Please see blood test results attached I did with Medichecks on 9th July. I discovered I have Hashimoto's in February this year with Thyroid Peroxidase Antibodies 932 (0.00-6.00iu/ml). You can see from my previous posts my Levothyroxine was increased on 3rd Feb from 100mg to 125mg due to experiencing lots of symptoms. Since then a gradual improvement in symptoms but gut issues in particular remain. I also have a concern about my weight, I did not need to loose weight but have lost over 1 stone in weight since December. I still not sure if this is due to overmedication, as my TSH became quite quickly supressed from 2.89 (0.35-4.94mu/L) in January to 0.03 in April. With this latest result from Medichecks, my TSH is still 0.062 (0.27-4.20mlU/L) and my weight is still slightly dropping. GP decided to lower my Thyroxine to 125mg/100mg alternate days on 1st June. However the next blood test done on 2nd July (At a pointless Endo appointment!) showed:
TSH 0.07 (0.35. - 4.94mu/L),
FT4 23.8 (12.22pmol/L)
FT3 4.6 (3.1-6.8pmol/L)
I decided myself to lower Thyroxine back to 100mg where I started! Have I done the right thing?!
My TPO antibodies have reduced but now I learn I have Thyroglobulin abtibodies as well, I'm not sure what this means. After I had a loading dose VitD3 in February due to severe deficency results in April Vit D 104 (70- 200nmol/L) I stopped taking Vit D supplement and now Vit D is back to 68.8 (50-200nmol/L). Do I have absorption problems?
I would be delighted if anyone can throw some light on these results and what you think I should discuss with GP. Many thanks in advance.
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SmPea
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As you have Hashimoto's you almost certainly have absorption problems and very very many of us are also gluten intolerant
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. Dairy is second most common.
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
Yes majority of us need ongoing maintenance dose of vitamin D
Aiming to improve to around 100nmol. Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you supplement 1-2000iu for 2-3 months and retest. It's trial and error what dose each person needs. Once you Improve level, very likely you will need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk
Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D
Your B12 and folate are also low. You will possibly benefit from good quality daily vitamin B complex. One with folate in. Eg Igennus Super B complex or Jarrow B-Right
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
Only make one change or add one supplement at a time. Waiting at least a fortnight to assess Vitamin D most important probably, then magnesium, then B vitamins, then gluten free diet
Retesting again in 2-3 months. If FT3 remains low then like many with Hashimoto's you may need addition of small dose of T3. But vitamin levels must be optimal first and very many benefit from gluten free diet or find it essential
Thank you Slow Dragon for all the information and a clear plan of action, it makes a lot of sense. Just one further question, do you have any ideas why I have lost weight?
Lots of people with Hashimoto's struggle to maintain weight. If your gut function is badly affected you struggle to absorb nutrients
Medics think we all tend to gain weight, but a small but significant number struggle to maintain weight
It is suggestive that gluten intolerance or coeliac are likely
Many coeliac patients have terrible trouble maintaining weight until strictly gluten free, Hashimoto's patients can be the same.
Myself, I didn't start loosing weight or mucin until strictly gluten free. Tested twice for coeliac, both negative results. Endoscopy showed severe gluten intolerance (no gut symptoms of any kind). Gastroenterologist so convinced it was coeliac, did DNA test...result "probably not coeliac"
It's not always clear cut
Getting vitamins optimal is first step, plus gluten free
Otherwise it's impossible to tolerate adding small dose of T3 (if it's required)
Thanks that's useful to know that some of us struggle to maitain weight. I've had one negative Coeliac test and last month had Endoscopy and colonoscopy, according to report from Gastro nothing significant but have an appointment end of August to discuss further. Going gluten free is getting louder in my ears but I understand once you start this, it's much more difficult to diagnose Coeliac, so I'm holding off while I dig deeper! Just ordering my supplements now as you suggest. Being on this site gives me hope thank you.
Hi SmPea, personally I woudln't get too hung up on getting a diagnosis of coeliac disease, I'd suggest you go properly full on gf for 4-6 weeks and record how you feel.
For example, my husband is coeliac, his mum is coeliac and his sister tests negative for coeliac but feels 100% better on a gf diet with the slight difference that if she gets some cross contamination, she doesn't get the massive 'ill' period that coeliacs know only too well and dread. She's probably in the 'non coeliac gluten intolerant' group for which there is as far as I know, no test for.
I have the genetic marker that coeliacs have (as well as Hashi's), as do my two girls, so we made the decision to all be gf (much to the puzzlement of the paediatrician who did their blood tests). Part of our reasoning was a study that suggested there is a 3 in 10 chance of developing coeliac when it's from father to daughter. Being gf is a lot to get your head round at first, but it's so much easier these days than it ever used to be, and the coeliac society do a great job about information.
Obviously I don't know your personal situation and what's practical for you, but if you can clear your cupboards of all the things that contain gf and give them away or chuck them out, it makes life a lot simpler going forward, as you only bring 'safe' food into the house. It takes ages going round the supermarket when you're new to ingredients checking, but if you use e.g. the Tesco app for click and collect, you can filter for gluten and only show food that you can have. Rice is a great, cheap, substitute for when you'd normally have pasta. And although it's tempting to switch up to gf bread, cakes, biscuits etc, do you really want to be eating those anyway? As they say, real food doesn't have ingredients!
My friend has a family of 4 and she's the only one who is gf due to joint pain (which has essentially gone since going gf). She does have gluten in the house but it's things like bread, biscuits, crackers etc, which are eaten separately as it were. She preps the same food for everyone, and luckily her family are very supportive and don't use her toaster etc.
Here's one of my favourite sources for gf recipes and info (plus other 'free from' recipes for auto-immune health). thepaleomom.com
Possible you have an absorption problem, but there's not much sign of it. However, you do have a conversion problem. Your FT3 is too low compared to your FT4 - which, whilst not over-range, is probably too high. But, if you lower the levo, the FT3 will also drop. So, what you really need is some T3 added to your levo.
Thanks greygoose adding T3 has been suggested by others. I asked my chemist if they had T3 in stock, he said yes but GP's don't like to prescribe it because it is too expensive! If I follow the protocol of supplements that Slow Dragon suggests first but find my FT3 level does not improve, do you think that will be convincing evidence for my GP to provide T3?!
Not knowing your GP and his attitude to all this, I really couldn't say. He'd probably tell you that he can't prescribe it, anyway, and you have to see an endo. It's all very unpredictable. But I doubt he knows enough about it to weigh up the pros and cons and understand the intricate details to be swayed by your nutrient regime. Doctors know nothing about nutrition, either!
I don’t know the GP either! I’m trying a different one in the practice as the one I was trying to develop a relationship with clearly knew nothing about Thyroid. When I presented her with lots of symptoms she said ‘ok I’ll increase your Levo to 125mg or 150mg I don’t mind’ dangerous incompetence!!
I will be asking to be referred to another Endo as the last one was a disaster. Familiar story for many on here.
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