I've been lucky enough to have been relatively quiet here for a long while. I have Hashi's, was prescribed NDT by my endo (on the NHS! Miracles do happen) then they stopped being able to source it so I've been self-sourcing taking 2 grains of Naturethroid for a year now.
All fine.. I had the usual ups and downs that you come to get used to with Hashi's but nothing debilitating thankfully.
I've had the usual sporadic NHS bloods done, never heard anything. I haven't seen my endocrinologist for nearly a year and he's less bothered now I'm not on the NHS drug anyway.
I've noticed a change in my hair over the last 3 months. Its breaking off and wiry and there's a lot less of it (there wasn't much to start with) I'm also going through an awful time at home so stress levels are pretty high.
I finally got enough money together to take a blue Horizon Thyroid +11. Took the blood first thing, made sure I hadn't taken a tablet the day before.
I've attached my results and just had a few questions if there's anyone who has any light to shed.
1. Obviously the TSH is low, but the T3 seems to be pretty low in range as well. Should I consider upping the dose? I don't have any extreme symptoms bar the hair. A bit of depression, but given my home situation, that may be reactive.
2. The Thyroglobulin being high.. should I call the endo about that? I'm aware it can be a cancer marker and obviously would rather hop onto anything like that sooner rather than later.
3. Can anyone recommend a vit D supplement that will help me get my levels up a bit?
Anyone who has any other thoughts.. please let me know. I did think maybe I should try to get Ferritin up a bit too to see if that helped with my hair.
Thanks to all of you.
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Your TSH is LOW, but your TT4 and FT4 are low - so I would ask for other Pituitary Hormones to be tested.
Google : ' low TSH and low T4' . Seems like possible Pituitary Gland problem.
Your Thyroglobulin hasn't been tested. I think that's tested when monitoring cancer treatment.
It's your Thyroglobulin Antibodies you had tested - I assume this is why you were given Hashimoto's diagnosis.
You have Vitamin D insufficiency so your GP should presribe a daily maintenance dose (therefore you don't need to pay) and retest in a few months time. Or you could ask your Endocrinologist about it. Your Endocrinologist might want to arrange an Ultrasound scan of your Thyroid and Parathyroids (several months after you've been on daily maintenance dose of Colecalciferol (D3).
Typo on the Thyroglobulin.. I meant antibodies. They have gone up and down over the 4 years or so that I've been trying to stabilise. I haven't tested high for TGA since I started this Thyroid madness back in 2015!
TgAb or Thyroglobulin Antibodies are " detected in 80% of people with Hashimoto's . . "
"Tg Thyglobulin is a protein produced by the Thyroid " - that's the one they test as a tumour marker during cancer treatments as far as I've read (have no personal experience ).
Took the blood first thing, made sure I hadn't taken a tablet the day before.
How many hours gap between last dose of NDT and blood draw? When taking NDT the last dose should be 8-12 hours before blood draw. Any longer and you get a false low FT3, too close and you get a false high FT3. The 8-12 hour gap gives the normal circulating level of FT3.
1. Obviously the TSH is low, but the T3 seems to be pretty low in range as well. Should I consider upping the dose? I don't have any extreme symptoms bar the hair. A bit of depression, but given my home situation, that may be reactive.
This could be because the gap between last dose of NDT and blood draw was too long.
Taking NDT lowers FT4 as well as TSH, and the long gap between last dose and blood draw could be why your FT4 is so low.
When you were originally diagnosed, was your FT4 below range and your TSH normal? That can indicate Central Hypothyroidism which is where the pituitary or hypothalamus is at fault rather than the thyroid. However, as you have Hashi's, if your TSH was over range with raised antibodies, with FT4 in range, I think you can possibly discount Central Hypothyroidism.
2. The Thyroglobulin being high.. should I call the endo about that? I'm aware it can be a cancer marker and obviously would rather hop onto anything like that sooner rather than later.
I don't have Hashi's so can't answer your question, but were your Tg antibodies raised when you were originally diagnosed with Hashi's? If so this could just be the normal antibody level fluctuation that occurs with Hashi's.
3. Can anyone recommend a vit D supplement that will help me get my levels up a bit?
Vit D: 45nmol/L (18ng/ml)As you are over the level where Deficiency is diagnosed (<30pmol/L) then you may not be able to get anything on prescription.
The Vit D Council recommends a level of 125nmol/L (50ng/ml) and the Vit D Society recommends a level of 100-150nmol/L (40-60ng/ml). For your current level the Vit D Council recommends taking 4,900iu D3 daily (nearest is 5,000iu)
When you have reached the recommended level then you'll need a maintenance dose to keep it there, 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:
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.
Check out the other cofactors too (some of which can be obtained from food).
As you have Hashi's, an oral spray gives best absorption, eg BetterYou, or you could take sublingual drops. Check how much you need to give 5000iu. BetterYou do a combined D3/K2 spray as well as D3 alone.
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Ferritin: 41.1ug/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
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."
Folate: 11.00 (8.82-60.8)
Folate is recommended to be at least half way through range - about 35+ with that range. You can help raise your folate by eating folate rich foods, and a good B Complex containing 400mcg melthylfolate will raise it, eg Thorne Basic B or Igennus Super B. The methylcobalamin (B12) it contains should nudge your B12 up a bit too.
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Don't start all supplements at the same time. Start with one, leave it 1-2 weeks and if no adverse reaction then add the second one. Continue like this. If you have any reaction then you will know what caused it.
I think it must have been too long a gap then. I take my NDT at night, so the last one I took was at about 1am on Sunday morning, the test was at 9am, so thats a 32 hour gap (if my befuddled maths is correct)
Thyroid hormone replacement is unlikely to have a direct effect. Antibodies fluctuate. 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. However there is no guarantee, it doesn't help everyone but it's worth a try.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
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