I am a 30 year old female with 2 children (8 and 6) and developed hypothyroidism after my second child (I did have hyperthyrodism initially).
My GP has me on 75mg of levothyroxine but I am suffering from very sever fatigue, restless legs, memory fog and lots of other symptoms - they are really starting to affect my day to day life now.
So, I decided to have the medichecks Thyroid Check UltraVit rT3 test done - The results are back and i'm confused as they appear to tell me that the Thyroid meds are correct - yet my symptoms are terrible. I didn't take my meds on the morning of the test so as not to skew the results.
I wondered if anyone could help me interpret them please and maybe offer some advice?
I have attached screenies of the lab tests.
Thank you so much for any help.
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For reference - here is a copy and paste of the "letter" that came with the lab report :
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Please find our comments below regarding your test results.
I note that you are taking 75mcg levothyroxine currently.
All of your thyroid hormones are normal indicating that your dose is correct.
Your thyroid antibodies are high in keeping with an autoimmune thyroid problem.
Your levels of vitamin B12 and folate are normal.
Your vitamin D levels are bordering on insufficient. This may progress to vitamin D insufficiency or deficiency if you don’t take steps to increase your vitamin D levels.
Low levels of vitamin D can cause fatigue, bodily aches, poor memory and difficulties concentrating.
Outside of the winter months there is enough sun for your skin to make at least part of your daily requirement of vitamin D, so it is worth trying to get 15-20 minutes of midday sun when the sun is out. Vitamin D can also be found in fortified foods such as breakfast cereals, plant-based milks, tofu and some fruit juices. The only reliable natural source of vitamin D is in oily fish, although it can also be found in some mushrooms (portobello, maitake, morel, button, and shiitake are particularly good), you can improve this by leaving the mushrooms in the sun before cooking them.
We recommend supplementing with 400 - 800 iu of vitamin D per day for twelve weeks. If you are already taking vitamin D then I recommend that you increase your dose.
Your CRP level is normal, suggesting low levels of inflammation within the body.
You have a decreased ferritin level which suggests that you are deficient in iron. If there is an obvious dietary cause for this then I recommend supplementing your iron and repeating the test in 12 weeks. If there is no obvious dietary cause, and particularly if you are experiencing any bleeding or bowel upset then this result should be discussed further with your GP.
I recommend increasing your dietary iron intake (green leafy vegetables). Orange juice will help you absorb dietary iron better. Over the counter lysine supplements can also help with this.
Additionally, as low iron can affect your red blood cells, I recommend checking your full blood count to ensure you are not anaemic.
Dr Ajay Deshpande
MBBS
Based on your Thyroid Check UltraVit rT3 results we recommend that you have the following tests:
There are a few things that stand out which could be causing your symptoms.
Ferritin: 11.9 (13-150)
You should discuss this with your GP. Low ferritin can indicate iron deficiency anaemia. You should ask for a full blood count and an iron panel and if iron deficiency anaemia is confirmed then your GP should prescribe iron tablets. Don't supplement yourself, this needs to be supervised by your doctor with regular monitoring.
You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
Vit D: 54.9nmol/L
This comes in the "normal" range but is low according to the Vit D Council who recommend a level of 100-150nmol/L. Your GP wont prescribe anything for this level so you should buy your own D3. As you have Hashi's (autoimmune thyroid disease) an oral spray will be better absorbed than softgels so I suggest you buy some BetterYou 3000iu and take 6000iu daily for 8 weeks, then reduce to 3000iu daily, then retest. Once you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
There are important cofactors needed when taking D3 as recommended by the Vit D Council -
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
BetterYou do a combined D3/K2 spray which you may prefer rather than buying a separate K2 supplement.
Folate: 11.97 (2.91-50)
This should be at least half way through it's range. A good B Complex will help raise ferritin (along with eating lots of leafy greens and other folate rich foods). Thorne Basic B and Igennus Super B are decent brands of B Complex.
Active B12: 92.3 (25.10-165.00)
Not bad. If it were below 70 it is recommended to test for B12 deficiency. If you buy one of the above B Complex supplements, there is a decent amount of B12 in those which may help improve your level.
Thyroid Antibodies
Both of your antibodies are raised, confirming Hashimoto's which is where the antibodies attack and gradually destroy the thyroid. The antibody attacks cause fluctuations in symptoms and test results. Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
These aren't terribly bad but FT4 is less than half way through range.The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well. You would probably benefit from an increase in your Levo - 25mcg now and retest in 6 weeks. This will raise your FT4 and because your conversion of T4 to T3 is good your FT3 will also rise. Ask your GP for an increase based on these results and in support of your request use the following information from thyroiduk.org/tuk/about_the... > Treatment Options
Dr Toft 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)."
Dr Toft is past president of the British Thyroid Association and leading endocrinologist.
You can obtain a copy of the article by emailing Dionne at tukadmin@thyroiduk.org print it and highlight question 6 to show your doctor.
Your thyroid results are acceptable with FT3 at 5.1, but you might feel better on an increased dose (25 mcg to start with) to get your TSH down to 1 or below; your T4 could be higher, over mid-range. What is noticeably are the low essential Vit D, folate and ferritin levels. You clearly have Hashimoto's which is characterised by poor gut absorption and often low vit/ min levels, so you need to supplement them. A bit of sunshine and portobello mushrooms are unlikely to improve them sufficiently. Have a look at the recent post replied to 'Mozart' by Seaside Susie with lots of info. Re vits/ mins.- improving them might help with symptoms like fatigue etc.
Hashimoto's and low vitamin levels strongly suggest gluten intolerance
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
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