Help with new blood results please.

[Music1]

So, here I am. 6 weeks after having ivf stopped for the 2nd time as their lab results came back with a TSH of 10.75. I went to the GP immediately following this, and she said my TSH was normal with 4.00. I know that means nothing, and she knows very little/ nothing about Hypothyroidism, Hashimotos

Anyhow, have been taking 75mg of Levothyroxine for 6 weeks, and have now started alternating between 100 and 75mg daily. Microgynon (the pill). Am also supplementing with 2 Vitabiotics ultra-d3 tablets vitamin D3 optimum strength, 1x Feroglobin capsule from vitabiotics.

TSH 1.47

T4 free 12.0

B12 239

Sorry, these are the only tests they have given me. I was tested for liver and kidney function, but they apparently came back normal. They/ she refused to test B12, D, Folate or anything else. Any advice on these I would greatly appreciate. I feel absolutely shattered and exhausted most of the time. Almost like flu. Wondering if a B12 spray or other vitamins sprays may work better than tablets? If anyone can recommend what I might consider doing next, as I don't physically feel good enough for ivf just yet even though my number has come down. Many thanks in advance. x

[SlowDragon Administrator]

Without the ranges no one can really advise.

FT4 looks low at 12

When on Levothyroxine usually we need TSH around or just under one, but most important test is FT4 and FT3

B12 ....assuming that's a standard NHS B12 test, (and not active B12 via Medichecks) then 239 is low too

B12 supplements are usually sublingual as difficult to absorb in gut

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

Essential to test vitamin D, folate, ferritin and B12

Obviously good levels of both folate and B12 are essential for a baby's neurological development

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

Are you on strictly gluten free diet as you have Hashimoto's?

[Music1 in reply to SlowDragon]

Thanks SlowDragon. I knew you would have some answers. My GP hasn't said anything... advised on whether I should continue with Levo 75mg or increase or ... anything. Mind you, saying that. Last time they tried to take me off Levo completely and then I dropped to 50mg with the result being that my TSH had gone up again and ivf was cancelled.

I appreciate the 'ranges'. Sorry, I should have thought. I was thinking there may be an ideal number for these things I think I will have to take your advice and go with private checks. Even though I've asked the GP they say the other tests are not necessary.

Yes I am completely gluten free diet. Have been for over a year, since I last posted my blood results on here and it was advised. Again... my GP hadn't even heard of Hashimotos.

Thank you so much for your advice. I will look into Medichecks.

Really, really, really appreciate your feedback/ advice. Without a site like this I would have no information at all. Kind Regards

[Saya85]

Hi music1,

I agree with slow dragon- we really need ranges to get better idea.

Glad your tsh has come down. Ft4 at 12 seems low (most ranges are usually between 11-22)

also test ft3. I would imagine your low vitamin levels will probably mean poor t4 to t3 conversion. Although the baby only needs your t4, (so prob does need increasing) you will feel awful yourself with low t3 also.

B12- if serum - usually is from about 180-900, so again 239 seems low and similar to my results between 180-240 and I felt like death. Look up b12 deficiency symptoms - esp neurological ones. If it fits you then I would def look to supplementing. I use b12 oral sprays but you can buy sublingual versions to dissolve under tongue. (We often don’t break down vitamins and minerals from food or tablets very well due to low stomach acid and other digestive and gut issues in Hashimotos)

Usually the advice is to have loading injections of b12 for two weeks + before continuing supplementing, and it’s worth testing for pernicious anaemia to see if you have an overlapping autoimmune condition causing low b12. Hashimotos patients often have PA and coeliac and other autoimmune conditions risk is higher.

*do not start supplementing before testing for b12/PA etc as any supplementation will skew results massively*

It doesn’t sound like your Gp is willing to do anything but local CCG guidelines should help you re:b12 treatment. (Also check the PA forum on here too)

Have you ever had vit D tested? I believe if you are taking 2 ultrad3 tablets from vitabiotics that’s 6000iu in total!

If you aren’t vit D deficient then that is a lot to take. You can overdose on vitD also so worth checking private bloods. Usually it’s loading doses again for few weeks if deficienct and then maintenance supplementation after. Usually 1000iu but a lot of Hashimotos patients need about 3000iu. It may be that you need 6000iu but without testing I’d be careful.

Also vitD3 needs cofactors of vitk2 mk7 and magnesium to direct calcium to bones properly. I use spray versions to help absorption too.

Similarly with feroglobin- were you told you had low iron/ferritin? If low doses it may not matter too much but again you can overdose on iron so should be tested to keep eye on levels.

Are you strictly gluten free ? I.e checked your thyroxine tablets also as well as any hidden gluten in most processed foods etc even a small amount of gluten can set you back. I also suffered badly on the TEvA brand of thyroxine as many others have so worth checking what brand you’re on too.

We should be taking folic acid 400mcg anyway whilst trying to conceive but if you are taking that it can also mask b12 deficinecy, and microgynon can also lower b12 levels (that’s how I found out why I crashed on microgynon) you need both folate and b12 to work together so you will most likely need to supplement both.

Medichecks often has vitamin and thyroid tests together and discounts on Thursdays so worth checking them out.

Good luck x

[Music1 in reply to Saya85]

Thank you Saya85, you know so much about all this. I really appreciate you writing.

I need to work out what brand my Levo actually is. I tend to open them straight away from the blister pack and put them into a plastic daily pill box.

I will defo start taking folic acid. I was putting this off until I was starting ivf, but I may as well start now. Interesting to know that microgynon can lower b12. No wonder I feel abs shattered. I've just bought some mouth sprays to see if they will work. I have been trying to phone the GPs as well to rebook another blood test. I do need all the other tests for vits, D, and T3 and 4 etc. I think I'll have to try and insist. I didn't realise you could have too much of a vitamin. I thought the body would just take what it needed regarding the vit D.

Am completely GF, although I will double check the Levo. Hadn't thought of meds possibly making things worse that way.

Thanks for ideas and suggestions. Wish you were my GP. I will update you when I go back and try and insist on those additional tests, or I will be going to medichecks. Do you have to take a vile of your own blood or can it be a pin prick? Sorry, totally useless with blood. x

[Saya85 in reply to Music1]

Hi

You’re welcome.

If you want to test further for b12 issues then do so before supplementing and before taking folic acid as they can skew results.

Medichecks is mostly pin prick testing (similar to what diabetics use) that u send in the post, but u can pay extra for blood draw at local pvt hospitals.

They have thyroid discounts on Thursdays

Keep us posted x

[Angel_of_the_North]

Well, your Gp is not obeying NICE guidelines for pregnancy as TSH is supposed to be < 2.5. So you could try that as an opening.

[Music1]

Thanks Angel of the North. I think the problem is, my surgery hasn't had GPs for nearly 3-4 years. We have so many different locums come in and out daily and I don't think they have the same care/ understanding possibly. I will be going back though and telling them about 'NICE guideline for pregnancy'. I really appreciate that. Thank you.