Latest blood results. Worried!

[ceedee81]

THYROID STIMULATING HORMONE *5.36 mIU/L (0.27 -4.20)

FREE THYROXINE 20.3 pmol/L (12.00 -22.00)

TOTAL THYROXINE(T4) 111.0 nmol/L (59.00 -154.00)

FREE T3 3.96 pmol/L (3.10 -6.80)

THYROGLOBULIN ANTIBODY *>4000 IU/mL (0.00 -115.00)

THYROID PEROXIDASE ANTIBODIES*74 IU/mL (0.00 -34.00)

ACTIVE B12 69.300 pmol/L (25.10 -165.00)

FOLATE (SERUM) 16.9 ug/L (2.91 -50.00)

25 OH VITAMIN D *43.5 nmol/L (50.00 -200.00)

CRP -HIGH SENSITIVITY 1.74 mg/l (0.00 -5.00)

FERRITIN 38.3 ug/L (13.00 -150.00)

Doctors comments:

I note that you are taking 150mg thyroxine daily.

Your TSH is high and you have a Thyroxine level which could be improved slightly if you are symptomatic.

People with hypothyroidism can feel better when their thyroid stimulating hormone is maintained in the lower half of the normal range

You should discuss this further with your doctor as you could potentially benefit from an increase in your dose.

Your thyroglobulin antibodies are positive. This can be associated with autoimmune thyroid disease and in particular Hashimoto’s disease.

Your thyroid peroxidase antibodies are elevated. This antibody is commonly associated with autoimmune thyroid disease. It is frequently seen in conditions such as Hashimoto’s disease (where the thyroid becomes underactive) but confusingly can also be seen in Grave’s disease (where the thyroid becomes overactive).

You have normal vitamin B12 levels.

You have normal levels of folate.

Your vitamin D levels show that you have vitamin D insufficiency. This may progress to vitamin D deficiency if you don’t take steps to increase your vitamin D levels. We recommend supplementing with 20-50 mcg (800 -2000 iu) of vitamin D per day for twelve weeks.

Low levels of vitamin D can cause fatigue, bodily aches, poor memory and difficulties concentrating.

We suggest that you repeat your vitamin D test in 8-12 weeks to ensure that your levels have returned to normal. Once your levels have returned to normal then you can decrease your vitamin D supplementation to 10 mcg (400 iu) per day.

Your CRP level is normal, suggesting low levels of inflammation within the body.

Your ferritin level is normal indicating healthy iron stores.

Refer to GP : We recommend that you make an appointment with your GP to discuss your results in more detail.

So, I think I understand the T4 and T3 side of things, but I don't understand how raising my dose of levo is going to help. Surely if my body isn't converting T3 then now amount of levo is going to change that? Also how does increasing levo help lower the antibodies that are so ridiculously high?

[shaws]

To reduce antibodies, going gluten-free can help reduce the attack of them on your thyroid gland.

You may have to source your own T3 as it will not be prescribed. If you need to source it put up another post requesting a Private Message to be sent to you of where to source it. I think the labs know T3 cannot now be prescribed and believe an increase in T4 might convert to T3 which it is 'supposed' to do but it doesn't happen to everyone whose on levo.

The following statement from above:-

"People with hypothyroidism can feel better when their thyroid stimulating hormone is maintained in the lower half of the normal range"

we on this forum believe a TSH to aim for is 1 or lower.

Other members will respond re your other results which could be higher.

[ceedee81 in reply to shaws]

Last year (July) my TSH was 0.95. I don't understand why it's now 5.36? How can it change that much in 9 months?

[greygoose]

You're right, raising your levo will make your conversion worse, not better. But, there seems to be a silent pact between doctors to ignore conversion issues and pretend they don't exist.

And, raising your levo will only help with your antibodies if you raise it enough to suppress your TSH - but, of course, adding in T3 will suppress it faster.

Your ferritin is not normal, and does not indicate healthy iron stores!

[ceedee81 in reply to greygoose]

I accidentally took 200mcg once a few years ago. I honestly thought I was going to die. I had the worse migraineI've ever had in my life, felt sick and had stomache cramps. All the classic signs of an overdose. So raising my dose from 150mcg scares the hell out of me.

[greygoose in reply to ceedee81]

Classic signs of an overdose of what? Levo isn't a drug. It takes about six weeks to fully make itself felt. It is highly unlikely that you would feel such a reaction to taking too much levo on the day you took it. Given that it's a storage hormone, the occasional excess is hardly likely to affect you at all.

However, raising your levo is hardly likely to help, either, because your problem is that you can't convert it. And the higher your FT4 goes, the worse your conversion will become. So, really no point in increasing it. You need T3, even if you have to buy it yourself.

