High TSH, Low Normal T4, High TG Ab but Low TPO? - Thyroid UK

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High TSH, Low Normal T4, High TG Ab but Low TPO?

Toria_Star profile image
44 Replies

Hello everyone,

I’m new here and paid for some private blood tests in Jan 2018 due to feeling like I’ve symptoms of underactive thyroid for about 10-12 years. I am a 31 year old female, 5ft 8 and usually normal build plus been pescatarian for the past 2 years.

I was wondering if someone could have a look at my results and give me their opinion? I’ve seen some of the crazy high TSH and Antibody results on here so just wondering if mine are high enough to actually be causing these problems.

TSH H 4.54 (0.27 - 4.20 mIU/L)

T4 Total 83.2 (66 - 181 nmol/L)

Free T4 14.70 (12.0 - 22.0 pmol/L)

Free T3 5.62 (3.1 - 6.8 pmol/L)

Reverse T3* 17.0 (10 - 24 ng/dL)

Reverse T3 ratio 21.52 (Normal >15 Ratio, Borderline 12-15, Low <12)

Anti-Thyroidperoxidase abs 18.5 (<34 kIU/L)

Anti-Thyroglobulin Abs H 408 (<115 kU/L)

Extra Tests

HbA1c-(IFCC) 28 (20 - 42 mmol/mol)

hs-CRP 0.20 (<5.0 mg/L)

Ferritin L 12.9 (13 - 150 ug/L)

Magnesium 0.86 (0.66 - 1.07 mmol/L)

Insulin 80.9 (<173(Fasting) pmol/L)

Vitamin D (25 OH) L 34 (Deficient <25 nmol/L, Insufficient 25 – 50, Consider reducing dose >175)

Vitamin B12 303 (Def <145 pmol/L, Insuf 145 – 250, reducing dose >569)

Serum Folate 18.40 (8.83 - 60.8 nmol/L)

Doctor’s TFT 2014

TSH 1.75 (0.35 – 5)

FT4 13.7 (9 – 21)

TT3 1.5 (0.9 – 2.5)

Doctor’s TFT 2012

TSH 4.1 (0.35 – 5)

FT4 13 (9 – 21)

Looking at my medical history, in previous tests my Alkaline Phosphatase has been low at 43 (40 -140) in 2012 and 31 (40-150) in 2008 when it was 118 in 2006 and 123 in 2003. I’m not sure if that could be linked? Also my white blood count is usually at the lower end of the scale and in 2014 my Lymphocytes were below range. I haven’t had recent blood work other than the private test so can’t really compare properly.

Some history, signs and symptoms that might be related:

My mother and her sister both diagnosed hypo (prob didn’t have Ab tests)

My gran (mother’s side) recently diagnosed pernicious anemia

My aunt (father’s side) had partial thyroidectomy at age 25

Suspect my dad has Thyroid problems but he refuses to get tested

History of bad sore throats and tonsillitis which penicillin wouldn’t shift

I had Glandular Fever 2005/2006

Diagnosed with depression 2014 – Prozac for 8 months, some periods of bad anxiety too

Hospital stay (2 nights) 2014, suspected viral meningitis though not confirmed.

Always cold – esp lower legs, feet, hands, nose (min 15 tog duvet, full pjs and socks year round)

Never get restful sleep – tired in morning, tired early evening, energy boost 10/11pm

Constant tight, achy muscles, itchy legs too. Can feel wiped out and breathless after walking up stairs – general weak feeling and felt like I had nothing more to give when I trained for a 10k in 2014 – strong metallic taste in mouth during last few weeks of training.

Mostly constipated recently (Bristol 1/2) although had bad IBS around 2013 – 2015

I feel like I have to urinate a lot more than people too

People say I look normal but I feel my face is puffier than usual, I sometimes have face ache around my eyes and I currently have a 37” waist which I can’t seem to shift so feel bloated(have a 31” chest (ribcase) to put it in perspective)

Loss of libido and my periods have become lighter most days with one heavy day and also shorter

Pain and dysfunction in left knee and right ball of foot

I seem slow to heal in terms of skin etc, nails have a lot of ridges and bulges

The skin on my face and scalp is very dry but I have always had acne on face, scalp, chest and esp back and I go through phases of losing a lot of hair in the shower plus dark patches under eyes.

Currently also getting food sensitivity issues which might be histamine intolerance?

