Thyroglobulin antibody >1300 (<115)
Thyroid peroxidase antibody 205.4 (<34)
TSH 36.5 (0.2 - 4.2)
FT4 10.2 (12 - 22)
FT3 3.0 (3.1 - 6.8)
Diagnosed hypothyroid Friday taking 25mcg Levothroxine, when to feel better on it please and what are thyroid antibody levels?
Thankyou
Thyroid antibodies show that you have autoimmune thyroid disease also known as Hashimotos thyroiditis. The majority of thyroid disease is caused by Hashimotos. If you can add the reference ranges to your thyroid results it will help people to comment. The laboratory reference ranges are the figures in brackets next to your results. Always get a print out of your blood tests, not just a verbal result. This will include the lab reference ranges. Or you can register online to access your blood test results. This is arranged via your GP reception if in the UK.
It takes 6 to 8 weeks for thyroid hormone to get around all your cells and you should retest in 6 weeks time and adjust your thyroid medicine according to results. You should begin to start feeling better in a few weeks, however, some people feel worse for a while during the adjustment period. This can be due to low vitamin levels so if you don't begin to feel better ask your GP to check vitamin D, B12, ferritin and folate levels.
Ensure you take levothyroxine on an empty stomach with a full glass of water and leave an hour before eating or drinking anything except for water.
Thankyou I have results of these
Ferritin 15 (15 - 150)
Folate 4.2 (4.6 - 18.7)
Vitamin B12 221 (190 - 900)
Vitamin D 35 (25 - 50 deficient)
Again, you need to add the laboratory reference ranges for us to make sensible comments. Lab ranges vary from lab to lab and country to country. However, I can see they are all too low.
Never mind guess they are fine
Yes, they are low where marked deficient, and the others are low in range, therefore not ideal. Your doctor should be discussing all of these levels with you. And ask if your vit D should be initiated with a high starting dose. Let him/her know how awful you feel. If you feel brave enough, say you have become a member of thyroid UK which is validated by NHS. Don't say you're googling.....they hate it.
At this stage, the way you feel, the lack importance to your medics, and the avalanche of information might make you feel like crying and giving up. As I said below, check out the thyroid UK information. Get back to the forum for any other queries that raises, or anything that worries you through your treatment journey.
Ranges added I just want answers to my symptoms I feel so alone
Are you in the UK? If so there are guidelines your GP should follow. GP may prescribe 800iu for vitamin D deficiency but this is not enough so you may need to buy your own to increase your vitamin D level. You need to aim for a level around 100nmol. Ask your GP for the correct treatment according to the NICE guidelines or local CCG guidelines whcih will be similar.
cks.nice.org.uk/vitamin-d-d...
The vitamin D Council gives some advice about levels to supplement if your GP cannot prescribe sufficient amounts of vitamin D3.
You may wish to take magnesium and K2-MK7 with vitamin D3 in order to absorb the vitamin D effectively. Magnesium citrate is ok but there are other choices for magnesium.
naturalnews.com/046401_magn...
Have you got symptoms of B12 deficiency because if so, I advise you to post your B12 and folate results along with an outline of your thyroid condition and symptoms, low ferritin etc on the HealthUnlocked Pernicious Anaemia forum healthunlocked.com/pasoc and ask their advice about what your GP should be doing. Really, it looks like you need further investigations to rule out pernicious anaemia. Your GP should check for intrinsic factor antibodies.
B12 symptoms of deficiency
b12deficiency.info/signs-an...
B12 The Guidelines Doctors follow
onlinelibrary.wiley.com/doi...
onlinelibrary.wiley.com/doi...
Ferritin needs to be at least 70 or mid-range for thyroid hormone to function properly. Have you had a full iron panel because if not, your GP needs to do one.
Iron deficiency anaemia NICE guidelines
cks.nice.org.uk/anaemia-iro...
The importance of vitamins and thyroid function
americannutritionassociatio...
Tell your GP you've taken advice from NHS Choices recommended organisation for information/advice about dysfunctions of the thyroid gland.
Thankyou yes I have symptoms of B12 deficiency. I am in UK and I have iron panel and complete blood count which has shown
Iron 7.6 (6 - 26)
Transferrin saturation 13 (12 - 45)
MCV 80.3 (83 - 98)
MCHC 357 (310 - 350)
The MCV and MCHC were the only things abnormal from complete blood count
Ok, well your iron store which is ferritin is too low for thyroid hormone to function effectively and you have low iron levels too. Has your GP prescribed anything? You can raise your iron level through eating iron rich food. If you tolerate liver you could eat 200g a week, no more due to high vitamin A in liver.
Thankyou no, the GP said my ferritin was technically in range, I feel I should challenge this. I have heavy periods every month and I bruise easily and unexpectedly which I don't think helps with the ferritin being so low. I think I should insist on treatment for iron.
