Private test results back advice please

[Foggyk]

Following advice from this site I had my thyroid checked and B12 with blue horizon.

Results back today. Could anyone advice on this please

I've been on 75mg thyroxin for 16 years

[SeasideSusie Remembering]

FoggyK

I have deleted your other post as this is a duplicate.

TSH: 2.07 (0.27-4.2)

FT4: 17.5 (12-22)

FT3: 3.5 (3.1-6.8)

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. Your FT4 is 55% through range and your FT3 is 10% through range. Your conversion of T4 to T3 would appear to be poor. You should ask for an increase in Levo, once you get your TSH down to 1 or below, look at FT4 and FT3 again. If FT3 is still low compared to FT4 then that will confirm poor conversion and the addition of T3 may be of benefit.

Ask for a 25mcg increase in Levo now, retest in 6-8 weeks, if necessary another increase of 25mcg followed by another retest 6-8 weeks later, etc.

To support your request for an increase in dose, use the information from Dr Toft, leading endocrinologist and past president of the British Thyroid Association, who stated in Pulse magazine (the magazine for doctors):

"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 recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.

You can obtain a copy of the article by emailing Dionne at [e-mail] print it and highlight question 6 to show your doctor.

TPO antibodies are very high and confirm autoimmune thyroid disease aka Hashimoto's which is where the thyroid is attacked and gradually destroyed. The antibodies fluctuate and cause fluctuations in symptoms and test results.

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

You can possibly help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Vit D: 56nmol/L is low. The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level between 100-150nmol/L. To raise your current level to the recommended level, the Vit D Council recommends supplementing with 3,700iu D3 daily (you will need 4,000iu). Retest after 3 months and 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 an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

There are important cofactors needed when taking D3 as recommended by the Vit D Council -

vitamindcouncil.org/about-v...

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 if taking tablets/capsules/softgels, no necessity if using an oral spray

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 if taking tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

Check out the other cofactors too (some of which can be obtained from food).

As you have Hashi's, for best absorption consider an oral spray (Better You do D3 and combined D3/K2) or sublingual drops.

B12: 486pg/ml is a bit low according to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

A good B Complex containing methylcobalamin will help raise your level and balance all the B vitamins, consider Igennus Super B or Thorne Basic B. It should contain methylfolate rather than folic acid.

Folate appears to be good.

Ferritin: 56 is low. 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...

[Foggyk in reply to SeasideSusie]

Thank you so much. Very comprehensive. I'll get on to it tomorrow. Thanks again. This site is so helpful

[SlowDragon Administrator]

Ideally get coeliac blood test BEFORE going strictly gluten free diet, either via GP or online for under £20

If test is positive you will need to remain on high gluten diet until endoscopy (max wait 6 weeks)

If test is negative you can immediately go strictly gluten free

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

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...

[Foggyk in reply to SlowDragon]

Again thank you so much for your help