Sorry for the long post, just thought it was better to put the info out there in the first instance. Any comments appreciated. I’ve read quite a bit about Hashi’s and understand the possible links with Gluten and Dairy (happy to trial removing these) and also know of the different meds for thyroid (although reckon Levo would be the only option from my doctor anyway) so really just seeking reassurance that I’m not totally mental and that it does seem like I have a thyroid problem (whether cancer or underactive)?

Personally, from the research I’ve done, I think there’s a chance it’s Hashi’s looking at my figures but don’t know why my T3 is higher end of normal and my TPO isn’t elevated? Do you think there’s any chance of getting a diagnosis from the doctor with these or am I likely to be a ‘wait and see’? Also, is there anything else I should ask/pay to get tested? If I can’t get a diagnosis, will my blood work Improve (and will I feel better) if I just supplement D3 and Iron (and Selenium?) plus change my diet to Gluten and Diary free? Or should I wait til I get worse before changing these things?

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Toria_Star
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Heloise profile image
Heloise

Hi Toria, I've been responding to posts here for several years but I almost hesitate to answer this because it's so puzzling. As you have already noted, it is strange to have a high T3 AND a high TSH. Plus a low FT4. Your ferritin is really low so your idea of taking iron is good and I would add zinc and selenium. Your TSH improved when you were on Prozac it seems.

Perhaps someone else can figure that out but whatever is going on may improve if you do eliminate gluten and dairy for a while.

Just how much fish do you eat? We have been watching a summit on heavy metal and seafood is definitely adding mercury and your higher level of TGS may be due to mercury levels. This man explains. Sorry I can't be more help.

youtube.com/watch?v=Z5SaM0R...

Toria_Star profile image
Toria_Star in reply toHeloise

Heloise,

Thanks so much for that. I've just watched the video and will watch the other one he recommends later. Very interesting! I wouldn't say I eat much fish, once or maybe twice a week and it tends to be prawns more often than fish but I am willing to take it out my diet if it could be the problem. I also have a couple of amalgam fillings so I guess that could also be contributing!

Toria_Star profile image
Toria_Star in reply toHeloise

Oh and with regards to TSH improving when on Prozac, I'm not too sure. I started on Prozac on 19/09/2014 and my bloods were on 10/10/2014 so would that really have time to take effect? I did also heavily supplement with D3, Vit D, omega 3 but again that probably started about the same time. Therefore, maybe it was something between April 2012 and early October 2014 that changed things? I'll need to have a good think and see what it could have been.

SilverAvocado profile image
SilverAvocado in reply toHeloise

Heloise, I was excited to see this particular pattern: high TSH, low freeT4, and decent freeT3, because it seems like an example of something Diogenes has been mentioning a lot recently (our resident thyroid scientist).

As the thyroid starts to struggle to produce T4 - which is the bulk of hormone it makes, the conversion into T3 is increased, so you get more T3 than expected.

Heloise profile image
Heloise in reply toSilverAvocado

That is an interesting theory but it doesn't seem to happen too often, does it? Or does it?

The thing is she has all those hypo symptoms so you wonder what is going on and if it's stagnant T3, where is it coming from? It's beyond me.

SilverAvocado profile image
SilverAvocado in reply toHeloise

I feel like it's a pattern we do sometimes see, but I haven't taken much notice before. Sometimes when people are on the borderline of getting diagnosed you read the TSH, freeT4, and get a surprise when you see the freeT3.

I will definitely look out for it in future.

Maybe the body knows that its living on 'borrowed T3', Diogenes was saying the feedback loops are too complicated for him to explain easily! We will have to wait for his next paper and study hard!

Toria_Star profile image
Toria_Star in reply toSilverAvocado

That's interesting if it is whats happening!

MikeM46 profile image
MikeM46

Hi Toria

I doubt you’ll get any enthusiasm from an NHS GP for prescribing T4 Levothyroxine with figures like that ‘cos although your TSH is just over range your T4 & T3 results are in range. Of course that doesn’t mean your thyroid function is as good as it could be. Some research indicates that the setpoint for TSH varies between individuals. Your T3 however is not that bad, though it could be higher.

Perhaps you should go over these vits & mins results & sort yourself out on those on the low side. Yes, especially ferritin, Vit D (& serum folate)

You might benefit from others more experienced than myself on how best to go about this, but it will take several months to improve.

Hope you find a way to improve how you feel & are ... this is such a complex area where so many factors can interrelate.

