3 months since my 1st Thyroid blood tests, had another set of tests done and not sure where to go

[Kevybob]

Had the full thyroid blood tests done in February where it was discovered i was 0.7 below Hashimotos with a TSH level of 2.6. Was severly deficient in Vitamin D and Folate. I posted my results on this forum and received some incredible advice. I adressed the Vitamin D and folate issues. Told my GP about the test results, who was not at all helpful and suggested i had nothing to worry about. So after 3 months i had the same tests again to check on where everything was at. My results were

TSH 2.78 mIU/L

(0.27 - 4.20)

Free Thyroxine 18 pmol/L

(12.00 - 22.00)

Total Thyroxine (T4) 82.1 nmol/L

(59.00 - 154.00)

Free T3 4.13 pmol/L

(3.10 - 6.80)

Reverse T3 23 ng/dL

(10.00 -24.00)

Reverse T3 Ratio 14.23

(15.01 - 75.00)

Thyroglobulin Antibody 11.69 IU/mL

(0.00 - 115.00)

Thyroid Perioxidase Antibodies 34.9 IU/mL

(0.00 - 34.00)

Active B12 62.9 pmol/L

(25.10 - 165.00)

Folate (serum) 7.61 ug/L

(2.91 - 50.00)

25 OH Vitamin D 140 nmol/L

(50.00 - 200.00)

CRP - High Sensitivity 3.34 mg/L

(0.00 - 5.00)

Ferritin 111 ug/L

(30.00 - 400.00)

I am still feeling the symptoms of Underactive Thyroid, which to be honest i think i have had for longer than i can remember (10 years +). On 2 occasions since then i have been treated with anti-depressants. I am finding it almost impossible to control my Type 1 Diabetes and my blood pressure medication is under review with a cardiologist.

Does my TPA result now confirm i have Hashimotos? If so, what is the best method to get diagnosed? Do i insist on my GP referring me to an Endo or am i wasting my time?

Really fed up with my weight gain, tiredness and foggy brain.

Was considering going to see Dr B Peatfield, but Crawley is a bit of a drive from my home in East London/ Essex border

[SlowDragon Administrator]

Your B12 and folate are both on low side. Suggest you add a good vitamin B complex daily

Active B12 under 70 is considered suspicious.

viapath.co.uk/our-tests/act...

You might want to do Homocysteine and MMA test before starting B complex

nutris.viapath.co.uk

Your antibodies are just over range. You may find strictly gluten free diet helps. As you have type one Diabetes recent research suggests it may help that too

diabeticlivingonline.com/fo...

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)

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

You do not need to have any gut symptoms

Ideally ask GP for coeliac blood test first, especially as you have type one diabetes

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...

Email Thyroid UK for list of recommended thyroid specialists

please email Dionne


[e-mail]

[Kevybob in reply to SlowDragon]

Thanks for your reply SlowDragon.

What i also forgot to mention is that i was diagnosed with Barrets Esophagus earlier this year due to undiagnosed acid reflux over a period of about 6 years, which may have caused the low vitamin D levels. I am taking prescribed medication to stop the swallowing difficulties that i experienced with this.

[SlowDragon Administrator in reply to Kevybob]

Presumably that's a PPI like omeprazole or Lansoprazole

Are you sure it's not low stomach acid. Most hypothyroid patients have low stomach acid not high

Absolutely essential NOT to suddenly stop a ppi. Going strictly gluten free may help significantly

Low vitamin levels are extremely common with PPI's, especially low B12 and low magnesium

thyroidpharmacist.com/artic...

drmyhill.co.uk/wiki/hypochl...

scdlifestyle.com/2012/03/3-...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

pulsetoday.co.uk/clinical/m...

gov.uk/drug-safety-update/p...

Over 5000 posts on here under sreach of low stomach acid

healthunlocked.com/search/l...

[Kevybob in reply to SlowDragon]

Yes i am taking omeprazole, which has cured my swallowing difficulties. I have a benign polyps caused by acid reflux. The omeprazole has allowed me to not have to worry about getting any food caught. I was on a soft diet for about 3 months whilst getting diagnosed.

I have been taking magnesium, folate, Vitamin D3 & K2 and selenium supplements for about 2 months

i don't know what caused my stomach acid problems, but someone mentioned that acid reflux could be caused by low stomach acid too

avogel.co.uk/health/digesti...

[SlowDragon Administrator in reply to Kevybob]

Essential to monitor vitamins then as PPI's lower them. Likely to need higher supplements

Gluten free diet can help gut heal, also bone broth and probiotics can help

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

You can test for low stomach acid

scdlifestyle.com/2012/03/3-...

[knitwitty in reply to Kevybob]

Hi Kevybob,

I was diagnosed with a hiatus hernia about 5 years ago, i had severe acid reflux on and off for months, my GP at the time was quite happy to keep prescribing omeprazole even though it should only be used short term.

I did some research with help from others on this forum and I gradually reduced my dose of omeprazole over about 2 months, I did it slowly to reduce the chances of a backlash .

I then started to drink very diluted apple cider vinegar before meals, I don't need to do this all the time, but if I have any reflux i take a small glass of it diluted.

I discovered that having low stomach acid causes the sphincter valve between the stomach and the oesophagus to become floppy and allow acid secretions back into the oesophagus when they should be contained within the stomach.

I am not sure if you are able to heal the Barrets Oesophagus or whether you need to take medication long term to prevent it becoming more problematical but it may be worth having a conversation with your doctor with regard to long term medication and the fact that low stomach acid can lead to absorption problems and how you can avoid malabsorption going forward.

Hope that helps, good health.

[Kevybob in reply to knitwitty]

thanks Knitwitty

i wasn't aware of this problem. Unfortunately, on the odd occssion that i have not taken the omeprazole i have encountered swallowing difficulties, so not sure i will be able to stop taking it. i will try to discuss this with my GP

kindest regards

[Kevybob]

Thank you so much for your help SlowDragon has given me food for thought.

i have felt for quite a while that all these problems i have are connected in some way

Gonna try to follow a Gluten free diet and speak to a specialist if i can

kind regards

[knitwitty in reply to Kevybob]

Hi again Kevybob,

It just occurred to me that you may have a gluten issue which is causing your reflux too. My son was diagnosed coeliac last year and the first thing to disappear was acid reflux almost as soon as he went completely GF.

Good luck sorting out your issues.