THYROID STIMULATING HORMONE *5.26 mIU/L (0.27 -4.20)
This is very similar to last time when your GP tested it [TSH 5.6 (0.2 - 4.5)]. You are over range and you are hypothyroid, this result would get you a diagnosis in many other countries.
FREE THYROXINE *11.7 pmol/L (12.00 -22.00)
You are below range this time [previously T4 11 (range 9 - 24)]
TOTAL THYROXINE (T4) 86.8 nmol/L (59.00 -154.00)
A very low total T4 which shows you aren't producing much naturally, NHS doesn't test this.
FREE T3 4.36 pmol/L (3.10 -6.80)
Low in range but your body is doing it's best to produce some, it is the active hormone which every cell in our body needs so your body will do it's best to make some T3, eventually this will decline.
REVERSE T3 13 ng/dL (10.00 -24.00) REVERSE T3 RATIO 21.83 (15.01 -75.00)
Absolutely fine, no problems here.
THYROGLOBULIN ANTIBODY *417.000 IU/mL (0.00 -115.00) THYROID PEROXIDASE ANTIBODIES *>600 IU/mL (0.00 -34.00)
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.
Gnerally, doctors attach little, if any, importance to antibodies and tend to dismiss them. However, with each antibody attack more and more of your thyroid will be destroyed and you will eventually become hypothyroid. Hashi's isn't treated, it's the resulting hypothyroidism that is.
Most doctors wont treat until TSH reaches 10, despite positive antibodies. However, Dr Toft (ex president of British Thyroid Association and leading endocrinologist) wrote an article in Pulse Online magazine which says that if antibodies present then patients should be prescribed levothyroxine to nip things in the bud. Email firstname.lastname@example.org and ask for a copy which you can then show to your doctor, I believe it is Question 2.
You will probably get no help from your doctor regarding the Hashi's (they call it autoimmune thyroiditis) so you will need to read, learn and 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...
ACTIVE B12 47.9 pmol/L (25.10 -165.00)
FOLATE (SERUM) 13.24 ug/L (2.91 -50.00)
B12 is low in range. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... If so then you should post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc I only know what is too low for Serum B12, so other than saying your level is low I can't comment any more on Active B12 although I expect you will need to supplement but I suggest you see what the PA forum says.
For serum B12 results, 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 and you can help raise this by taking a good quality B Complex containing methylfolate (eg Thorne Basic B).
25 OH VITAMIN D 77.6 nmol/L (50.00 -200.00)
This is in the replete range but doesn't reach the level recommended by the Vit D Council which is 100-150nmol/L. If you wish to supplement to improve your level then D3 2000iu daily may be enough. I like Doctor's Best D3 softgels which come in different strengths, but for Hashi's patients, where there is often gut/absorption problems, SlowDragon recommends an oral spray such as Better You.
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 helps D3 to work and 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
Check out the other cofactors too.
It's possible to get combined D3/K2 supplements, just make sure that the K2 is MK7.
CRP -HIGH SENSITIVITY 1 mg/l 0.00 -5.00
This is good
FERRITIN 47.4 ug/L 13.00 -150.00
This is too low. For thyroid hormone to work (that's our own as well as replacement hormone) 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...
CORTISOL (SALIVA) WAKING 6.430 nmol/L (6.00 - 21.00)
CORTISOL (SALIVA) 12:00 2.170 nmol/L (1.50 - 7.60)
CORTISOL (SALIVA) 16:00 1.740 nmol/L (0.00 - 5.49)
CORTISOL (SALIVA) BEFORE BED <1.5 nmol/L (0.00 - 1.99)
For proper interpretation of an adrenal stress test it's necessary to test DHEA as well, I don't understand why some companies do cortisol only. It's also better to see the result on a graph where you can see if you follow the normal curve, whatever your results are. Cortisol should be highest in the morning and it lowers during the day, the lowest point being at bedtime.
You have low waking cortisol, lowish midday, low afternoon. The bedtime one really doesn't make any sense. With the bottom of the range being 0.00 and top of range being 1.99, you need to know exactly where you are within that range. Saying <1.50 means you could be 0.00 and you could be 1.49 - they would mean very different things.
Also any advice on vitamins and diet as I would prefer to deal with the problem from that angle if possible
Getting optimal levels of vitamins and minerals will help, but it can't subsitute for the hormones a failing thyroid needs.
Your GP may not accept your Medichecks results and may want to repeat his own. In one respect, you are lucky that both types of antibodies are high. The NHS only does one sort - TPO - and if that had come back negative you would never have known you have Hashi's unless you were referred to an endo and he ordered TG antibodies too.