Toria_Star profile image
Toria_Star in reply toMikeM46

Hi Mike,

Yeah I worried that might be the case. Tests back to 2005 seems to have my T4 relatively low in the range (1.6/1.2) with T4 at 12/11 (range 9 - 24), in 2003 TSH was 2 (0.4 - 6) and my FT4 was 17 (10 -24) so that's the only time it's been a little higher. The T3 is bizarre though as, from what I can tell, it would seem like I am converting, just not producing much thyroid hormone in the first place?

TSH110 profile image
TSH110

Your TSH is over range, you have obvious and very unpleasant hypothyroid symptoms. Ask your doctor for a trial of Levothyroxine. Things will only get worse without medication. It is not worth suffering all that. You may be refused but it is worth a try.

Toria_Star profile image
Toria_Star in reply toTSH110

Thanks TSH110, I have an appointment on Friday so I plan on taking in my new results and a print out of my past ones plus a list of all my symptoms. I will ask if a trial is possible but if not then hopefully sorting out the vits and mins will help quite a bit.

SilverAvocado profile image
SilverAvocado in reply toToria_Star

I was thinking it's time to shop around doctors - try every doctor in your practice one by one, to see if any are better than the others.

You are on the borderline of what they will diagnose. The important points are: TSH over range - they only really care about TSH. Positive for antibodies, and considerable symptoms. I'm sure the NICE guidelines mention that if you're positive for antibodies you can have a trial of hormones.

But many doctors know nothing, or are waiting for ridiculously high TSH. Yours will get there eventually, but it may require waiting years of ill health :(

You also have multiple vitamin deficiencies. You will definitely feel improvement when they are sorted. Don't trust doctors for that. They will leave you hanging with eg low dose vit D forever!

Toria_Star profile image
Toria_Star in reply toSilverAvocado

This will technically be a new doctor for me at the practice as I've only seen her once to discuss potential food sensitivities and to ask if I could get my blood drawn at the practice for my private test (she was kind enough to say yes). I have slight hope that this one might be better as she is also a lecturer so hopefully open to studies and new learning etc.

I'll make sure I draw her eye to the TSH and antibodies specifically then and I'll see if I can find the NICE guidelines you mention and take a copy of them.

I'll also have a look on here for previous recommendations on vitamin supplement levels then. If you have any suggestions on where is best to buy them, that would be appreciated as all that comes to mind is Holland and Barrett!

I've felt so crap through the whole of my 20's so now is the time to sort it, I can't waste my 30's as well! Thanks for your advice.

TSH110 profile image
TSH110 in reply toToria_Star

I wonder if it is worth taking a copy of the Toft article stating TSH should be under 1 and free T4 and free T3 in the top third of the range for most people being treated for hypothyroidism to feel well, although it is for those who have a diagnosis of hypothyroidism already. Your antibodies prove you have autoimmune thyroiditis so there is your proof and I am sure the guidelines say Doctors can treat if the patient has symptoms and an elevated TSH. Lay it on with a trowel about how it is ruining your life/job etc and that they are known symptoms. I felt completely dire with a TSH of 6 but because I had been so ill and very overtly hypothyroid before getting any help, they aimed to get mine well below 1. It has to be 0.5 or less for me to feel vaguely human! Also make sure they are aware of any family members with it - all the female line from my grandmother down have/have had thyroid disorders bar one sister who looks like she is hypo. They should bear this in mind when looking at your case. I think you said some relatives have it. Daft app won’t let you read any of the post as you type a response. Good luck with your appointment I hope you get a sympathetic and proactive GP 🍀☘️🍀 if not you can always take the law into your own hands and self medicate but let’s hope that is not necessary 🤞🏼

Toria_Star profile image
Toria_Star in reply toTSH110

Yes, I have family members on both sides that have it so I'll definitely be mentioning it. I have heard of the Toft article but where can I find a copy?

TSH110 profile image
TSH110 in reply toToria_Star

I think you can email admin - it might be Diane now I’ll find the address for you now

Contact is: email dionne.fulcher@thyroiduk.org for the Toft article

It is in qn 6 of the article

Hope that helps

This is what it says (via post by SeaSide Susie):

an article in Pulse Online Magazine (doctors' magazine) written by Dr Anthony Toft who is past president of the British Thyroid Association and leading endocrinologist in which he states

"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)."

silverfox7 profile image
silverfox7

Well where to go next! A few important but illogical readings. You appear to be super good at converting but the vitamins etc to help that are low so may be that infers that will be very short lived.

