New Blood test results

[knitwitty]

Hi all I was hoping that you helpful people could cast an eye over my latest results from medichecks.

I have been on 50 mcg of levothyroxine for 7 weeks ( 25mcg starting dose for 6 weeks prior to that)

I have a telephone appt. with the practice pharmacist tomorrow morning and I am assured she can increase my dose if necessary.

I haven't been feeling too great for the last couple of weeks and was thinking I would need an increase in dosage, these results would look to me to be little low on the T3 side.

Also my antibodies have never been high before so at least they now confirm I definitely have Hashimoto's.

Other TFT's have shown a reasonable conversion ration but this most recent one would maybe suggest otherwise.

What I am wanting to know is would anyone else push for a rise to 75mcg and retest in 6 weeks to see how it goes?

ENDOCRINOLOGYThyroid Function

THYROID STIMULATING HORMONE 0.852 mIU/L 0.27 - 4.20

FREE THYROXINE 18.700 pmol/L 12.00 - 22.00

FREE T3 4.36 pmol/L 3.10 - 6.80

THYROGLOBULIN ANTIBODY *389.000 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES 9.07 IU/mL 0.00 - 34.00

Thanks in advance

[knitwitty]

I forgot to mention I have been completely gluten free for the last two months, which is a bit odd as I never had any antibodies in previous blood tests when I was eating gluten freely!! Lol.

[greygoose]

You do have a conversion problem, that's for sure, and increasing your levo by another 25 mcg could make it worse. What you need is some T3 added to your levo.

[knitwitty in reply to greygoose]

Thanks gg, I am a little perplexed as my conversion ratio was 3:1 approximately when I went hyper a few months back. Can your ability to convert fluctuate too?

I doubt I'll be able to get any T3 from the doctor let alone the pharmacist.

I am right in thinking those antibody results reflect Hashimoto's aren't I?

[greygoose in reply to knitwitty]

I don't know if the ability to convert fluctuates, but it can deteriorate.

Yes, you do have Hashi's, and Hashi's people often have poor conversion.

[knitwitty in reply to greygoose]

Thank you again gg, I may have to settle for 50mcg and I made an appointment to see the GP next week so I will go along and discuss it with her.

However based on the fact that the ccg won't prescribe without the say so from an endo I may have to wait until I can see one, I have the list of "thyroid friendly" ones and one close to where I live is said to prescribe T3 so maybe I might be in luck.

Would a higher dose of levo, suppress T3 conversion, in a poor converter?

Sorry for all the questions

[greygoose in reply to knitwitty]

It would in any sort of converter. Once the FT4 gets to a certain level, the T4 starts converting into more rT3 than T3, so you wouldn't end up with much improvement in the FT3 for the extra levo. It wouldn't give you enough T3 to make you well, anyway.

[knitwitty in reply to greygoose]

Thanks again gg, I didn't see your reply until this morning hence the delay in getting back to you.

I will ask to stay on 50mcg for the moment and I will see the (new) GP next week, perhaps just as well I kept the appointment as I had to wait 5 weeks to see this GP (she's obviously popular!).

I am going to ask if I can have my Vit D retested to see if that has improved from 38(75-100) as I have been sunning myself ,taking Vit D and eating lots of salmon. I was hoping that if I could get that up it might help me to convert better.

As slow dragon suggests I will ask for a thyroid scan, whether the GP will agree I don't know.

Our CCG will only test TSH ( despite the GP requesting other things) so I shall have to continue with private testing for the moment, it's costing me a small fortune but I shall buy a few tests when they are on special offer. I don't want to have to get the whole raft of tests each time if I am testing every 6-8 weeks if I can help it though.

Many thanks for you help it is always appreciated.

[greygoose in reply to knitwitty]

What about your other nutrients? vit B12, folate and ferritin? And zinc is very important for conversion, too.

Good luck with the GP.

[knitwitty in reply to greygoose]

Hi my other nutrients were:

B12 was 569 ( 181-910)

Ferritin 109 (10-291)

Folate 10.6 (>5.4)

Vit D 38 ( 75-150) this was the one that most concerned me.

Zinc wasn't tested.

Do you think any of the other results + the low Vit D could be hindering conversion?

I assumed that when I went hyper and my T4 was 27.5 and my T3 9.7 ( both out of range) that it would suggest I was converting ok, but thinking about it they were probably both high because it was my thyroid dumping the hormones following a Hash attack, I'm beginning to get my head around the complexities of this condition very slowly.

[greygoose in reply to knitwitty]

Your B12 could be higher. So could your folate. But ferritin is fine.

They don't normally test for zinc, but try taking some, anyway - most people are low on zinc and hypos are low on zinc, high on copper, so taking zinc evens it out.

I don't know if low vit d affects conversion, but it needs to be optimal, anyway. So many things can affect conversion that it's very rare to actually find the cause, I find.

'T4 was 27.5 and my T3 9.7', these are typical results after a Hashi's 'hyper' swing (not true hyper), and nothing to do with conversion.

[knitwitty in reply to greygoose]

Apologies for not replying sooner, I don't seem to be getting alerts when someone has responded to a query.

I guessed as much about the hashi "hyper" swing from what you said a few weeks back when you helped me out before, I think my slow brain did not quite absorb all that you said at that time, I may have been clutching at straws and hoping that the right dose of levo would get me back on the straight and narrow.

