Results advice please

[Kathelen]

I had some blood tests done last week and have been told today I am overtly underactive thyroid and I am to start on 50mcg levothyroxine. I have been told I need a repeat test in 6-8 weeks. I have some symptoms such as weight gain, numbness, dizzy spells, hard stool, fatigue, are these all likely hypothyroid symptoms please or unrelated? Sorry but my GP didn't tell me what sort of symptoms I should be having. Thank you very much

Serum TSH *89.5 mIU/L (0.27 - 4.20)

Serum Free T4 *10.2 pmol/L (12.0 - 22.0)

Serum Free T3 3.1 pmol/L (3.1 - 6.8)

Thyroid Peroxidase antibodies *>1300 IU/mL (<34)

Serum Ferritin *15 ug/L (30 - 400) prescribed 3x iron tablets a day as of today

Serum Folate *2.0 ug/L (2.5 - 19.5) prescribed 1x folic acid 5mg a day as of today

Serum Vitamin B12 203 pg/L (180 - 900)

Total 25 OH vitamin D *34.4 nmol/L (25 - 50 vitamin D deficiency. Supplementation is indicated) prescribed 800iu D3 1x a day as of today

[Nanaedake]

Hello Kathelen, I'm sorry you've been diagnosed hypothyroid but you're in good company here. You have elevated antibodies so I wonder if your GP has told you that you've got autoimmune thyroiditis otherwise known as Hashimotos thyroiditis?

Please ensure you have a blood test in 6 weeks and don't leave it 8 weeks or it will take forever to get to your optimal dose. Most people feel well when their TSH is around 1 or a little lower so you have a long way to go. Everything about thyroid is slow I'm afraid but we don't want to make it slower than necessary.

Your symptoms sound like hypothyroid symptoms but considering all your vitamins are very low you must feel pretty terrible. Numbness and dizzy spells may be due to low vitamin B12 and/or low iron levels.

800iu is not enough vitamin D3 to raise your levels sufficiently. Unfortunately, it's the amount the NHS prescribes if your vitamin D is above 30 on diagnosis of deficiency. Therefore, you may need to buy your own to supplement and I would take 5,000iu for 3 months and then retest. It's trial and error to find the right dose for you but you need to retest every 3 months until you find your correct maintenance dose. If your GP won't do it, then you can use City Assays which is listed on Thyroid UK's website, cost £28. Vitamin D builds up to toxicity if you take too much which is why you need to retest when supplementing. You can aim for 100nmol or mid laboratory range which is recommended by the vitamin D council.

What has your GP prescribed for other deficiencies?

[Kathelen in reply to Nanaedake]

Thank you, I haven't been told I have Hashimoto's thyroiditis and I have only been prescribed 5mg folic acid as of today, 800iu D3 as of today and 3x ferrous fumarate as of today

[Nanaedake in reply to Kathelen]

Your B12 is very low and before you take folic acid your GP should exclude pernicious anaemia. Taking folic acid can mask a B12 deficiency or pernicious anaemia. You should start B12 supplements about a week before folic acid I believe. You need to get your B12 level above 500 or near to the top of the lab range to ensure sufficiency. When supplementing B12 and folic acid it's best to take a B complex to keep all the B's in balance. Try to find one with all the methylated forms of B vitamins for best absorption. I use Thorne Basic B.

Have you got symptoms of B12 deficiency because if so, I advise you to post your B12 and folate results along with an outline of your thyroid condition and symptoms, low ferritin etc on the HealthUnlocked Pernicious Anaemia forum healthunlocked.com/pasoc and ask their advice about what your GP should be doing. Really, it looks like you need further investigations to rule out pernicious anaemia and GP should check for intrinsic factor antibodies.

B12 symptoms of deficiency

b12deficiency.info/signs-an...

B12 The Guidelines Doctors follow

onlinelibrary.wiley.com/doi... l

You need to take magnesium and K2-MK7 with vitamin D3 in order to absorb the vitamin D effectively. Magnesium citrate is ok but there are other choices for magnesium.

naturalnews.com/046401_magn...

Ferritin needs to be at least 70 or mid-range for your own thyroid to function properly. Ferrous fumerate 3 times a day is the correct treatment according to guidelines.

Iron deficiency anaemia NICE guidelines

cks.nice.org.uk/anaemia-iro...

The importance of vitamins and thyroid function

americannutritionassociatio...

Check B12 and folate advice on Healthunlocked Pernicious Anaemia forum and then contact your GP and query folic acid supplements. You could also ask if Vitamin D supplements could be increased athough it may not be possible on NHS.

[Kathelen in reply to Nanaedake]

I have these symptoms of B12 deficiency from the list:

Tinnitus

Tremor

Paresthesia - numbness, tingling and pain

Confusion / disorientation

Weakness of legs, arms, trunk

Impaired vibration - position sense

Abnormal reflexes

Unsteady or abnormal gait / falls

Ataxia (Neurological disorder affecting balance, coordination and speech)

Balance problems

Difficulty walking

Dizziness

Restless legs

Visual disturbances / decreased-blurred vision / damage of optic nerve

Forgetfulness, memory loss

Dementia / intellectual deterioration

Impotence

Paralysis

Impaired fine motor coordination

Muscular spasticity

Bladder or bowel incontinence

Impaired pain perception

Nocturnal cramping

Disturbance in taste and smell

Optic atrophy

Confusion/disorientation

Hallucinations

Memory loss

Delusion

Depression

Suicidal ideation

Mania

Anxiety

Paranoia

Irritability

Apathy

Violent/aggressive behaviour

Schizophrenic symptoms

Sleep disturbances

Insomnia

Changes in taste, smell, vision, and sensory/motor function which can be mistaken for psychiatric problems

Haematological signs and symptoms

Anaemia

Macrocytosis (large red blood cells)

Generalised weakness, fatigue

Breathlessness

Pallor / jaundice

Chronic fatigue

Vascular Problems

Orthostatic hypotension/ Postural hypotension (low blood pressure when standing, which can cause fainting and falls)

Postural orthostatic tachycardia

palpitations

Female

Infertility

Loss of appetite/weight loss or anorexia

Epigastric pain (poor digestion, bloated feeling after eating small or normal sized meals)

IBS - Irritable bowel syndrome

Constipation

GERD - Gastric reflux disease - ulcers / mouth ulcers

Giardiasis

Pancreatitis, pancreatic exorine insufficiency

Decreased stomach acid

Gastropareisis

Helicobactor pylori infection

SIBO Small intestinal bacterial overgrowth

Dry cracked corners of the mouth

Premature greying

Glossitis - swollen / sore tongue, geographic tongue

Fainting/light headedness

Fractures

Radiculopathy - chronic pain disorder

Increased susceptibility to infections

Poor wound healing

Malnutrition

Skin hyper pigmentation or hypo pigmentation

Will go to pernicious anaemia forum now

[Nanaedake in reply to Kathelen]

Good plan!! Let us know how you get on.

Just noticed link wasn't working - try again!

B12 The Guidelines Doctors follow

onlinelibrary.wiley.com/doi...

onlinelibrary.wiley.com/doi...

[crimple in reply to Nanaedake]

You need to take Vit K with the D3 and also try a gluten free diet because of your very high antibodies.

[silverfox7]

Before you take folate and B12 then have a word with the PA group on HealthUnlocked and they will advise you as it looks like you need to be tested for PA BEFORE yorcsupplement.