I would wait 6 weeks and retest. It may be at the moment you have a virus you aren't aware of so waiting for that to pass may give different results or if you body is really starting to struggle then you may be on the way to more reliable results as to your health. At the moment I can't see you being able to be put on medication just looking at your results but something isn't right so retesting in a few weeks may help in sorting it out or it may have righted itself but with a family history it's as well to get to the bottom of it.

Toria_Star profile image
Toria_Star in reply tosilverfox7

Yes, thanks silverfox7. I believe a re-test will be on the cards. Do you think it's worth just asking the doctor to retest (probably only TSH and FT4 would be available, I'd guess) or should I get another panel done privately?

Even if I improve my vits and my TSH drops and T4 rises, do you have any idea if that could reduce the antibodies or will I still have to tackle that on my own?

Heloise profile image
Heloise in reply toToria_Star

Toria, antibody type will reveal more. Gluten proteins look very similar to thyroid tissue and that is why once a sensitivity to gluten begins it extends to other tissue. The David Clark video has 19 other reasons for low thyroid function, you may want to go through them and see if anything resonates. I'm not doctor but in desperation I would get progesterone cream and try it. You'll see how important these other factors are if you watch Dr. Bergman's lengthier video. He's brilliant and you will understand why regular medical doctors have NO CLUE. You will be surprised at what you probably didn't know about your own body. Keep posting.

Toria_Star profile image
Toria_Star in reply toHeloise

Thanks, I will definitely be watching the rest of the Clark videos and having looked up Bergman, I am guessing it's the video titled 'Dr John Bergman - Thyroid and Adrenal Health' which is about 1hr 43?

Heloise profile image
Heloise in reply toToria_Star

Yes, but he has many, many more and I recommend all of them. His nervous system video is great and female health also great. He's a phenomenon. His criticisms of the FDA in the USA and doctors in general when it comes to hormones and autoimmune conditions are right on target.

Toria_Star profile image
Toria_Star in reply toHeloise

Great, I'll treat myself to an educational evening on YouTube this week then! Thanks for the recommendation.

Heloise profile image
Heloise in reply toToria_Star

Take notes:)

Greybeard profile image
Greybeard

One of your antibody levels is high, so that indicates hashis. They indicate your thyroid is slowly being damaged so tsh is likely to rise over time. Some people have success lowering them by going gluten free. As Mike says look at your nutrients and vitamins, getting them optimal rather than low in range will help. Gut health can be a cause of thyroid problems so eating less processed food and taking a good quality probiotic helps. Thyroid health is very much a jigsaw, you need to get all the pieces in place before the puzzle is solved.

Toria_Star profile image
Toria_Star in reply toGreybeard

Thanks Greybeard63, do you know if antibodies drop at all when people take Levo/another alternative or is it really quite separate since it's an auto-immune attack? I guess I'm wondering if my mum and aunt should get their antibodies tested to see if it's Hashi's they have rather than just underactive or if the fact they are already on Levo means that even if they do have Hashi's then they will feel better? They both have quite bad diets so I'm not too sure if they would be prepared to change them but at least it would be their choice?

TSH110 profile image
TSH110 in reply toToria_Star

The antibodies are better controlled with treatment on thyroid hormone replacement which is why it is so bonkers not to treat straight away with TSH at c.3, like in the rest of the world.

Heloise profile image
Heloise in reply toToria_Star

Antibodies possibly go away when the trigger goes away. Taking thyroid hormone does not cure the underlying autoimmune issues. Gut permeability allows undigested food to leave the gut and enter the blood stream. Gluten is good at doing that and this begins immune cells to go get them and then see thyroid tissue as similar. I hate to throw all this at you but you have to know how complicated this all becomes. But it is all fixable with some effort on your part. Don't hesitate getting your own hormone if they keep putting you off.

Another issue is your glandular fever back in 2005. They have actually found virus in the gland itself. Functional doctors have more knowledge about these as well. Izabella Wentz is also a good source and has several books.

Toria_Star profile image
Toria_Star in reply toHeloise

Yes, I have been doing a little research over the past few years and Wentz was one of the people I checked out for a period of time which is where I first learnt about the benefits of gluten free with thyroid problems. I am hoping to buy one of her books soon to find out more info. I also found an article mentioning the glandular fever and it really was shortly after that period that everything seemed to be on a downward spiral so that seems possible to me.

