Test results fine?

[Lisa_middle_earth]

Hiya! I’m looking for some advice or pointing in the right direction please.

I’ve had these results back from GP following blood tests for increasing fatigue. GP said except for folate everything else is fine. I’m autoimmune hypothyroid for past year currently on 125mcg levothyroxine. I also take Fluoxetine 60mg, CalciChew 1000 units daily, and folic acid 5mg daily.

Serum ferritin 68ug/L (range 10 - 150)

Serum vitamin B12 304ng/L (range 191 - 663)

Haematocrit .418 (range .36 - .46)

Serum folate 2.9ug/L (range 3.9 - 26.8) - given folic acid

Is there any other tests recommended? I’m having increasing salty cravings and wondering if the adrenals may be behind this increasing fatigue? Not sure if I’m looking in the right direction. My last TSH was 9.7 and levothyroxine was increased from 100mcg to 125mcg.

Thanks for looking x

[SlowDragon Administrator]

How long since you had dose increased?

You should have bloods retested 6-8 weeks after dose increase

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. (Patient to patient tip, GP will be unaware)

Dose should be increased in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Have you had vitamin D tested? It's extremely common to be too low with Hashimoto's

Is folic acid prescribed for taking daily? Not just once a week

B12 is not brilliant.

As you have Hashimoto's are you already on 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)

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, and vitamin D if not already tested

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...

[Lisa_middle_earth in reply to SlowDragon]

Thank you for your reply. I’m due to have the TSH retested in the next week or two. Vitamin D was tested and was very low, I’ve had a five week high dose course and now on 1000 units daily for maintenance. Folic acid is a daily dose also. I’ve only just found out it’s Hashimotos - I wasn’t aware that my antibodies were tested until I was badgering my GP to test them so I’m looking to eliminate gluten from my diet.

Thanks for the links and for your help

[SlowDragon Administrator in reply to Lisa_middle_earth]

Vitamin D should be retested, 1000iu may not be high enough maintenance dose, especially with Hashimoto's. We often need 2-3000iu just to stay level

Post your new results when you get them

All thyroid tests should ideally be done as early as possible in morning and fasting.

If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Levothyroxine dose should be increased in 25mcg steps, retesting each time after 6-8 weeks, until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Yes strictly gluten free diet likely to help

[silverfox7]

Just deleted my post to you! Sorry I was replying to someone else!

[greygoose]

Everything is not fine! Your ferritin and B12 are also too low, and a with a TSH of 9.7, you're bound to have increasing fatigue! Your doctor is somewhat ignorant!

[Lisa_middle_earth in reply to greygoose]

Thanks for your reply I’ve been seeing one of the GPs in the practice as she has hypothyroidism - I mistakenly thought she’d be more understanding of the condition!! After some serious badgering, she reluctantly agreed to test everything - and she said my above levels were just fine! I’m due to retest TSH in the next week or two. I’ve been off work sick for the past 8 weeks as I fainted at work and have been seriously fatigued ever since, with the fatigue seeming to worsen. I’ve also noticed an increase in salt cravings, hence wondering if adrenals need some TLC. GP said it wasn’t my adrenals as my electrolytes were fine. Needless to say, I’m not going to see her again! I’ve just ordered some sublingual vitamin B12 tablets to see if that helps

[Fruitandnutcase in reply to Lisa_middle_earth]

Let’s hope one day her TSH reaches the dizzy heights of 9.7 and her B12 is barely ticking over etc and her doctor tells her that her results are ‘fine’.

[greygoose in reply to Lisa_middle_earth]

Quite amazing, isn't it!