Advice on bloods please

[Tamzynne]

Hi. I am a newbie here. If someone could advise on how rubbish I feel it would be appreciated. So I have been feeling unwell for about 6 years. TSH in 2011 was 6.5 (0.2 - 4.2) FT4 15.7 (12 - 22) Ferritin 26 (30 - 400) nothing given for low ferritin and I wasn't told what symptoms to expect with the TSH that high, just that at the time of the blood draw I had symptoms like tiredness, mood swings, feeling low, heavy periods, dry skin, low stamina, a feeling of "running low on petrol". Two ultrasound scans on the thyroid revealed it was enlarged. Last one showed there was now damage to it.

I have had some new bloods in December and they show the following:

TSH 4.77 (0.2 - 4.2)

Free T4 14.5 (12 - 22)

Free T3 3.3 (3.1 - 6.8)

TPO antibody 276.3 (<34)

TG antibody 358.5 (<115)

Ferritin 15 (30 - 400)

Folate 2.2 (2.5 - 19.5)

Vitamin B12 217 (190 - 900)

Vitamin D 10.1

Ideas welcome as to what these mean, I feel a bit lost at this present moment in time.

Thank you in advance.

[fibrolinda]

Are you getting treatment now for your dire low results? Vitamin D 10.1?? You should get loading dose immediately then high supplement to bring level up to over 100-150! With lowish b12 (pernicious anaemia society recommend nearer 1000 and below 500 can cause permanent neurological damage)and under range ferritin you should be checked or pernicious anaemia before supplements start I think, have you had an iron panel blood test done? I would pop over to the Pernicious anaemia forum on health unlocked and post for advice. But all it's and minerals you've posted are too low. You have tested positive for Hashimotos, often called Autoimmune Thyroid by Doctors, have you been told that. Gut issues can cause difficulties absorbing nutrients. I believe gluten free can hep reduce antibody attacks on the thyroid . Oh hck there is so much info you need and I have to go, someone much more knowkedgbke will hopefully be along soon but you have an underactive thyroid. Over range TSH, low range ft4 and scrape the bottom ft3

[Tamzynne in reply to fibrolinda]

Hi. No treatment for vit D. Iron panel was done and I was told nothing conclusive from it. Thanks

[fibrolinda]

Check out parent site thyroiduk.org read and learn. Site won't let me do direct link o hypothyroid info, must be a problem

[SlowDragon Administrator]

You are severely under medicated for your Hashimoto's (autoimmune thyroid disease)

Make an appointment to see GP ASAP

You need 25mcg dose increase in Levothyroxine and bloods retested 6-8 weeks after each dose increase

Dose increase in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Your vitamin levels are terrible BECAUSE Hashimoto's is not correctly treated

However they still need serious improvements

How long since test was done and have you seen GP

What has GP prescribed? If nothing see a different GP urgently

You need loading dose of vitamin D

Look up your local CCG guidelines

Eg Oxfordshire

oxfordshireccg.nhs.uk/profe...

Ferritin, you need full iron panel and at least ferrous fumerate 3 x daily. But really an iron infusion

B12 is very low, ask for testing for Pernicious Anaemia before B12 injections are started

Folic acid supplements should not be started until after first injection for B12

Detailed supplements advice here for Low vitamins due to under medication

healthunlocked.com/thyroidu...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
[e-mail]

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead 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

Ask GP for coeliac blood test first

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...

[Tamzynne in reply to SlowDragon]

Hi. No treatment for vit D. Iron panel was done and I was told nothing conclusive from it. Results taken Dec 2017. No action needed was what I was told. Thanks

[SlowDragon Administrator in reply to Tamzynne]

Can you see a different GP urgently

Change practices if necessary. Your GP is negligent