Heloise profile image
Heloise in reply toToria_Star

She has two books, one is the Protocol and maybe the Root Cause would be good in your case. She does give some explicit products to try which I appreciated. You may need B5, molebdenum or manganese and non ordinary supplements you don't think of. Minerals are difficult to get broken down because lack of gastic acids so Betaine HCL and digestive enzymes can be very important.

Bacteria very important because B vitamins need certain ones to metabolize them. People have heart attacks when they do not have that bacteria due to. Tom O'Bryan said it happened to his father. He had no heart disease but eventually found that he had no B vitamins in his system. There are some herbal antibiotics that may help as well.

Greybeard profile image
Greybeard

There is no cure known for hashis, going glutten free can lower the antibody level and the frequency of flare ups. The way it seems to happen is that a chemical that is a component of glutten has a very similar molecular shape to parts of your thyroid. Your body tries to remove this chemical because it sees it as a threat, it then attacks your thyroid, as cells die from the attack they dump excess amounts of thyroyd hormone into your system, so the tests doctors do go up and down causing difficulty getting your prescription just right. Once the thyroid cells are destroyed they are gone, over time you get more and more hypo. So going glutten free slows down the progression of the disease, it won't reverse it.

Toria_Star profile image
Toria_Star in reply toGreybeard

Ah OK! So I can try going gluten free and it may help slow the progression but since the antibodies are present, they will pretty much always be attacking my thyroid (in different intensities) and therefore at some point or other I will need hormone replacement.

SilverAvocado profile image
SilverAvocado in reply toToria_Star

I'd say you already do need hormone, just that doctors are pretty lunk headed, and wait till patients have suffered a long time before they will diagnose!

Salphy profile image
Salphy

Hi Toria,

My first results were similar to yours when I first got diagnosed. Though my antibodies were a bit higher and t3 a bit lower. But all the gp's I've seen have completely ignored these anyway and just gone off TSH.

My gp wanted to address the vitamin deficiencies first and see if it helped but after 3 months I still had symptoms.

I argued that due to symptoms, family history and high antibodies they let me trial levothyroxine.

Anyway after starting the trial my levels got worse before they got better.

The highest my TSH has been is 6.6. My T3 has never been below 4 and t4 never below 12.49 (bottom of range)

I have only been on Levo for 10 months but my levels got quite good on 75mcg (TSH 0.29, T4 19, t3 5.5) and I felt SO much better.

Recently my T4 dropped to 12.5, T3 4.5 and TSH 2.23. Doesn't look bad but I can tell you I felt like crap again. I asked for an increase and I'm starting to feel better again.

What I'm getting at is that even though my levels have never looked "that bad" I felt like absolute death. And it's only from having them couple months of feeling well and stable on meds that I'm able to see now how bad it has been making me feel eventhough my levels never really show it.

Diogenes wrote a great post yesterday from a retired endo professor responding to some statements about thyroid and made the point that for people who's thyroid isn't working properly everyone's baseline levels where they feel well will be different so we need to look at symptoms as well.

I genuinely just think my tsh isn't sensitive enough to get that high when I'm feeling rubbish or that I just naturally need it very low and my t4 and t3 high in range to feel well. Every one is different :)

Hopefully you get a good gp who will help you get your vitamins etc right then if you still need to trial meds to see if it helps you.

Good luck x

Toria_Star profile image
Toria_Star in reply toSalphy

Awww Salphy, thanks so much!

It's really nice to hear of someone who's levels weren't too far different from mine and who has had some success. Have you tried Gluten or Dairy free too or have your results just been due to the Levo and vits?

This has given me hope that if I can get the diagnosis and some medication then there is actually a chance of feeling better! At the moment, everything just feels a bit bleak and I spend my life in my house feeling cold and tired and missing all the things I used to be able to do (and generally just missing my life).

At 31, it would be nice to be able to start living again before I die. Thanks for your kind words and support! X

Salphy profile image
Salphy in reply toToria_Star

I went gluten free after I had the good results. My levels got worse but I posted on here and apparently it can take up to a year for it to work so I'm plodding on. I definitely get less bloating. I lost 10kg from starting thyroxine last March to about November. I went gluten free end of September. I've put 3kg back on since feeling unwell but I have to admit that may have been a little to do with it being over Christmas too.

Haven't tried dairy free yet. I don't think I've got the will power to do both!

