Hi everyone, this is my first post and I was wondering if anyone can help with my medichecks thyroid results. I have added them in photos. I was on 150 Levo which was reduced to 125 in September as Doc said I was over medicated. Tested in Jan due to stomach problems but only TSH (1.17 mU/l range 0.4-4) blood tests showed highish mcv of 107.9 H fl range 85-105 so was then tested for vit b12 and folate. B12 showed 510 and folate 2.8
I'm confused as Doc said everything fine but latest tests show different.
Any help would be greatly appreciated.
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Tinydiva
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You are currently very undermedicated, as you can see from your high TSH and FT4/FT3 both low in range.
When on Levo only, the aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.
However, your raised antibodies confirm autoimmune thyroid disease aka Hashimoto's - did you know that? This is where the thyroid is attacked and gradually destroyed. Fluctuations in symptoms and test results is common with Hashi's, you can swing from hypo to "hyper" back to hypo, which is possibly why your TSH has gone from 1.17 to 9.23 - can't comment on your actual thyroid hormone levels - FT4 and FT3 - as you've not give previous ones. The reduction in your Levo would have made a difference to your results, but not to the extent we can see with your TSH.
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.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand (maybe this is the cause of your stomach problems) and can very often result in low nutrient levels or deficiencies.
blood tests showed highish mcv of 107.9 H fl range 85-105 so was then tested for vit b12 and folate. B12 showed 510 and folate 2.8
If you can list these with their reference ranges, and unit of measurement for B12, further comment can be made.
Also, was Ferritin tested - this is important, especially as you have a high MCV result.
This is folate deficiency and you should point this out to your GP. He should prescribe folic acid.
A high MCV (and yours is over range) means that the red blood cells are larger than normal (macrocytic). Causes of macrocytic anemia include B12 deficiency and folate deficiency (also hypothyroidism).
Hi and thank you so much for replying again, I had new blood tests done by Medichecks and got the active B12 test Folate and Ferritin tested the results are below
Vit b12 Active 77.7 pmol/l 37.5-188
Folate Serum 2.6 ug/l 3.89-19.45
Ferritin 45.2 ug/l 13-150
I haven't had vitamin D tested but will arrange to get that done.
Unfortunately I have no info on other thyroid tests as the only one that ever seems to be tested is the TSH.
The blood tests done by medichcecks in March seem to be the same as the ones the doctor did in Janaury just a bit lower so do you think it could just be the thyroid causing the issues?
I had no idea about Hashis as my doctor just tells me my thyroid is either fine or I need to change the thyroxine. Sorry about the long post but I am at my wits end with feeling so lousy now.
Despite a reasonable Serum B12 result, your Active B12 result is rather low, just 7 points above where it's suggested to be tested for B12 deficiency (that level is <70).
Do you have any signs of B12 deficiency - check here
If you do, list them to discuss with your GP and ask for further testing. If not you could supplement with methylcobalamin sublingual lozenges or get a good B Complex with a decent amount of methylcobalamin.
Folate Serum 2.6 ug/l 3.89-19.45
Again, this shows folate deficiency, comments as above are still appropriate.
NICE Clinical Knowledge Summary about folate deficiency here
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.
Your level is probably not low enoug for your GP to offer any help. 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
The blood tests done by medichcecks in March seem to be the same as the ones the doctor did in Janaury just a bit lower so do you think it could just be the thyroid causing the issues?
I think it's possible that your folate deficiency is causing problems, possibly B12 as well (you need to check the signs and symptoms linked to). I definitely think that your low ferritin could be causing problems. Article listing symptoms of low ferritin here:
I had no idea about Hashis as my doctor just tells me my thyroid is either fine or I need to change the thyroxine.
As mentioned above, 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. This is where we have to help ourselves.
Thank you so much, I have a doctor's appointment tomorrow so I will speak to her about what's been happening. I've looked at the symptoms in the b12 link and have some so will mention it but doubt it will make any difference. I have been taking 5mg folic acid as prescribed for a month so hopefully will see a difference soon. Thank you again.
Your TPO antibodies are high this confirms cause is Hashimoto's, also known by medics here in UK more commonly as autoimmune thyroid disease
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. Dairy is second most common.
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 test online for under £20, just to rule it out first
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
Folate result looks extremely low. What was the range on this? Did GP start folic acid supplements?
Levothyroxine should be increased slowly in 25mcg steps until TSH is around one and FT4 in top third of range and FT3 at least half way in range.
Bloods retested 6-8 weeks after each dose increase
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw). This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Hi there and thank you for replying, I have posted the ferritin results in my reply to seaside susie. I haven't had Vit D tested but will arrange to get that done. I had no idea about autoimmune thyroid condition so it looks like I have a lot of reading to do. Thank you to you and seaside susie for being so helpful and giving me lots of info.
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