I will get some B12 spray and I will but some folate to try and get those up a little.

would I be right in thinking it is ok to take folate alongside the B complex that contains folic acid?

Thank you so much for taking the time to reply to all my questions, it's very much appreciated.

[greygoose in reply to knitwitty]

I think you would be much better off getting a B complex that contains methylfolate.

[knitwitty in reply to greygoose]

I shall get some zinc too, thanks for the heads up on zinc and copper.

[greygoose in reply to knitwitty]

You're welcome.

[SlowDragon Administrator]

I see from previous posts you are supplementing various things.

Have you actually had vitamin D, folate, B12 and ferritin tested at all.....or recently

GP won't necessarily see high TG antibodies as confirmation of Hashimoto's

High TG antibodies can be due to other issues, but can also confirm Hashimoto's. Perhaps push for ultrasound scan of thyroid to confirm if GP is not helpful

healthline.com/health/antit...

Do you always make sure you get same brand of Levothyroxine

[knitwitty in reply to SlowDragon]

Hi slow dragon, sorry I didn't reply last night I was really tired and went to bed.

I had B12, Vit D, folate and ferritin tested in April/May. The only one that was low was Vit D which was 38 (75-100) GP wouldn't prescribe any Vit D ( not low enough cut off point was 30) but she suggested lifestyle changes or supplementing myself, which I have been doing since. I was going to ask if Vit D could be tested again to see if the warm summer (sunbathing + supplementation has changed anything).

I will maybe ask for a thyroid scan to see if that shows up anything.

I have been on the same brand of levo since I started taking it ( Mercury pharma) about 14 weeks ago, started on 25mcg then moved up to 50mcg about 8 weeks ago.

Just read your link and have now scared myself into thinking has have something even more serious!

I don't think I have diabetes as the Hb1n blood test I also had done didn't suggest a problem.

I have had TFT tests many times over the last few years and my T3 has always only just scraped over the bottom of the normal range, with T4 a couple of points over the bottom, I suspect this may have masked my inability to convert and it is now only becoming apparent as my T4 is much higher and the T3 has not improved very much.

Thanks for your input it is most appreciated.

[SlowDragon Administrator in reply to knitwitty]

High TG antibodies is almost certainly due to Hashimoto's, but GP may be reluctant to agree

Your GP should have prescribed vitamin D

oxfordshireccg.nhs.uk/profe...

Suggest you retest vitamin D now

vitamindtest.org.uk

Do you have actual results and ranges for B12, folate and ferritin

[knitwitty in reply to SlowDragon]

Hi Slow Dragon, apologies for not replying sooner, I don't seem to be getting any alerts when anyone has responded.

The results below are the latest I have regarding nutrients. I am seeing the GP in about 10 days so I shall request another Vit D test and maybe take along a print out of the oxfordshire guidelines to back me up.

B12 was 569 ( 181-910)

Ferritin 109 (10-291)

Folate 10.6 (>5.4)

Vit D 38 ( 75-150) this was the one that most concerned me.

Zinc wasn't tested.

GG has suggested that my folate could be higher so I shall buy some folate, I thought it might be ok as there was no upper limit, do you have any idea what it should be to be optimal?

Many thanks for taking the time to respond to all my queries, it makes a world of difference knowing that there are knowledgable people out there who are willing to help you in such practical ways.

[SlowDragon Administrator in reply to knitwitty]

Usually recommended on here to supplement a good quality daily vitamin B complex, one with folate in not folic acid

Rather than just folate

But remember to stop any supplements with biotin in 3-5 days before any blood tests

Biotin can falsely affect test results

[knitwitty in reply to SlowDragon]

Thanks again SD, I did remember about the supplements and blood tests, I stopped for 5 days prior to the test just to be on the safe side.

I am going to get some new B complex as the ones I have contain folic acid not folate. I bought some better ones for my son ( he has coeliac disease ) along with a B12 spray, I think I shall have to go down that route, thanks again for your input it is much appreciated.

[SlowDragon Administrator in reply to knitwitty]

As your son has coeliac have you been tested too?

[knitwitty in reply to SlowDragon]

Hi again slow dragon, yes I had a coeliac blood test and I had no antibodies, whereas my sons were 6x higher than normal when he was tested, mind you he had been ill for nearly 3 years and everyone kept fobbing him off with a diagnosis of IBS, stress, anxiety, depression etc..

When we obtained his medical records half the things they said they had tested had not been done and the other tests had not been followed up and no results had been obtained. I was made to feel like an overanxious mum and a pain in the neck or just dismissed for thinking his symptoms could be something really serious like bowel cancer, the consultant laughed at me when I asked about that one.

We were just relieved to find out it was coeliac disease in the end, my son has just gone abroad to uni for a year, something I thought would never happen 18 months ago, he was so ill.

Sorry have gone a bit off topic.

[SlowDragon Administrator in reply to knitwitty]

Delighted you got there in the end

Many with Hashimoto's are gluten intolerant (not coeliac) and that gets missed for years, the only way to know for sure is to try it

[knitwitty in reply to SlowDragon]

I thought it would be a good idea to try going completely gluten free since he was at home over the summer, so I'll continue for the time being, it's not too difficult if you make an effort to cook your own food, which I have done for many years. It just requires a bit of forward planning and we still eat cakes, and they are just as delicious as before I just don't make as many which is probably a good thing anyway!!

Thanks again for all your responses, they are very informative and much appreciated.