Please help with my blood results. In need of some advice

[cherylwadey]

I seem to have gained even more weight lately which is really depressing and really uncomfortable and my hairloss is just the same. The iron tablets made my constipation worse causing bloating and pain despite taking 3000mg of Vit C daily. After I had one appointment with the endo and he discharged me my Levo was increased from 50mg to 75mg. My blood results from last week are as follows: TSH 1.49 0.30 - 3.94 FT4 15.5 12.30 - 20.20 FT3 4.3 3.70 - 6.70 Folate 7 ug/L >3.8 ug/L Feritin 39 13.00 - 150.00 How can I stop this awful weight gain and hairloss and shed this excess? I eat really healthily and I exercise regularly as you know. Should they increase or decrease the Levo or should I buy some T3? I would really appreciate your help once again. Many thanks,

[SlowDragon Administrator]

Do you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies

What about vitamin D and B12 test results

Ferritin, you can also eat liver once a week to help improve levels

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Is that how you did test?

[cherylwadey in reply to SlowDragon]

Hi Slow Dragon I was diagnosed 5 years ago and was not told that I had autoimmune disease. My Vit D and B12 levels are good as I take supplements. My thyroid bloods were done two weeks ago at 8am and I had fasted and not taken my Levo for 24 hours. What can I do? What is the next step?

[SlowDragon Administrator in reply to cherylwadey]

Ask GP if antibodies were ever tested. If not been tested then please test

For full Thyroid evaluation TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Ferritin is too low

Folate looks on low side

Essential to test thyroid antibodies plus vitamins

Private tests are available

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

Your FT3 is on low side. You probably need dose increase in Levo

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 at

[e-mail]

Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH to bring FT3 high enough

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

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

Many need TSH nearer 0.2 than 2.0

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

[cherylwadey in reply to SlowDragon]

Thank you so much for your assistance. Your extensive knowledge is invaluable.

Kind regards

[SlowDragon Administrator in reply to cherylwadey]

If you have high thyroid antibodies (Hashimoto's) then, like majority of us you are likely to benefit from strictly gluten free diet

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

Ideally 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...

thyroidpharmacist.com/artic...

[cherylwadey in reply to SlowDragon]

Thank you Slow Dragon. I am amazed by your knowledge.