My private blood test back yesterday

[Gary19610]

Could you give advise what supplement I should take

[SlowDragon Administrator]

Your results show you have very poor conversion, probably due to very low vitamins

Your TSH is too high, but your FT4 is high. Your TT4 is low, this suggests you have room for Levo dose increase. Or you may need small dose of T3 added, as FT3 is on low side, most find they feel better when it's over 5

Vitamin D is far too low. Do you supplement any vitamin D already? Aiming to improve to around 100nmol

Trial and error what each person needs. With Hashimoto's using vitamin D mouth spray is good as avoids poor gut function. Retest twice yearly via vitamindtest.org.uk £29 NHS postal kit. You will very likely need ongoing maintenance dose, once you get level up.

B12 is very low. Do you have any low B12 symptoms?

If so ask GP to run further testing, and see if they will give B12 injections

b12deficiency.info/signs-an...

If not you will need to take daily sublingual B12 supplement. Also recommended to take a good quality vitamin B complex with folate in.

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...

Are you still on strictly gluten free diet? Have TPO antibodies reduced since last tested?

Most importantly, how do you feel. Are symptoms improving or bad?

[Gary19610 in reply to SlowDragon]

Thankyou,not taken any supplements only taken 100mg of Levo and was low on folic so been eating a lot of green and taking 5mg of folic acid 2 week but said take one daily .My antibodies on last test before this was 3400.Going to show Doctor my private blood test but dort think he give me anything for B12 if it's in range .

[SlowDragon Administrator in reply to Gary19610]

You will most likely need to self supplement vitamin D, B12 and Vitamin B complex

You may be better taking Vitamin B complex with folate in, rather than folic acid.

Doctor may agree to supplement vitamin D, but likely to only prescribe 800iu daily.

Guidelines say it should be 1600iu daily, though even this may not be enough when Hashimoto's is involved

oxfordshireccg.nhs.uk/profe...

[Gary19610 in reply to SlowDragon]

My antibodies while been gluten free have gone down 1000 taken 2 years .And 100% gluten free very carefull on what I eat and with anybody giving me food I check it out first.Before I went gluten free I was very ill nealy house bound would hate to go back to that .while been gluten free I am about 70% better but at the moment I have like week leg and thiegh muscles bit of brain fog and headache

[SlowDragon Administrator in reply to Gary19610]

Suggest you take these results to GP and ask for help improving low B12. Can they test for Pernicious Anaemia before you start self supplementing, if GP will not offer B12 injections

Have you asked GP for 25mcg Levothyroxine dose increase, they can't deny you need that. Your TSH is above range

NHS Guidelines which I also attached on earlier reply. GP should be treating you. Though you likely need higher dose than this with Hashimoto's

oxfordshireccg.nhs.uk/profe...

As you clearly have gluten intolerance and gut issues once vitamin deficiencies are improved and TSH lower, if FT3 remains low then you may need addition of small dose of T3

Thyroid Uk has list of recommended thyroid specialists

[Gary19610 in reply to SlowDragon]

Gave my results to reception about a 5 days ago but nothing from doctor yet . I am on 100mg to 125mg of Levo but has you can see t4 bit high but the more Levo I take the higher my t4 go,s

[SlowDragon Administrator]

Can see on this post you are on strictly gluten free diet

Ft4 was 60% through range

Ft3 only 33% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Poor conversion of Ft4 to Ft3 common with Hashimoto’s and especially when we are gluten intolerant

Absolutely essential to get vitamins optimal

Gluten free diet is very low in magnesium an£ Hashimoto’s patients are frequently low in magnesium anyway

ncbi.nlm.nih.gov/pubmed/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

endocrine-abstracts.org/ea/...

Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.

Important to maintain high B12 levels and folate levels

ncbi.nlm.nih.gov/pubmed/186...

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,

[Gary19610 in reply to SlowDragon]

I get a bit confused with all this but will try and work it out has doctors not much use . I had an intolerance test by hair came back that I am intolerance for lactose and cheese and some more intolerance I should not eat . What you think about the hair tolerance test any good . Trying to get of dairy but meant can not have my cup of tea lol

[SlowDragon Administrator in reply to Gary19610]

Well many Hashimoto’s patients are gluten intolerant

Lactose intolerance is also very common.....but quite a few people on here have found lactose intolerance improves after 2-3 years on strictly gluten free diet

coeliac.org.uk/information-...

Hashimoto’s is as much a disease of poor gut function as it is a thyroid disease

Getting all vitamin levels optimal helps levothyroxine work better and should also improve gut function

Once you are on high enough dose levothyroxine to have Ft4 in top of range and all four vitamins also at GOOD levels....if Ft3 remains low then you may need the addition of small doses of T3 alongside levothyroxine

It’s EXTREMELY difficult, but not impossible, to get T3 prescribed on NHS

But you aren’t ready yet. Before even considering adding T3 everything else needs to be sorted

Trying lactose free diet.....there are other milk options ....sheep, goat ...or even camel 🐫!

Goats cheese is yummy...goats milk in tea is an acquired taste. M&S goats milk was the least “goaty” that I found

Links about lactose and Hashimoto’s

thyroidpharmacist.com/artic...

drhedberg.com/avoid-dairy-h...