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Hi I am new I have been told thyroid results are normal and I am to be given a generalised anxiety disorder diagnosis so here are other results

FOLATE 2.2 (4.6 - 18.7)

VITAMIN B12 214 (190 - 900)

FERRITIN 10 (15 - 150)

VITAMIN D 26.3 (25 - 50 VITAMIN D DEFICIENCY SUPPLEMENTATION IS INDICATED)

Thanks for reading

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You need to post your thyroid results as well.

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TSH 5.3 (0.2 - 4.2)

FREE T4 12.9 (12 - 22)

FREE T3 3.2 (3.1 - 6.8)

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Taking 50mcg levo diagnosed 2012

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You can refuse the 'diagnosis', you know, tell them not to put it on your records. It's meaningless, anyway, Just psycho mumbo-jumbo to say that they have no idea what's wrong with you, so have decided to blame you for your symptoms, rather than doing their job and looking for the cause. Utter rubbish!

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So sorry, we have had several new people turn up having had same ridiculous diagnosis

Your vitamin levels are extremely low. You must feel terrible

Will add in SeasideSusie reply here to similar case

healthunlocked.com/thyroidu...

Once you add your thyroid results we can comment further

Guessing you have high thyroid antibodies (Hashimoto's)

Possibly had dose constantly adjusted and/or T3 started then stopped

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TPO ANTIBODY 278 (<34)

TG ANTIBODY >1000 (<115)

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Welcome to the forum, Annais.

Has your own GP seen those results?

Vitamin D is deficient. Your GP should refer to local guidelines or the NICE CKS recommendations for treating vitamin D deficient adults cks.nice.org.uk/vitamin-d-d... Please do not accept 800iu D3 which is a maintenance dose to be taken once deficiency is corrected. Vitamin D should be taken 4 hours away from Levothyroxine and T3.

Ferritin is deficient and this may indicate iron deficiency anaemia. Your GP should do an iron panel and full blood count to check. If you are prescribed iron it should be taken 4 hours away from Levothyroxine and T3.

B12 is low. If you have symptoms of deficiency in b12deficiency.info/signs-an... go to healthunlocked.com/pasoc for advice.

Folate is deficient. My GP prescribed 5mg folic acid for a couple of months to correct folate deficiency.

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Thanks GP has seen results and I have below range MCV and above range MCHC and he has written no action required

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Annais,

You are iron deficient if ferritin and MCV are below range and should be prescribed 3 x 210mg Ferrous Fumarate daily. Taking iron with 1,000mg vitamin C aids absorption and minimises constipation. Iron must be taken 4 hours away from Levothyroxine.

You are undermedicated to have TSH 5.3 on 50mcg Levothyroxine. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.roberts@thyroiduk.org if you would like a copy of the Pulse article to show your GP.

Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

Change your GP and don't accept the diagnosis of general anxiety disorder if it was made by the same GP. I would also write to the practice manager making a formal complaint about the GP who signed off as no action required on your thyroid and vitamin/mineral results.

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I agree absolutely with Clutter

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Annais Who has given you the generalised anxiety disorder diagnosis?

Have you been given anything for these dire nutrient levels? Anything been said about them?

FERRITIN 10 (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...

Below range ferritin can suggest iron deficiency anaemia so you need a full blood count and an iron panel. If iron deficiency anaemia is confirmed, 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.

**

VITAMIN D 26.3 (25 - 50 VITAMIN D DEFICIENCY SUPPLEMENTATION IS INDICATED)

You are 1.3 away from severe deficiency, you need loading doses of D3 - 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.

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FOLATE 2.2 (4.6 - 18.7)

VITAMIN B12 214 (190 - 900)

You are folate deficient.

Do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an...

You now need to post these results on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc/posts Also quote your ferritin result (and iron deficiency information if you already have this). You probably need testing for Pernicious Anaemia and may need B12 injections, and you will need folic acid prescribed for the folate deficiency. Do not start taking folic acid until other investigations have been completed and B12 must be started before folic acid.

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."

**

I agree with SlowDragon that there is a good chance that you have Hashi's and this has caused your dire nutrient levels.

If your GP has ignored these results, it might be better to see a different GP, get treatment sorted then give very serious consideration to making a formal complaint for negligence against this one, (particularly if he is the one who mentioned generalised anxiety disorder).

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Thanks endo gave me generalised anxiety disorder diagnosis and GP has seen results and I have below range MCV and above range MCHC and he has written no action required

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Annais endo gave me generalised anxiety disorder diagnosis

An endo is not qualified to give that diagnosis. Either ask for it to be removed from your records or ask for a referral to someone qualified in mental health eg phsyciatrist/psychologist.

below range MCV and above range MCHC

Suggests iron deficiency anaemia, and along with your below range ferritin I imagine this is a certainty. See another doctor and ask for treatment - see 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.

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Annais

TSH 5.3 (0.2 - 4.2)

FREE T4 12.9 (12 - 22)

FREE T3 3.2 (3.1 - 6.8)

TPO ANTIBODY 278 (<34)

TG ANTIBODY >1000 (<115)

Taking 50mcg levo diagnosed 2012

If you have been on 50mcg only since diagnoses in 2012, then run as far away as possible from these doctors. You already know that your vitamins are totally trashed, your endo has given you a diagnosis of generalised anxiety disorder because he hasn't got a clue about treating lhypothyroidism.

You are grossly undermedicated to have a TSH of 5.3 with extremely low in range free Ts. Clutter has already pointed this out and linked to the Pulse article by Dr Toft which you should send for, print, highlight question 6 and show your GP:

Dr Toft (past president of the British Thyroid Association and leading endorcrinologist) states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

Your high antibodies confirm 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.

If your GP or endo have not mentioned these (they call it autoimmune thyroiditis) then they have no idea what Hashi's does and how it affects the patient. Read and learn to help yourself because you're getting no help from your doctors.

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 causes gut/absorption problems which often results in dire nutrient levels, as yours are. SlowDragon will pop along with information and links on how you can deal with this but you can read about it in her reply in this thread healthunlocked.com/thyroidu...

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Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

With Hashimoto's, until it's under control, our gut can be badly affected. Low stomach acid can lead to poor absorption of vitamins. Low vitamin levels stop thyroid hormones working.

Poor gut function can lead to leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

chriskresser.com/the-gluten...

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

drknews.com/changing-your-d...

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...

drmyhill.co.uk/wiki/hypochl...

scdlifestyle.com/2012/03/3-...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

Read as much as possible about Hashimoto's and never assume GP or endo know anything. Always double check and learn to manage your condition

There's always help on here ......sadly this is far far too common .

Hence the vast number on the forum ......68,000 and growing

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you have at indicators of at least 2 absorption problems - both of which can lead to anxiety.

your doctor needs to be treating these not sticking a label on you - which is what GAD is.

Please take a look at the PAS forum

healthunlocked.com/pasoc

and this is a link to an article on thyrogastric syndrome

ncbi.nlm.nih.gov/pmc/articl...

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load of crap ...all 4 must be at least halfway in their ranges otherwise your body cannot function let alone utilise levothyroxine

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