Just looking for some help interpreting my recent test results from Blue Horizon. Results are as follows:
Biochemistry
hs-CRP 2.02 <5.0 mg/L
Ferritin 46.4 13 - 150 ug/L
Thyroid Function
TSH 0.43 0.27 - 4.20 mlU/L
T4 Total 121.0 66 - 181 nmol/L
Free T4 24.30 (noted as high) 12.0 - 22.0 pmol/L
Free T3 4.70 3.1 - 6.8 pmol/L
Immunology
Anti-Thyroidperoxidase abs 250.0 (noted as high) <34 kIU/L
Anti-Thyroglobulin Abs 21 <115 kU/L
Vitamins
Vitamin D (25 OH) 89 Deficient <30 nmol/L
Insufficient 30-50
Consider reducing dose >175
Vitamin B12 426 Deficient <30
insufficient 145 - 250 pmol/L
Consider reducing dose >569
Serum Folate 44.80 8.83 - 60.8 nmol/L
I had hoped that these tests would give me some answers about how I've been feeling, but they have just left me with more questions. Can anyone help answer these:
1. The doctor at Blue Horizon interpreted these as meaning I am borderline hyperthyroid. I am going to reduce my dosage of levo from 125mcg to 112mcg to resolve this. Does this sound like a good plan?
2. I originally got the tests done as I have been feeling tired and unwell, and thought I may have a conversion problem, but given my free T3 seems to be on target I am assuming that I'm converting fine?
3. My antibody results of 250 TPO is over 100 lower than an antibody test result I had done on the NHS in November. I don't understand how my antibody levels can have dropped over three months. Is this due to different testing?
4. Since I've been feeling tired and unwell a lot recently if I don't have a conversion problem could being on too high a dose of levo be making me feel this way? Could it be something else connected to my hashis?
Thank you all ever so much for your help and support. I really appreciate it.
momo x
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momo33
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This is too low, needs to be at least 70 for thyroid hormone to work properly, recommended is half way through range. Article listing symptoms of low ferritin here
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
You might want to nudge this up to the level recommended: the Vit D Council recommends a level of 125nmol/L [50ng/ml] and the Vit D Society recommends a level between 100-150nmol/L [40-60ng/ml].
**
Serum Folate 44.80 8.83 - 60.8 nmol/L
This is good.
**
Vitamin B12 426pmol/L = 577pg/ml
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."
So you are just over the level recommended to avoid deficiencies in cerebrospinal fluid, you may wish to raise it higher.
**
TSH 0.43 0.27 - 4.20 mlU/L
T4 Total 121.0 66 - 181 nmol/L
Free T4 24.30 (noted as high) 12.0 - 22.0 pmol/L
Free T3 4.70 3.1 - 6.8 pmol/L
1. The doctor at Blue Horizon interpreted these as meaning I am borderline hyperthyroid. I am going to reduce my dosage of levo from 125mcg to 112mcg to resolve this. Does this sound like a good plan?
No, you can't possibly be borderline hyperthyroid, you have Hashi's and you are hypOthyroid, you can't swing from under to over active, but you can be overmedicated.
Your TSH is still within range, your FT4 is very slightly over range, your FT3 is only 43% through range. What you actually need is a bit less Levo and the addition of T3 because your T4:T3 conversion is poor. Raising your ferritin may help conversion a bit, as can supplementing with selenium, but it's very likely that T3 is needed.
2. I originally got the tests done as I have been feeling tired and unwell, and thought I may have a conversion problem, but given my free T3 seems to be on target I am assuming that I'm converting fine?
As mentioned above in answer to (1), FT3 is only 43% through range and FT4 is 123% of range so conversion is poor. When on Levo only the aim is to have FT4 and FT3 balanced in the upper part of the range.
3. My antibody results of 250 TPO is over 100 lower than an antibody test result I had done on the NHS in November. I don't understand how my antibody levels can have dropped over three months. Is this due to different testing?
That's the nature of Hashi's - antibodies fluctuate so you are going to get different results.
Hashi's information:
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.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
4. Since I've been feeling tired and unwell a lot recently if I don't have a conversion problem could being on too high a dose of levo be making me feel this way? Could it be something else connected to my hashis?
As mentioned, you do have a conversion problem, it's low T3 that causes symptoms. But don't forget that Hashi's causes fluctuations in symtoms (and results) as you can go through hypo phases then "hyper" phases and back to hypo phases.
Hello SeasideSusie, thanks again for all your thoughts and advice. I didnt think I could have a conversion problem if my T3 was within the range, when I saw the results I thought that since I seemed to have enough T3 and too much T4 if I took less levo the two would become in balance but it looks like that isnt the case? What are the next steps then if I have a conversion problem? I'm sure my GP wont prescribe me T3 so should I get some myself and see if I can get everything the way it needs to be or try and find a good private endocronologist? That's interesting about my ferritin, it was 25 in November so I was surprised to see it jump up to 45 in a short space of time, hopefully I can get it up to around 70 soon. Sorry for all the questions, got a lot of thoughts going through my head.
I didnt think I could have a conversion problem if my T3 was within the range,
It's where within range that matters, not just the fact that it's within range. If FT4 and FT3 are balanced then conversion is good. If FT4 is high and FT3 low then conversion is poor.
I thought that since I seemed to have enough T3 and too much T4 if I took less levo the two would become in balance but it looks like that isnt the case?
No. If your FT4 lowers, then so does your FT3. Because T4 converts to T3, if you reduce the amount of T4 (Levo) then there is less to convert so both FT4 and FT3 levels will reduce.
What are the next steps then if I have a conversion problem?
As mentioned in my previous reply:
Raising your ferritin may help conversion a bit, as can supplementing with selenium,
When all nutrient levels are optimal and you are supplementing with selenium (200mcg selenium l-selenomethionine) if conversion is still poor then consider adding T3.
Thanks Seasidesusie, i'll look at getting ferritin up and take some selenium suppliments and see if I can improve conversion. Was also thinking about getting cortisol levels checked to see if there was an issue here. Thanks again for all the help x
Quick glance through previous posts, can see you mention tinnitus, this can be linked to low vitamin B12
Are you on strictly gluten free diet? If not it's definitely worth trying. Many people are astonished at the improvement
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 or buy online for under £20 just to rule it out before starting
That is interesting about being gluten free. I have been tested for coeliac disease and don't have it, so that is good. Thanks for the helpful links, much appreciated!
Hello SeasideSusie, thanks again for all your thoughts and advice. I didnt think I could have a conversion problem if my T3 was within the range, when I saw the results I thought that since I seemed to have enough T3 and too much T4 if I took less levo the two would become in balance but it looks like that isnt the case? What are the next steps then if I have a conversion problem? I'm sure my GP wont prescribe me T3 so should I get some myself and see if I can get everything the way it needs to be or try and find a good private endocronologist? That's interesting about my ferritin, it was 25 in November so I was surprised to see it jump up to 45 in a short space of time, hopefully I can get it up to around 70 soon. Sorry for all the questions, got a lot of thoughts going through my head.
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