I've just turned 26 and know exactly what you mean about missing life! Especially when everyone around you seems to be having the time of theirs.

Before my recent increase I was back to sleeping 16 hours a day. It's crazy how much you miss out on. Then the time you are awake and moving is spent catching up on things you should have done when you couldn't.

Fingers crossed we'll both get there eventually x

SilverAvocado profile image
SilverAvocado

Hi Toria_Star, you've had a lot of comments, but no one has really tried to answer your questions or give an analysis of your results. So I will try, altho I'm not as knowledgeable as some.

Yes, the results you showed us are bad enough they they are the cause of your problems! Healthy people have TSHs up to about 2. Anything beyond that will mean you are unwell, but doctors know nothing about thyroids, and it's people in your position that suffer the worst, as you fall through the cracks. Your numbers are quite conclusive, but no dramatic fireworks!

With the antibodies, yes, these indicate you have Hashimotos (also called auto-immune thyroiditis). Again, the numbers don't need to be spectacular, just over range! So this means your thyroid is being attacked, and will continue to get worse. This explains why your numbers have been a bit up and down over the years. As your thyroid is broken down, sometimes you will get a Hashi's flare - a dumping of thyroid cells and stored hormone into the blood, which takes you back into healthy levels, or even into being hyperthyroid briefly. It's very unlucky if this happens when a doctor gives you a blood test. This is the sort of thing that can give you a lot of discomfort, and is why people do things like go gluten free to try to reduce antibodies. Altho doctors say they don't, antibodies can cause discomfort and ill health in themselves, too.

Now on to vitamins. I know less about this, and if no one else comments it's worth clicking through Seaside Susie and looking at her excellent comments about vitamins elsewhere, to see the best way to raise levels.

You're vitamins all look pretty bad! Ferritin and vitamin D look terrible, folate and B12 could do with being raised. Overall you want these at least halfway through their range, and some are better near the top. Magnesium is a bit of an unreliable test, many people supplement this a little anyway, because it's a common deficiency. I use a Better You spray on my sore legs at night. It's good for tight or restless muscles.

The two that have been marked deficient are very serious. Ferritin is stored iron. I don't know much, but I think ferrous fumerate is what you need, in a large-ish dose. But you'll have to find another member giving more detail about it! For vitamin D you need a very high dose, something like 5 or 6,000 international units per day, or even more.You need to take vitamin K at the same time. The vitamin D council are good for this. Or you'll find knowledge able people on the forum with advice.

Vitamin B12 needs to be more than about 500. The UK ranges are stupidly low, and this is one that can cause permanent damage when low. For this you want methylcobalamin, the kind of tablets you dissolve under your tongue, and a good B-complex at the same time. Again, I don't know much about dosing, so look around for some better advice! Folate is another B vitamin, and my mind has gone a blank on how to raise it!

But I'm sure you will find some very good comments if you look. Go by some keywords I've mentioned, or search for the comments good people have made. I'm pretty sure Seaside Susie is the main expert! Altho I may have got her confused with someone else! So go to her profile page, and you can find the tab for comments she's made on other posts. The kind you're looking for is quite similar structure to what I've said, covering each vitamin, but with a bit more detail and knowledge on what you need to do!

Looking at your symptoms. Fantastic descriptive language! I think this is some of the best I've ever seen :) You've really captured some of the symptoms I've had myself. Most of these are classically hypothyroid: lack of sleep, tired tight and achy muscles, puffy face, exercise intolerance, feeling cold, constipation, low libido, ridged nails, dry skin, losing hair. Getting a diagnosis of depression, and developing other illnesses are all very common too - thyroid hormone is needed by every cell and organ in your body, so everything is slowed down and can be damaged :( Being alert late at night can be adrenals, but that may clear up when your vitamins improve, maybe something to look into when you've got everything else started up.

Thyroid disorders also run in families. It's likely your relatives go have Hashis, because it's very rare to be hypothyroid in other ways. Doctors often don't check for it because it doesn't effect the treatment they offer. If they have quite poor health you could help them by getting their vitamins tested too, as they're often deficient, or even look at their own thyroid panels, as they may be on poor doses, too. But depends how much you want to be involved ;) If you stay using the forum you will become a big expert, and might not be able to help yourself nosing into all their blood tests. That's what I'm like with mine ;)

Toria_Star profile image
Toria_Star in reply toSilverAvocado

SilverAvocado, thank you so much for taking the time to give me so much information! I'm super grateful for it all!