Technically your GP may be correct saying ferritin is in range but it's only just in range in which case NHS is not required to help. You could try insisting with your GP or alternatively just help yourself and eat liver or buy your own supplements. I have used Spatone liquid iron to increase iron levels in the past. You can buy it from Boots I think. If you hang around waiting for the NHS to fix you, you'll probably just stay ill so do what you can if you've discussed it with your GP and next time you visit, tell your GP that you've supplemented yourself since the NHS wouldn't help and at least they should offer a blood test as it's dangerous to go over range. At least insist on a blood test since you've had to supplement yourself. Get a blood test in 4 to 6 months time to check your ferritin is ok after supplementing.
Thankyou I will keep going back to GP. I have had low ferritin for over 5 years and it has been under range. They should do something. I will feedback what happens.
Your ferritin may have become low partly because you were becoming hypothyroid. You may maintain better levels now you are on levothyroxine or there may be something else going on. For example, you may have pernicious anaemia since you have low B12 levels or you may have undiagnosed coeliac disease or be intolerant of gluten. You could discuss with your GP whether it makes sense to rule out these other problems as they often coexist with autoimmune thyroid disease since they are also autoimmune conditions. As you can see this is not a quick fix and it takes time and effort to investigate. I expect your GP is waiting to see if your problems resolve once you are on the full amount of levothyroxine you need and you may find it the best approach or you may invest a lot of time in unnecessary investigations.
You may simply have gut dysfunction which very often goes hand in hand with Hashimotos thyroiditis and you may not be absorbing nutrients efficiently in which case you need to improve gut function by going gluten free. SlowDragon has good advice on gut function and Hashimotos so you could read her posts to other people to find out more.
Thankyou my ferritin is actually 13 it was a typo I will push for treatment
Ferritin needs to be at least 70 or mid-range for thyroid hormone to function properly but I wouldn't expect your GP to know that.
Iron deficiency anaemia NICE guidelines
Please help advise I have added ranges I just want answers to my symptoms
Hi Nikki, sorry you are struggling right now but in time you will feel much better. The high antibodies mean your body is confronting some chemical or protein that immune system is trying to destroy. But also a virus like Epstein Barre can be involved. Do you have digestive problems with wheat or dairy? Many times this all begins in the gut.
You should be increasing your dose of 25 mcgs over the next few months until you get the TSH down to under 2.0 and the FT4 and FT3 in the upper part of the range.
The reason you feel so badly is the whole body is involved so anything can show symptoms. You can go to you tube and watch more of this man's videos about low thyroid. This is in regard to your antibodies.
youtube.com/watch?v=Z5SaM0R...
Thankyou I have problems with wheat and dairy
When your stomach is irritated when eating inflammatory foods, it will have a hard time producing enough acid or enzymes to extract nutrients and that may be why your levels are too low.
I see others have given you good advice so even if your doctor will not help you with this you can supplements yourself. Use methylfolate and methylcobalamin if you have methylation problems. You can look into that at some point.
Hi Nikki,
No wonder you're feeling dreadful with those results. There are other tests for b12 deficiency, the MMA urine test and active b12.These are considered to be more accurate. If your GP is unwilling to order, you could request this privately. Viapath at St Thomas's in London do private testing, either as postal or attending there.
If you have neurological symptoms, such as pins and needles and/or balance problems, this should be treated with alternate day injections until no further improvement as per the BNF/NICE guidelines. 221 is far too low but of course in range according to the medical profession. Patients can be symptomatic if their reading is under 500. Your GP should have acted on your ferritin of 13 and your folate being that low as it would have flagged up as under range at your surgery. My low ferritin has been helped by Solgar Gentle Iron tablets and eating liver once a week.
To bear in mind too that if you supplement with any b12, which even includes energy drinks, that you will skew any results. Ideally, you need to have been off any b12 supplements for 4 months before testing. It is not recommended to treat your folate deficiency before treating your b12 deficiency.
All the best.
Thankyou I have neurological symptoms
Hi Nikki, some great advice here.
My two pennarth is that all those tests can be out because of hypothyroidism. And you could well have been in and out of hypothyroidism for some time. All my levels came back up with thyroid hormone replacement. 25mcg is a very low starting dose so try and keep the faith. Take the appropriate supplements suggested providing there is no other contraindications for you not to do so. You're on the right track now you are on replacement hormone, and it takes time, as others have said. It's important to get on the PA forum. Also, low thyroid function can impair B12 absorption.
Check the thyroid UK pages on hypothyroid symptoms and treatment. You are not alone, hypothyroid symptoms are legion. Pace yourself, keep apace of your blood test results, and keep researching the basics. 
Hi Nikki you’ve come to the right place for advice and hopefully are reading the reports and information on the Thyroid UK website. You will feel better once you get your vitamins and thyroid hormones balanced, unfortunately Hypothyroidism is a long term condition that you’ll need to manage. It was heavy periods and low iron that prompted me to have a BUPA Medical in 2012 as I was refused at a blood donor session as borderline anemic which I discovered was due to thyroid issues. I was also at peri menopause stage but things improved after starting Levothyroxine. You must be feeling exhausted with those levels, take on board all the good advice and I hope you get well soon
The bad news is that there is no instant fix and it is possible to initially feel worse on 25 mcg .The good news is that every six to eight weeks you should have another blood test and be prescribed more levothyroxine as needed to bring TSH down and FT4 and FT3 higher. As others have said your vitamins are too low and you will need to supplement.You will find most GPs know little about the disease or of the necessity to have optimum vitamins. You will have to read up and you have reached the right place for help.
