Hi! Just wondering if anyone can give their thoughts on my test results please? I had thyroid destroyed in 2015 nd went under-active. I take 125mg levothyroxcine a day. (I did not take my meds 24hrs before the test.
) Within about 9 months I started to feel dreadful, and have ever since. They then said I had CFS but I feel it is possibly thyroid related?
The Dr added a note to my test results which said: The Thyroid Stimulating Hormone (TSH) is elevated. If you are already taking a form of thyroxine, it is possible that that your dose is too low or that you have forgotten to take it on occasion. It may be that an increase in dose is in order - if adjusted it would be sensible to repeat thyroid function (TFT) testing in around 2 months’ time. If you are not taking thyroxine, and this is the first time TSH has been noted to be high, it is possible that 'non-thyroidal illness' or other medication effects are the cause of the elevation. It may be that hypothyroidism (underactive thyroid gland) is about to develop. In these scenarios, it would be advisable to repeat thyroid function tests in 3 months’ time. I would suggest undertaking this repeat test sooner if symptoms develop.
Thyroid Function
TSH H 4.57 0.27 - 4.20 mIU/L
T4 Total 90.2 66 - 181 nmol/L
Free T4 14.30 12.0 - 22.0 pmol/L
Free T3 3.85 3.1 - 6.8 pmol/L
Immunology
Anti-Thyroidperoxidase abs 18.0 <34 kIU/L
Anti-Thyroglobulin Abs 17 <115 kU/L
Vitamins
Vitamin D (25 OH) L 46 Deficient <30 nmol/L
Vitamin B12 H 671 Deficient <145 pmol/L
Serum Folate 42.60 8.83 - 60.8 nmol/L
Biochemistry
hs-CRP 1.92 <5.0 mg/L
Ferritin 31.7 13 - 150 ug/L
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cazmania7
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Your thyroid results show that you are undermedicated. 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.
However, you have some nutrient deficiencies and thyroid hormone needs optimal nutrient levels to work properly, particularly ferritin. These need addressing
Ferritin 31.7 13 - 150 ug/L
For thyroid hormone to work (that's our own as well as replacement hormone) it's said that ferritin needs to be at least 70, preferably half way through range. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
Vitamin D (25 OH) L 46 (which is 18.4ng/ml)
The Vit D Council recommends a level of 125nmol/L (50ng/ml) and the Vit D Society recommends 100-150nmol/L (40-60ng/ml).
To reach a level of 125nmol/L from our level, the Vit D Society suggests taking 4,900iu D3 daily along with it's important cofactors
You'd need to take 5000iu, then retest in 3 months. When 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/
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 such as hardening of the arteries, kidney stones, etc.
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. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium 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
Check out the other cofactors too (some of which can be obtained from food).
B12 and folate are fine.
I would still ask your GP to increase your Levo, 25mcg now, retest in 6 weeks, if necessary repeat every 6 weeks until your levels are where they need to be for you to feel well.
SeasideSusie that is BEYOND helpful! Thank you SO SO much for this info! I am going to book in with a Dr that Thyroid UK suggested and show him your reply and see where we go! You are amazing. Thanks!!
Don't expect any doctor to agree about the nutrient levels. They're not taught nutrition so they think that anywhere within the range, even just one point up from the bottom, is absolutely fine.
As for the information of TSH needing to be 1 or below with FT4/FT3 in the upper part of the range, you can refer to an article in Pulse magazine (the magazine for doctors) written by Dr Toft (past president of the British Thyroid Association and leading endocrinologist) which says:
"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)."
He has recently confirmed in a talk that instead of Total T3, the same applies to Free T3.
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.
You can also refer to information from NHS Leeds Teaching Hospitals:
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
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