Interpreting Hashimoto's blood test before endo visit.

[presto21]

Hi

I am a newbie,

I have an appointment with an endo next month.

I have had Hashimoto's disease for the past two years.

Could you please comment and give me some advice on the blood test results below, so I can have a knowledgeable conversation with the consultant.

I suffer from a permanent muzzy head, my hair is thinning and I can easily fall a sleep.

My base pulse rate is low and I have been informed i suffer from pernicious anemia.

The aches and pains in my arms and legs have been relived by vit B complex tablets.

THYROID CHECK ULTRAVIT RT3 MEDICHECKS

TEST Result Units Range

Road, Nottingham, NG90 6BH, UK Medichecks.com Ltd, MediCity, Thane

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Registered no : 6491221 |

Registered Office : Mathon Court, West Malvern Road, Mathon, Malvern WR13 5NZ

ENDOCRINOLOGY

Thyroid Function

THYROID STIMULATING HORMONE 7.28 mIU/L 0.27 -4.20

FREE THYROXINE 19.500 pmol/L 12.00 -22.00

FREE T3 4.21 pmol/L 3.10 -6.80

REVERSE T3 18 ng/dL 10.00 -24.00

REVERSE T3 RATIO 15.23. 15.01 - 75.00

THYROGLOBULIN ANTIBODY 887.000 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES 172 IU/mL 0.00- 34.00

HAEMATOLOGY

Vitamins

ACTIVE B12 159.000 pmol/L 37.50- 188.00

FOLATE (SERUM) >19.98 ug/L 3.890 - 26.80

25 OH VITAMIN D 78.7 nmol/L 50.0 -0 200.00

Interpretation of results:

Deficient <25

Insufficient 25- 49

Normal Range 50 -200

Consider reducing dose >200

BIOCHEMISTRY

Inflammation Marker

CRP

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HIGH SENSITIVITY 0.29 mg/ 0.00 - 5.00

Iron Status

FERRITIN 180 ug/L 30.00- 400.00

Terry

[SlowDragon Administrator]

How much Levothyroxine are you currently taking?

Clearly you are under medicated to have TSH so high

FT3 is too low

Will GP agree to dose increase?

As you have Hashimoto's have you had coeliac blood test

Are you now on strictly gluten free diet

Your vitamin D is a little bit low

[presto21 in reply to SlowDragon]

75 levothyroxine.

I thought FT3 was too low. Needed advice.

-Do not know if the GP will increase the does,endo results may influence his decision.

Not had coelias blood test.

Not on Gluten free diet.

I thought my vitamin d was within limits---open to correction;

I take vitamin B and D supplements.,

[SlowDragon Administrator in reply to presto21]

75mcg is a low dose. Ask for 25mcg dose increase in Levothyroxine

With Hashimoto's we are often poor converters.

As you also have PA gut is affected

But first you might improve by getting vitamin D around 100nmol . Vitamin D Mouth spray is effective as avoids poor gut function of Hashimoto's

Do you supplement magnesium?

But more importantly many, many of us find strictly gluten free diet helps or is essential

Getting coeliac blood test first, just to rule it out

What supplements do you take?

Selenium supplements can help improve conversion of FT4 to FT3

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, sometimes 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 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...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

[e-mail]

Aim of Levothyroxine is to be on high enough dose to bring TSH down to around one

New NHS England Liothyronine guidelines November 2018

sps.nhs.uk/wp-content/uploa...

[presto21 in reply to SlowDragon]

Hi

Vitamins taken#

Magnesium 374mg

Selenium 200ug

Vit B 12 250ug

VitB 6 10mg

VitD3 25ug

Zinc 15mg

Folic Acid 400ug

Omega 3 1000mg

What is a PA gut

I will get a coeliac blood test.

What are your thoughts on Liothyronine

Are you dairy free as well as gluten free

[porter5]

Youtube Dr Brownstein on thyroid issues brilliant.

[presto21 in reply to porter5]

Thanks I will take a look.