an urgent appointment to discuss them. I take it they are either Blue Horizon or Medichecks??? If your GP wont accept them then invite him to do his own.

TSH 60.7 (0.27 - 4.20 mIU/L)

Free T4 10.1 (12.0 - 22.0 pmol/L)

Free T3 3.2 (3.1 - 6.8 pmol/L)

There is no doubt whatsoever that these results confirm primary hypothyroidism. You need to be started on Levo straight away, and unless you are elderly or have a heart condition, you should start on no less than 50mcg. You need to be retested in 6-8 weeks then have an increase of 25mcg. Retesting/increases of 25mcg should then be repeated every 6-8 weeks until your symptoms abate and you feel well. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo

Take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, hot chocolate, etc., as this can affect absorption. Also take Levo l2 hours away from other medication and supplements, some need 4 hours.

When having thyroid tests, always book the very first appointment of the morning, fast overnight (water allowed) and leave off Levo for 24 hours. This gives the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction. TSH is highest very early in the morning and lowers throughout the day, it also lowers after eating. This is a patient to patient tip so we don't discuss it with our GPs or phlebotomist.

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Thyroid peroxidase antibody 503.5 (<34 IU/mL)

Thyroglobulin antibody 357.3 (<115 IU/mL)

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 may find that as the antibodies fluctuation you may swing from hypo to hyper and back again. This is the nature of Hashi's. Unfortunately, most doctors attach little importance to antibodies and tend to dismiss them so you will need to help yourself here.

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_...

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Hashi's and low nutrients tend to go hand in hand, and yours are a typical example. For thyroid hormone to work, all nutrients need to be at optimal levels so you will need to see your GP about appropriate treatment for your deficiencies.

Ferritin 12 (30 - 400 ug/L)

You need an iron panel and full blood count to see if you have iron deficiency anaemia, so ask your GP to carry these out.

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

If you are diagnosed with iron deficiency anaemia the treatment will be with 2 or 3 x ferrous fumarate tablets daily. 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.

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Folate 1.6 (2.5 - 19.5 ug/L) Vitamin B12 103.5 (180 - 900 pg/L)

You are folate deficient with B12 deficiency also. You need to check for signs of B12 deficiency here b12deficiency.info/signs-an... then post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc

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."

Don't underestimate the seriousness of your B12 level. You will need testing for Pernicious Anaemia and will most likely need B12 injections, usually for life. If your GP suggests taking folic acid, don't start taking it until the other investigations have taken place.

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Vitamin D total (25 OH) 23.3 (<25 nmol/L severe deficiency)

You have severe Vit D deficiency and you need to take loading doses of D3 as per the 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, don't accept 800iu daily which a lot of doctors will prescribe, that amount wont help at all. Once the loading doses have been completed you will need a reduced amount (not 800iu) 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, 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.

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Please come back and tell us what your GP is going to do.