Help needed please.

[Ballito]

I am a newby to this forum and have received my Blue Horizon Medical results today as follows.

HbA1c-(IFCC) 42 20 - 42 mmol/mol

hs-CRP 0.81 <5.0 mg/L

Ferritin 107.0 13 - 150 ug/L

Magnesium 0.97 0.66 - 0.99 mmol/L

Insulin 51.3 <173(Fasting) pmol/L

TSH 0.94 0.27 - 4.20 mlU/L

T4 Total 79.3 66 - 181 nmol/L

Free T4 13.90 12.0 - 22.0 pmol/L

Free T3 4.21 3.1 - 6.8 pmol/L

Reverse T3* 14.0 10 - 24 ng/dL

Reverse T3 ratio 19.58 Normal>15 Ratio

Borderline 12-15

Low <12

Anti-Thyroidperoxidase abs <9.0 <34 klU/L

Anti-Thyroglobulin Abs <10 <115 kU/L

Vitamin D (25 OH) 55 Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 437 Deficient <145 pmol/L

Insufficient 145 - 250

Consider reducing dose >569

Serum Folate 17.30 8.83 - 60.8 nmol/L

I am 74 and drank the RAI in my 20s. I had had a miscarriage and hair problems but did not have overactive thyroid as always felt the cold. The hospital report at that time after the RAI said that they didn't think I had Myxodema but if I felt the cold, then to go back. Unfortunately we moved areas shortly afterwards, and then countries. I did take Thyroxine when we lived overseas. My Mum had an overactive thyroid. I have anxiety, had the carpal tunnel op. Have slow metabolism, have worn a wig for three years. At first it was when I went out, but I feel so much more comfortable with wig on, so I wear all the time as it gives me confidence. My hair is like fuzzy wire and is very thin on top. I always feel the cold, have brain fog and cannot find the right words. I would just like to get my life back. I have been reading your site for a while and have great confidence that someone can help me, as the doctor says my thyroid is o.k. Perhaps it is my adrenals then as something is not right. Sorry about the long blog. p.s. the doctor on BH did write that the first result needed looking at.

[SlowDragon Administrator]

So are you currently taking any Levothyroxine?

Your FT4 is towards bottom of range, total T4 low in range, FT3 too low

So you are either under medicated and need a dose increase, or if not on any Levothyroxine you need starting on 50mcg

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

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

Possibly as direct result of low thyroid, low stomach acid is common and leads to low vitamin levels

Your vitamin D is too low and needs supplementing to improve to around 100nmol.

Vitamin D mouth spray is good as avoids poor gut function. Perhaps start on 1000-3000iu

Retesting in 2-3 months via vitamindtest.org.uk £29

Look at magnesium and vitamin K2 Mk7 supplements too

articles.mercola.com/sites/...

Vitamin B12 and folate are both on low side. You might benefit from supplementing a good vitamin B complex with folate in, rather than folic acid

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...

[Ballito in reply to SlowDragon]

Thank you SlowDragon. No, I am not on Levothyroxine as the doctor has said for years that there is nothing wrong with my thyroid. I forgot to mention that I also have a multi nodular goiter. I take Biotin 5000; 2 x Curcumin for inflammation; folic acid 400 (which I will change; a multivitamin tablet for women 50+; evening primrose oil and co-enzyme Q10. I have just started on Spirulina tabs as well. My only prescription tablet is one daily Calcichew D3 forte tab. After being on statins for years I have taken myself off them. Usually my cholesterol goes up to 8.5, but I think this has to do with the thyroid doesn't it. Dr. Michael Mosley said that coconut oil was good for raising the good cholesterol, so I take a good teaspoon of that with my porridge every morning. Am I wasting my money on these tabs? I will certainly take the steps you have recommended and thank you so much for your help.

[SlowDragon Administrator in reply to Ballito]

High cholesterol is linked to being hypothyroid

nhs.uk/conditions/statins/c...

So did you stop biotin supplements 3-5 days before these tests?

Suggest you get the recommended list of thyroid specialists from Thyroid UK - email

[Ballito in reply to SlowDragon]

Hello SlowDragon. I took the last Biotin on Friday morning, and the blood test was Tuesday morning. I hope the tabs I have been taking are not screwing up the test results. I will email Thyroid UK for the specialists. Thank you for your help. Much appreciated.

[Nanaedake]

You should discuss your HbA1c with your doctor as it's right at the top of normal range and could indicate the beginnings of a problem. You might benefit from a low carb diet and a gentle exercise program now before you run into problems. However, if you get your thyroid level right, you may find the HbA1c level reduces too. You may need a little more thyroid hormone but your vitamin D is still on the low side and might be better around mid-range, you might do best to correct that first and see how you feel. Good advice above on vitamins from Slowdragon. Ensure you are eating enough calcium rich foods in your diet. You could add vitamin K2-Mk7 to ensure vitamin D3 and calcium are directed to your bones. Vitamin C is also a good addition.

[Ballito in reply to Nanaedake]

Thank you Nanaedake. I will go to the doctor, but want to start on the new vitamins first. I do try to eat very healthily as I also have osteopaenia as well. I will try a low carb diet and exercise more. I am prepared to do anything to feel healthy. Thank you for your support and advice.

[Nanaedake in reply to Ballito]

As you have osteopaenia, has your doctor prescribed vitamin D and calcium supplements? (just noticed you take calcichew) Make sure you eat some calcium rich food with every meal as you will likely not absorb all the calcium in the calcichew tablets. Exercise is very important to prevent osteopaenia from developing into osteoporosis. If you go low carb then make sure you get enough healthy fats in your diet. Good fats include avodaco oil, coconut oil, olive oil and organic, whole dairy products from grass fed cattle according to what I've read. These are the fats I consume on a low carb/high fat, gluten free diet.

[Hidden in reply to Nanaedake]

Good morning Nanaedake. I do have a treadmill but don't find the time to go on it every day, so I will have to change that and make time! We love avocados, but they are usually in a sandwich with other salad greens but I haven't tried the oil. I have porridge made with milk but the milk isn't organic, and I have a probiotic yogurt drink and biopot yogurt. I also have 2 or 3 brazil nuts every day. There is so much to think about and it would be easier if my head would retain information, but I will make changes and google information for a low carb/high fat, gluten free diet. I try so hard to eat healthily but think it might be more fun to eat junk, get drunk and start smoking or taking snuff!

[Nanaedake in reply to Hidden]

diabetes.co.uk/ this website has useful information about low carb/high fat diet suitable to avoid diabetes and other health problems. If you can't do the treadmill then try a dance class. Dancing is the best all around exercise for bones I believe.

[Ballito in reply to Nanaedake]

Thank you for the diabetes website. I will join as there is a lot of help there. Today I have purchased H & B finest Vit B complex; Vit C, and vit D oral spray together with vit K2 spray. Yes, dancing would be fun. I did exercise on the treadmill today. I thought I ate healthily but looking at the low carb diet I realise that I was eating far too much fruit. I am trying to cut out all bread and potatoes. We are going on holiday on Monday until Saturday, so will try to stick to low carb if possible. Thank you for all your good advice.