[ceedee81]

Thanks guys. I feel so dejected I just feel like giving up. I'm taking so many supplements now to try to change this I feel like a walking pharmacy. And now I have to up my ferritin and vit D as well. I'm going gluten free as of now as I constantly have ab pains and digestive problems too. Is going to see my own GP likely to get me anywhere? The last thing I want to do is increase my dosage.

[SlowDragon Administrator in reply to ceedee81]

You might ask GP to run coeliac blood test before you change to strictly gluten free diet. Best to rule it out before starting.

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)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

Your B12 level is possibly a bit low too, suggest you keep an eye on that, or supplement a good vitamin B complex

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Getting vitamins optimal and addressing food intolerances, if FT3 still remains low after this then consider seeing a T3 friendly endo

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]

Plus list of recommended thyroid specialists, some are T3 friendly

Professor Toft recent article saying, T3 may be necessary for many

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

[Sus64 in reply to SlowDragon]

Should you stop your multi vitamin for 3-5 days before testing if it has a small amount of Biotin, or would that only apply to the greater B complex formulas?

[SlowDragon Administrator in reply to Sus64]

Not generally recommended on here to take multivitamins. Partly they contain far too little of what we need, most contain iodine, not a good idea at all unless specifically tested and found deficient

Generally advised to test vitamin D, ferritin, folate and B12 and supplement if necessary

Vitamin D should aim to be around 100nmol. Supplementing with vitamin D mouth spray by Better You is good as avoids poor gut function. Trial and error what dose you need.

Magnesium and vitamin K2 Mk7 along side vitamin D

betterbones.com/bone-nutrit...

articles.mercola.com/sites/...

Taking a good quality vitamin B complex with folate in to keep B12 and folate up

Ferritin, if not too low eating liver once a week should help improve levels

If Hashimoto's then strictly gluten free diet likely to help too obviously

[Sus64 in reply to SlowDragon]

Thank you, I'm planning on going for testing soon. Eating liver is going to be a challenge I'm afraid.

[SlowDragon Administrator in reply to Sus64]

Liver pate?

Or hiding it in shepherds pie, or Lancashire hotpot etc

[Sus64 in reply to SlowDragon]

I'm in the USA, not familiar with Lancashire hotpot! But I'll look that up. I love shepherds pie. Where do you get liver pate? Is it canned? Maybe my cat's tin. LOL

[SlowDragon Administrator in reply to Sus64]

In UK we have lots of liver pates. Chicken, duck, pork. Look in chiller cabinet in supermarket - cold meat section

[Sus64 in reply to SlowDragon]

Thank you, I think I'll call the store, I've never seen such a selection.

[Marz in reply to Sus64]

Buy some chicken livers and make your own pate 😊

[Sus64 in reply to Marz]

Yes, I need to figure out this whole pate thing for eating liver. Thanks for that idea!

[Marz in reply to Sus64]

I saute onions and garlic in olive oil ( I live in an Olive Grove ! ) - I also use belly pork and saute that in with the onions. Although it does make a coarser pate ! Towards the end add the rinsed chicken livers with bits removed ! - and cook slowly until soft. Then liquidise it in batches until smooth. You can add whatever herbs and flavourings you like to the cooking process - I love to add Juniper Berries You can also add brandy and cream or yogurt .... the variations are endless.

[Sus64 in reply to Marz]

Wow, that sounds amazing! What bits do you remove from the chicken liver?

[Marz in reply to Sus64]

Sometimes there are little tiny threads of connective tissue - I basically tidy livers up with a pair of kitchen scissors Old hens my have a fatty liver - so chop that bit off too ..... bit like us really

[Sus64 in reply to Marz]

No kidding, haha. Thanks!

[shaws in reply to ceedee81]

After you follow SlowDragon 's advice and as most of us have stomach issues, many take Betaine/pepsin tablets with meals which provide the acid our stomachs need and some take Apple Cider Vinegar in water or juice and sip during meals.

[Nerkalj]

The suggestion to try gluten free is an excellent one, however beware of the increase in carbohydrate consumption in gluten free products as they contain a lot of starch, which spike blood sugar and therefore insulin levels. When insulin is in charge, reactive oxygen species, which cause inflammation, are formed. Definitely want to avoid that with an autoimmune diagnosis. Dr. William Davis’ newest book, “Undoctored”, covers this very well and specifically addresses thyroid autoimmunity.

I would add that the recommended dosage of Vitamin D is too low, something that Dr. Davis also addresses, although he isn’t not my sole source of information. You want a D3 supplement, not D2.

[ceedee81]

Ok so I have a 2 week wait to see my GP about these results - despite saying it was urgent. I am now taking a liquid D3 supplement, a good Vit B complex, Gentle iron, vit c, EPA and DHA omega oil, and probiotics.

I've also removed gluten from my diet.

I suspect my whole journey will end up in me taking T3 which is fine. But I will fight tooth and nail to get it prescribed before I have to source it myself.