Thyroid UK
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New ACTIVE B12 test from Medichecks: what does this mean?

Dear all; I have found your previous advice on this forum very useful. However I am somewhat disappointed with my test results received today, and wondered if you have any answers. My first test was in March 2017.

I have been free of my Beta Blockers, and my PPI for 5/ 6 months to aid gut absorption. ( with GP's overview)

My Levothyroxine has been increased to 150 mg which I take in the morning, waiting 1 hour before breakfast and coffee.

I have been taking all the previously recommended supplements:

200mcg L-selenomethionine: Vit D 800 iu : Vit K2 MK7 200 ug : Vit B12 1000 ug; Vit B complex: Vit C 1000mg : Chelated Magnesium 400mg:

I have been on a Gluten Free diet for 6 months - but do have the occasional lapse! I have lost a little weight a kilo and remain fairly static. I feel better in myself with a little more energy and my bloating has eased, all in the hope that my Hasimoto's antibodies would decrease.

However the reverse has happened as the anitibodies have both gone up.

Today'a Results by Medichecks is as follows;-

TSH 3.57 Range ( 0.27-4.2) mIU/L - up

FT4 19.6 Range (12-22) mIU/L

- down

T4 117.0 Range (59 -154)nmol/L

- down

FT3 4.57 Range (3.10-6.80) pmoL/L - up

TGAB antibodies ^4000.000 Range (0 - 115) IU/L - Higher

TPOAB antibodies ^351 Range ( 0-34) IU/L - Higher

25 OH Vitamin D 93.9 Range (50 -200) nmo/L - up greatly

Folate serum 8.89 Range (2.91 - 50)ug/L

- down

Active Vitamin B12 ^256 Range (25.10-165.00)pmol/L- (HIGH NEW TEST)

Ferritin 42 Range (13-150)ugL - down

CRP 6.3 Range (0-5) mg/L - down

Not sure what these results mean especially the Thyroid tests - are they better?

Suggestions are most welcome

Regards Cheslee

4 Replies
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Well your TSH is much too high, suggests you need an increase in Levothyroxine

However your FT4 is quite high. You could possibly try small dose increase. Your Total T4 shows room for increased dose

But your GP probably reluctant to agree

Your FT3 is on low side.

So the other option is to add T3. GP be even less likely to agree to that

Like many with Hashimoto's you may need addition of small dose of T3

With high TSH not surprised antibodies have risen. We need a TSH as low as possible, usually below one

Your ferritin is a bit low. Eating liver once a week should help

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:
tukadmin@thyroiduk.org

Prof Toft - article just published now saying T3 is likely essential for many, otherwise we need high FT4 and suppressed TSH

rcpe.ac.uk/sites/default/fi...

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Thanks slowdragon for helpful advice.

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Unfortunately not everyone's antibodies decrease once gluten free. I am both dairy and gluten free and my antibodies are still up and increasing. It is disheartening but everyone is different. If you feel better off gluten then do continue with that, you may need to try dairy free as well. I feel better off dairy, has gotten rid of some gut pains I was having.

I am like you in that I have high FT4 whilst FT3 is low, and TSH still not low enough. You may not convert well and likely need some T3 in the mix. I now take a small amount of T3 and it has definitely helped, but not with my antibodies.

Do you take selenium? That may help, you can try 200 mg daily.

Best wishes! :)

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Thanks Jadzhia for your advice. Yes I have been taking 200 mg of Selenium daily for 6 months.

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