The high levels of antibodies came to confirm Hashimoto's.

She has felt better on T3 because she is not converting properly. T4 levels high are near the top of the range whereas T3 is very low and accordingly she will continue to feel poorly without T3.

Unfortunately, most doctors will look at the TSH levels and T4 and will believe that she is over-medicated. She is not! T4 alone will not help and there is no more scope for any more of thyroxine.

She needs to be on a combination of T4 and T3 either in their synthetic form or switch to NDT. The likelihood for the doctors to support this treatment is not very good. Self-medication could be the way forward.

However, her GP should be on the case and ought to refer her for celiac's investigation (blood tests and endoscopy with biopsies taken from 3-4 areas within the small intestine.

Once the tests are done (she needs to be on gluten during the tests), she can move to the next stage which is to reduce antibodies.

To do so, it is recommended and has been proven with research and patients' experiences, she needs to give up all sort of gluten. Gluten can be found in all grains within different amounts. Wheat, Rye, and Barley have the most gluten content. She also needs to add 200mcg selenium/daily for 6 months to help with the reduction of antibodies, then moves to 100 mcg.

Once she off gluten, her absorption of iron will be better, and the same for most minerals.

Meanwhile, a gentle iron supplementation, iron bisglycinate, 25 -30 mg daily with vitamin C and 4 hrs away from her Thyroxine medication, for 6 months then retest.

Vitamin D: as we are approaching winter, a dose of 5000 iu per day taken with her main meal (Vit D is fat soluble) until January, then move to one 5000 iu every other day.

B12: methylcobalamin is the natural form of b12 and a dose of 5000 mcg per day for 6 months then reduce to 1000 mcg a day. Optimal levels of b12 are near 900-1000.

To balance all her B levels, an additional b-complex (most have 400 mcg of folate) I am not in favour of pushing more folate along with high methylcobalamin in case she has methylation issues.

Dr Izabella Wentz' publications and videos are very informative. She has documented her journey with Hashimoto's and her recovery.

I hope this helps for now!

Ferritin 53 (15 - 150)

Iron 10.3 (6 - 26)

Transferrin saturation 13 (10 - 30)

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You'll find optimal results for iron-related test results here :

rt3-adrenals.org/Iron_test_...

Serum iron

• 55 to 70% of the range

Doing the arithmetic, gives an optimal serum iron of 17 - 20 with the reference range provided, and your wife's is clearly too low, suggesting she can safely supplement.

Saturation

• optimal is 35 to 45%

I've seen the reference range you supply for Transferrin Saturation i.e. 10 - 30 appearing for the first time in people's posts fairly recently. I've never seen such a low saturation appearing in my own tests, nor have I seen such a range appearing anywhere else on the web. It baffles me, it really does. Because the idea that 35% to 45% is optimal is fairly widespread. But if the reference range stops at 30, what on earth (or how on earth) are they measuring it in some labs in the UK?

Anyway, your wife's transferrin saturation is low in range, which adds to the evidence that she needs to supplement iron.

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Ferritin 53 (15 - 150)

Patients on this forum have found that they feel best with ferritin mid-range or a smidgen higher.

So - with the reference range you've supplied, you're aiming to get ferritin to around 80 - 100.

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Supplementing iron can be done in various ways. If you were to get a supplement prescribed by a doctor in the UK, they would probably prescribe ferrous sulfate or ferrous fumarate (on the basis of cost).

Note with all iron supplements that the important thing is how much iron each tablet or dose contains.

Ferrous fumarate 210mg (FF210), which is what I'm familiar with, contains 69mg pure iron per tablet, and I was prescribed 1 tablet, 3 times a day, making a total of 207mg pure iron per day. You should consider that to be an approximate maximum.

See these pages for info from the British National Formulary - the doctors' prescribing bible. You're looking for the therapeutic dose, not the prophylactic dose :

bnf.nice.org.uk/treatment-s...

bnf.nice.org.uk/drug/ferrou...

bnf.nice.org.uk/drug/ferrou...

Ferrous sulfate and ferrous fumarate 210mg are the most commonly prescribed by doctors, and can be bought in pharmacies in the UK without a prescription. You can also buy online. It is up to the pharmacist whether they sell it to you or not. Boots frequently insists on a prescription, but I've successfully bought ferrous fumarate 210mg from Tesco Pharmacy and Lloyds Pharmacy. Don't try and buy more than a couple of boxes at a time.

multipharmacy.com/images/P/...

terrapharma.co.uk/media/cat...

I've bought both of the above - other brands are available. Ferrous fumarate 210mg come in boxes of 84, which is enough for 1 tablet, 3 times a day, for 28 days. Your wife's results aren't that bad, so I would suggest 1 tablet, 2 times a day would probably be the right dose.

Some people prefer ferrous sulfate to ferrous fumarate, some are the other way around.

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Alternatives to the above...

It is the amount of iron in an iron supplement that makes it more or less tolerable. The higher the iron, the fewer people tolerate it. Oddly enough, the lower the iron content the more expensive the supplements seem to get.

Ferrous gluconate - contains roughly half the iron of FF210.

Ferrous or iron bisglycinate - also sold under the name Gentle Iron - contains roughly 20mg - 25 mg iron per tablet.

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All the above are referring to iron salts but iron can be supplemented in other ways.

Eating liver is a good way to improve iron for people who don't tolerate iron salts and who eat meat. The suggested maximum is 200g per week.

For more alternatives see this document by helvella, one of the admins on this forum :

dropbox.com/sh/3waycnbzhywi...

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Iron supplements often cause constipation. Taking 500mg - 1000mg vitamin C with each dose of iron will help in two ways - it reduces the risk of constipation and helps the body to absorb iron.

Take iron and thyroid meds at least 4 hours apart. Iron will reduce the absorption of thyroid meds.

Keep iron supplements well away from children. Iron is highly poisonous and overdoses can be fatal.

It is essential to avoid supplementing for too long and overshooting the desired levels, so test every 2 - 3 months, depending on the speed that levels go up. A good test to use which isn't outrageously expensive is this finger-prick test :

medichecks.com/tests/iron-s...

Once your wife has got her levels up to optimal then she should reduce to a maintenance dose or eat some iron-rich foods every week.

Bear in mind that making a massive change to the diet could alter absorption, so test more frequently. For example, I went gluten-free and my iron absorption improved a LOT.