Thyroid results

[ShannonJ]

Hi new here not diagnosed what do results mean thanks

TSH 64.3 (0.2 - 4.2)

FREE T4 10.6 (12 - 22)

TPO ANTIBODY >1300 (<34)

TG ANTIBODY 356.3 (<115)

[SeasideSusie Remembering]

ShannonJ

Primary hypothyroidisnm (over range TSH/under range FT4) with autoimmune thyroid disease aka Hashimoto's (high antibodies confirm this).

You need to be started on Levothyroxine immediately, no less than 50mcg unless you are elderly or have a heart condition. A retest in 6-8 weeks with a 25mcg increase in dose, and regular retest/increase of 25mcg every 6-8 weeks until you are well and your symptoms abate. 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 only.

When booking 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 early morning and lowers throughout the day. It also lowers after eating. This is a patient to patient tip which we don't discuss with doctors or phlebotomists.

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, etc for one hour either side. If you take any other medication or supplements, take 2 hours away from Levo (4 hours for some) as it affects absorption.

**

Doctors know very little or nothing about Hashi's and attach no importance to antibodies, so you will need to help yourself here by reading and learning.

Hashimoto's is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

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_...

Hashi's and gut/absorption problems tend to go hand in hand and very often low nutrient levels are the result. You should ask for the following to be tested, all need to be at optimal levels for thyroid hormone to work:

Vit D

B12

Folate

Ferritin

[ShannonJ in reply to SeasideSusie]

Ok thanks I will get appointment with GP today. Also had vitamins and minerals checked.

[ShannonJ in reply to SeasideSusie]

Ferritin 12 (15 - 150)

Folate 1.6 (2.5 - 19.5)

Vitamin B12 147 (180 - 900)

Total 25 OH vitamin D 22.9 (<25 severe vitamin D deficiency)

[SeasideSusie Remembering in reply to ShannonJ]

ShannonJ

OMG - has GP said anything about these? These are absolutely dire, serious deficiencies here that need immediate action. Hopefully my reply gets to you before you see your GP.

Ferritin 12 (15 - 150)

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 need an iron supplement and as your level is so low you should ask for an iron infusion which will raise your level within 24-48 hours, tablets will take many months.

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...

You need an iron panel and full blood count to see if you have iron deficiency anaemia, chances are that you do with such a low ferritin.

If you have a diagnosis of iron deficiency anaemia then the treatment is 2 or 3 ferrous fumarate 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.

**

Folate 1.6 (2.5 - 19.5) Vitamin B12 147 (180 - 900)

You are folate and B12 deficient. This is serious. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... You really need to post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc but if you see your GP today before getting advice from the PA forum then you need testing for intrinsic factor. You may have pernicious anaemia, you probably need B12 injections. If you are prescribed folic acid for the folate deficiency don't start taking it until further investigations are complete and I believe you should have your first B12 treatment before folic acid, not quite sure on that one.

**

Total 25 OH vitamin D 22.9 (<25 severe vitamin D deficiency)

Severe Vit D deficiency which requires loading doses, not 800iu, it must be loading doses - see 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 maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU 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 regims 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 (more than 800iu so post your new result as the time for members to suggest a dose) 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 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

naturalnews.com/046401_magn...

Check out the other cofactors too.

[ShannonJ in reply to SeasideSusie]

Thanks not prescribed anything and I have iron anaemia

[SeasideSusie Remembering in reply to ShannonJ]

OK, so here's the treatment - 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.

If your GP has seen these results and ignored them, and you are seeing the same GP today, I would make it known that you know he has ignored serious deficiencies and you are very unhappy about it as he appears to have been negligent.

If you see a different GP, point out that

the other GP has ignored the results, sort out the treatment, then give serious consideration to making an official complaint for negligence against this original GP.

[shaws Administrator]

Welcome to our forum and you have an Autoimmune Thyroid Diseased, also called Hashimoto's. It is diagnosed due to high thyroid antibodies which is attacking your thyroid gland until you become hypothyroid and also because your TSH is very high at 64+. To try to control the antibodies attacking your thyroid gland (they wax and wane) going gluten-free can help reduce the antibodies.

However, the treatment for hypothyroidism or hashimoto's is exactly the same, i.e. levothyroxine. Starting at 50mcg of levothyroxine with a blood test and increase in levo of 25mcg every six weeks.Until TSH is 1 or below. You should also have B12, Vit D, iron, ferritin and folate tested as deficiencies can also cause symptoms.

Blood tests have to be at the very earliest (TSH is highest then) fasting (you can drink water) and allow a gap of 24 hours between your last dose of levothyroxine and the test and take afterwards. The aim is to reduce your TSH to 1 or below.

You can also listen to the following Link which finishes in 13 hours. It is very informative.

thethyroidsecret.com/specia...

Levothyroxine should be taken on an empty stomach, usually first thing when we awake with one full glass of water and wait an hour before eating. Or last thing at bedtime, as long as we've last eaten about 3 hours previously if we've eaten protein but miss this dose if we're having a blood test next a.m. and take it afterwards and bedtime dose as usual.

Always get a print-out of your results with the ranges. Ranges are important and enables members to respond.