Endo advice needed before consultations

[Adametcartwright]

Hello,

I have been diagnosed with Hashimoto’s i Am currently on 100 Levo daily. I have improved slightly but still have a lot of symptoms.

My TSH is within range so my GP says everything is fine, I have paid for some private bloods and have asked for a referral to an Endo.

I would like some advice on the below test results and any advice on speaking with the Endo would be great. Thanks in advance

TSH, 1.63 mIU/L (0.27 - 4.20)

Free Thyroxine, 18.400 pmol/L ( 12.00 - 22.00)

Free T3, 5.48 pmol/L (3.10 - 6.80)

Reverse T3, 25.00 ng/dL (10.00 - 24.00)

Reverse T3 Ratio, 14.27 (15.01 - 75.00)

[Marz]

.... and the ranges are ? The all important figures in brackets after the result

[Adametcartwright in reply to Marz]

Thanks for the reply, I have updated the results and ranges

[Marz]

Have you had the tests done for B12 - Folate - Ferritin - VitD ? Are they all optimal ?

[Adametcartwright in reply to Marz]

VitD was slightly low so I am taking supplements, Ferritin was slightly high but is now within range (on the higher side)

I haven’t been tested for B12

[Marz in reply to Adametcartwright]

How low is low ? How much are you taking of VitD ? You need to have B12 and Folate tested - they work together in the body in an important way ...

[Adametcartwright in reply to Marz]

I will post my VitD when I get home I think it was only just below the range, I be back in 20mins so will post then. Thanks

[SlowDragon Administrator in reply to Adametcartwright]

You need B12 and folate tested..

Has vitamin D been retested since started supplementing. How much are you taking daily?

We see many thyroid patients prescribed 800iu daily for years and they remain deficient. With Hashimoto's we often need high dose vitamin D and/or find vitamin D mouth spray works best as avoids poor gut function

You do not need any gut symptoms to still have poor gut function, low vitamins and gluten intolerance

[Adametcartwright in reply to SlowDragon]

I have had IBS symptoms for years

[SlowDragon Administrator in reply to Adametcartwright]

IBS is often gluten intolerance

Ask for coeliac blood test BEFORE changing to strictly gluten free, (just to rule it out)

But by far the majority with Hashimoto's are not coeliac, but gluten intolerant (no test available) or it's due to leaky gut - see Amy Myers link in my first reply

Gluten free is easier than you might expect

[SlowDragon Administrator]

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.

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

Ideally ask GP or endo for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's gut connection is very poorly understood

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

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.

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Is this how you did this blood test?

[Adametcartwright]

Thank you, much appreciated