Having had a nosy at some of the blood work results on here before people have been diagnosed, I am amazed these people are still alive giving how I feel with results just slightly out of the ranges! I didn't know about the Hashi's flare up stuff, hormone dumping etc so that was really useful to read about.

Thanks also for all the vitamin info. As suggested, I'll have a look and see if I can find the more detailed post that you mentioned but so far that's great info. Looking back, my B12 was actually tested in 2008 and was 294 (180-900) so looks like it's not been great for the past 10 years. eeep! I'll be supplementing that one too then.

I had wondered about adrenals too but didn't buy the 6 x swab test at the time due to money. I may be pursuing that at a later date too.

Just a thought, could psychological trauma cause me to go from Hypo to Hyper for a period. In 2014 (when my TSH dipped lower again between two higher results) I had an unexpected relationship break-up and took it really badly. I ended up with insomnia, waking at 3am with a pounding heart, sweating etc, no appetite, massive weight loss, extreme anxiety, constant IBS. These seem quite similar to Hyper symptoms but then again could just be the depression and grief.

Ah the human body! haha

Thanks again for helping. :)

SilverAvocado profile image
SilverAvocado in reply toToria_Star

I'm glad it's useful! I'm not sure about this question about hyper. I think it's more likely that the stress would have just messed up your TSH levels, rather than actually make you hyper. But that is really just a guess. If you had a Hashi's flare you might have felt uncomfortable. But I doubt youd have noticed it with all that was going on!

A funny coincidence, I had a relationship break up a few years before I was diagnosed, and also had terrible abdominal pain all through the time I was getting over it. It was so bad I couldn't imagine the pain ever stopping. But when I got over the break up it did stop, and has never returned

I now think the IBS must have had something to do with my thyroid, as thyroidies often do have it. Some combination of distress, adrenal problems, low functioning thyroid, etc.

SilverAvocado profile image
SilverAvocado in reply toSilverAvocado

Oh yes, the other thing with the lower TSH score is that your freeT4 wasn't much higher than usual. So maybe it is more likely your TSH was distorted by all the stress. If it was a flare you'd expect the hormone in your blood to be higher (that's what freeT4 measures. T4 is the storage, inactive form of hormone, and T3 is the active form that gets used up quickly).

Or could even have been a lab mistake, as it's discrepent from your other results. Those sometimes do happen.

TSH110 profile image
TSH110 in reply toToria_Star

I think stress can set it off - my partner tried to commit suicide twice and it was after this I really spiralled down with short bouts of hyperthyroidism but longer periods of hypo both of which were truly horrendous. Mind you I had been hypo for a long time before so it could be a coincidence, but I don’t think that level of stress did me any favours. As explained you may get variations ranging from hyper to hypo as bits of the thyroid are destroyed by the antibodies and dump their load of thyroxine then settling down but with inadequate production of thyroid hormones. I think Isabella Wentz says she has put her hashis into remission with diet/gluten free, vits and minerals esp selenium. I think that is unusual but if you stop the antibodies you ought to stop the degeneration of the thyroid. I find gluten free helpful

Chris Kresser thinks stress can be key:

chriskresser.com/5-ways-tha...

Niamho profile image
Niamho

It might be an idea to assess your adrenal output also.. you mention you don’t get a restful sleep, tired morning and early evening and energy boost at 10-11pm.. that sounds classic ‘adrenal fatigue’ although that term is disputed.. better described as poor adrenal function where cortisol levels are too low in morning (groggy awakening), perhaps low most of the day with a spike late evening when they are meant to be low in order to facilitate sleep. Do you have low blood pressure or postural hypotension/dizzy when standing from sitting position? My thyroid panel is very close to yours and I am self medicating whilst following the advice of the wonderful people on here.. but I have a constant nag that Its all my adrenals fault lol! My main symptom is feeling terrible and unrefreshed in morning. In fact I feel steam rollered! I did a salivary cortisol test and it’s low (I think.. I’ve yet to post my results and get advice, but I will). I’ll follow you with interest, good luck.

Toria_Star profile image
Toria_Star in reply toNiamho

Hi! Looking at previous blood pressure results the systolic is normally OK and the diastoic has sometimes been quite low - 55. I do occasionally get dizzy when going sitting to standing. Sometimes i'm fine and sometimes i'm not. I totally get the unrefreshed thing. The only time I have actually felt refreshed in the last 10 or so years was when I fainted after giving blood and when I came to I felt amazing! Must have been a burst of adrenaline. Been groggy in mornings ever since. Haha Did you do the 6 x salivary cortisol? I'm tempted!