Just going to add a few points.
Unless elderly, frail etc, the standard starter dose is 50mcg, not 25mcg. Your TSH shows you are clearly hypothyroid. So GP could have started you on 50mcg dose. Trouble with 25mcg is it's enough to switch your own thyroid function down, but too small a dose to replace it.
You must get low B12 tested for Pernicious Anaemia before starting on B12 injections
Folic acid supplements should not be started until 48 hours after first B12 injection.
Ferritin you may be able to help improve by eating liver once a week. GP should be prescribing ferrous fumerate or similar to improve. I will flag SeasideSusie . She's good on iron test results
Vitamin D, your GP is only likely to prescribe 800iu. With Hashimoto's we often need high dose. Better You vitamin D mouth spray is very good as avoids poor gut function of Hashimoto's. Perhaps start on 1 x 3000iu per day. If that seems fine, after a week, double the dose for two months and then retest via vitamindtedt.org.uk £29
Important to retest twice yearly when taking vitamin D. Aiming to improve to around 100nmol
Thankyou I am 30 years old
NICE guidelines below saying how to initiate, normally at 50mcg and to increase in 25mcg steps.
The guidance saying test after 4 weeks is too soon. 6-8 weeks is recommended
Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine
SlowDragon, would elderly be 60 plus?
According to that NICE document, any one over 50.
Blimey.... thanks
That's only starting off dose.
They do not mean sticking on just 25mcg
Overly cautious perhaps
Over 50 isn't elderly (in my view!)
Yes, my GP started me off on 25 in my 50s. And no neither do I. I should think general health/ heart health would count more.
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working, so it's essential to improve vitamin levels
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)
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
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...
But don't be surprised that GP never mentions gut, gluten or low vitamins with thyroid, even though your vitamins are all low. Hashimoto's gut connection is very poorly understood
NikkiBlandford
MCV 80.3 (83 - 98)
MCHC 357 (310 - 350)
These results plus your below range Ferritin suggest iron deficiency anaemia. You ideally need an iron infusion. If you are given iron tablets you should take each one with 1000mg Vit C to aid absorption and help prevent constipation, and take them 4 hours away from thyroid meds and 2 hours away from any other medication and supplements.
Having read through the thread you have been given advice covering just about everything. You should read through, make notes about what has been covered, check out the links you have been given so you know how your should be treating you. Then go and see your GP and request appropriate treatment for
Iron deficiency
Folate deficiency
Low B12 - further investigation and injections
Vit D - see if he will increase your prescribed dose of D3. If not you will need to buy your own and match the loading doses mentioned in the link given for treatment. Then retest, come back to the forum with your new level for suggestion of new dose to take.
When taking D3 there are important cofactors - magnesium and Vit K2-mk7 which you should take.
Address the Hashi's as mentioned.
Ensure you get regular 6 week retests for your thyroid levels and increases of 25mcg each time until your levels are where they need to be for you to feel well.
Read and learn everything you can from the links given. Come back and ask about anything you're not sure of.
You have Hashimotos thyroid which is auto immune. Many people have this including me. You are on way to little thyroid medication Typically 100 mcgs and thats even kinda low.. with your other levels of D, B, ferritin etc..you more than likely will not even convert your T4 medication into T3 which is what you need. I am on T3 only. Too bad your MDS there have no idea how to treat you. This I dont understand. It a wonder you are not feeling well...Bless your heart.
Could you please explain - for the benefit of members reading this thread - which of the remarks made by Nanaedake are foolish. In order to post something positive and helpful - perhaps you would like to add your own experiences/advice - rather than criticise members. Many of the 80,000 members HAVE discussed their concerns with both GP's and Endocrinologists to no avail - hence the Forum exists. This forum has many experts from the field of research and other areas.
Oh dear ! - what happened ? Why would anyone blindly follow on-line advice without first knowing and trusting the person giving the advice. Did you really do that ?
I have been on this Forum for almost seven years - and no doubt have been rambling as you describe - however you do soon learn who offers good/excellent advice and who does not. The level of knowledge by many here is impressive.
DrC4550,
Are you medically trained as a doctor?
Your member name appear to imply that but there is no confirmation so far as I can see.
Hi Nicki. As you can see your TSH level is very high and until it comes down you will feel all those hypothyroid feelings sluggish, cold, hair loss, weight gain (and strange things sometimes - like frozen shoulder and like you have rubber bands round your wrists).
25mcg is a starter dose which can only be added to incrementally ( after 6- 8 weeks at least) so make sure you get tested regularly. Unfortunately it does take time (in my case about 2 years to feel really good). So patience is needed and make sure you share with friends and family what is going on as it can feel like a lonely road on your own. Maybe get one of the pamphlets on thyroid disease for friends to read. All the best!
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