Niamho profile image
Niamho

I did the 4 salivary cortisol.. as far as I’m aware the 6 isn’t necessary. Although I’m due to retest everything next week (on thyro gold and was hoping it would help symptoms.. so far it hasn’t!) so I’m going to get DHEA rested along with cortisol.. I have bad pms also so testing that will help build a picture. It’s so hard to know what to treat first! When I get retested I’ll post my results for advice. I’m 38 with four children and run my own solo business and I just get by and no more. It’s tough. And you have to help yourself. I’ve been to Doc several times and had to refuse anti depressants etc. I have one nice Gp who put me in Levo to shut me up lol but it made my periods late. X

Toria_Star profile image
Toria_Star

Hi everyone and thanks so much for your input so far. I just wanted to update on where I'm at incase anyone is interested and see if you have suggestions for supplementing.

I went to see my GP last Friday with my Blue Horizon results. She agrees autoimmue thyroid disease but said my TSH wasn't hugely above range (along the "nothing to worry about" lines) and my T4 is "fine" so she won't medicate straight away as I'm "too young" (ahem...31!) and being medicated would mean for life and could lead to heart problems???

Therefore, she wants to try to improve my Ferritin levels and Vitamin D and then re-test me in mid-May. She prescribed 2 x Ferrous Fumarate 210mg per day to be taken with orange juice and suggested taking 100% RDA Vitamin D. Realising that is a pretty low amount of Vit D, I declined the offer of a prescription saying I had my own.

So, for the last week I've been taking the FF 210mg twice a day and have been taking 2,000IU Vitamin D3. Having looked around on this forum, I realise there are probably other things I should be taking so I'm looking for some advice. Here are my levels again to save any scrolling...

Ferritin = 12.9 (13 - 150 ug/L)

Magnesium = 0.86 (0.66 - 1.07 mmol/L)

Vitamin D (25 OH) = 34 (Deficient <25 nmol/L, Insufficient 25 – 50, Consider reducing dose >175)

Vitamin B12 = 303 (Def <145 pmol/L, Insuf 145 – 250, reducing dose >569)

Serum Folate = 18.40 (8.83 - 60.8 nmol/L)

My Ferritin was also tested in 2008 = 40 (10-275ng/mL) and 2006 = 55 (15-300ng/mL) so I would guess this is below optimum and has been for over 10 years? Does anyone have an idea of what level I should be aiming for? Also, no blood count has been run since 2014 but I did advise the doctor my Hemoglobin is usually fine for giving blood (usually about 140 (115-165) which is what it was 3 months ago) so is it possible my iron levels are actually ok and therefore taking these FF tablets might not be ideal? Do you think I'll actually see an increase in my Ferritin levels on these? I'm a bit confused. Should I be taking anything else along with the FF tablets?

Vitamin D - I've been taking 2,000IU per day but have read about the BetterYou DLux spray that people have recommended so I'm thinking of getting that. Any thoughts on what level of IU would be best given I am at the lower end of insufficient? I'm also seeing that I should be taking K2-MK7 (any recommendations?) and taking both with my fatties meal of the day.

Magnesium - my levels look ok but I've been reading that I should be taking some as it helps D3 to work? Any thoughts? Also Selenium? I haven't had that tested but would it cause any problems supplementing.

B12 - this is within range but I would like to take some more. I have some 100ug B12 as Cyanocobalamin already at home, are these any use and how much should I be taking?

Folate - although not below range, this still looks a bit low. Should I also be taking something for that?

Obviously, I'm aware I need to go gluten-free now so I'll be working on that too. Does anyone have any good resources for gluten-free vegetarian or vegan recipes?

I'm looking to buy most of these supplements online over the weekend so any suggestions for the best ones would be most helpful (PM me if not allowed on forum).

Lastly, by taking all these supplements in the next couple of months, do you think my TSH will drop and therefore mean I will never be medicated? I'm a bit on the fence about whether a complete change of lifestyle and diet will mean I feel much better and don't need medicated for a while or whether I should suffer a bit longer and just get on the meds. If I could live comfortably without medication then I'd be more than happy to do so, I guess the question is, is this possible with Hashimoto's?

Thanks in advance,

Toria

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