I have posted on here before and had lots of good advice.
I am asking for some help again.
Just been to the doctor with these results:-
Thyroid Antibodies -118- I already knew I had Hashimotos.
My Levo dose is 75. I take Vit D suppliment as previously suggested by the doctor, and think I should start B12 as recommended on this forum. She was not too bothered about any of the results being out of range, which is worrying, as apart from the bloating I feel ok.
TSH 6.5 (0.27-4.2)
Free T4 22.7 (12-22)
Free T3 3.0 (3.1-6.8)
Vit D 73.7
B12 299 (180-914)
Folate 4.1 (3.0-20)
Ferritin 38 (10-307)
I went with the complaint of bloating and obviously the results!
I had previously been referred to an Endocrinologist who was no help, and told me that they did not give T3 as it caused brittle bones.
I am gluten free.
The doctor has asked me to go on a low FODMAP diet as she thinks it is IBS.
She has also sent me for a blood test to check for Ovarian Cancer .
Peppermint oil has also been recommended by her.
I do not think it is IBS, and believe if the blood test for OC comes back negative it is either leaky gut or SIBO both of which have been suggested to me by this forum.
I have also switched Levo brand from the Teva to another brand, with no difference so far. (about 3 weeks of a different brand), so do not think it was causing the bloating.
Please any tips, I think I should follow the FODMAP as suggested by the doctor, but still do not think it is IBS, unless leaky gut falls into this category. IBS has sudden flare ups, and bouts of bad stomach cramps etc, I have none of these symptoms. Consistently I have a hard bloated stomach, made slightly worse when I eat.
Anyway, any more help would be much appreciated.
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goofball
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- are you sure that's correct? Is it really 22.7 or is it a typo and should be 12.7?
Free T3 3.0 (3.1-6.8)
She was not too bothered about any of the results being out of range,
What! You are on Levo and she's not bothered about your TSH over range and your FT3 below range? If your FT4 is 22.7 then that doesn't make sense considering what your TSH and FT4 are, but if it's a type and it's 12.7 then your results show your are very undermedicated and need an immediate increase in Levo - 25 mcg now, retest in 6 weeks, continue with increasing/retesting every 6-8 weeks until your levels are where they need to be for you to feel well. Use the following information from Dr Toft, past president of the British Thyroid Association and leading endocrinologist, who states 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
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
Also refer to NHS Leeds Teaching Hospitals who say
If so then list what you are experiencing and ask for testing for B12 deficiency/pernicious anaemia. Some people with a B12 level in the 300s have been found to need B12 injections. If you do have any of those signs/symptoms, don't start supplementing until after further testing has been carried out.
Folate 4.1 (3.0-20)
This is very low. It's recommended to be at least half way through range. Include plenty of folate rich foods in your diet and consider a good B Complex such as Thorne Basic B or Igennus Super B. You need one that says "bioactive" or "bioavailable" and containing methylfolate, not folic acid, and methylcobalamin, not cyanocobalamin. Don't start supplementing this until after B12 injections/supplements have started. When doing any blood tests, including thyroid, leave off B Complex for 7 days beforehand, this is because it contains Biotin (B7) which is often used in the testing procedure and will give false results.
Ferritin 38 (10-307)
This is low. It's said that for thyroid hormone to work properly (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range although I've seen it said that 100-130 is good for females and 150 for males.
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
Yes, that is correct for my Free T4, is 22.7 pmol/L, it was 25 pmol/L for a blood test that I had in December,with my TSH at 4.0. She did say that my results were all over the place. I am thinking as I do not seem to have many adverse side effects apart from the bloating, she did not think anything needed changing.
I do have some of the symptoms of a B12 deficiency, mainly involving train of thought, bladder, and of course the gastrointestinal symptoms of IBS/SIBO/leaky gut. etc.
This time I did not take my medication mid way through the night and left it more than 24 hours, before testing, so maybe this is causing the results to be everywhere, but this was the right way to do it as suggested to me on a previous post.
I am more worried about the bloating at the moment as this is what is causing me trouble. If my results were more in line with what they should be, would the bloating sort itself out? I am thinking more about the B12 supplement as I can do this myself.
Do you have any ideas about the lowfodmap diet, do you think this would help at all?as I do not believe that I have IBS despite it being a side effect of a B12 deficiency.
This is such an uphill battle and very demoralizing, it is hard to believe that I have waited three months for an Endo appointment which was a waste of time, and seen about 4 different doctors to try and get somewhere.
This forum is absolutely fantastic and I am so grateful for all the great advice that I have received.
There's something very strange about a high TSH which means the pituitary isn't sending the correct signal to the thyroid, and a high FT4 which means you have plenty of T4.
TSH is a pituitary hormone which detects how much thyroid hormone we have. If it detects to little thyroid hormone (T4) it sends a signal to the thyroid to produce some - that signal is TSH. If TSH is high, the pituitary is saying there's not enough T4. However, you have plenty of T4 so there is a problem in the feedback system here, your TSH should be showing low.
Did you take Biotin or a B Complex in the week before this test?
If your FT4 an FT3 levels are accurate then you aren't converting T4 to T3 and possibly making rT3 instead of FT3. Pumping more Levo in will make this worse.
Good conversion needs optimal nutrient levels across the board so it's essential to work on those.
Also supplementing with selenium can help with conversion, also zinc. You may wish to test these before supplementing, especially zinc because zinc needs to be balanced with copper.
I did not take my medication mid way through the night and left it more than 24 hours, before testing, so maybe this is causing the results to be everywhere,
No, that wont be a problem. Leaving off Levo for 24 hours is correct. If you take it too close to the blood draw it gives a false high FT4, if you take it more than 24 hours away it gives a false low FT4. Altering the timing of your dose of Levo only affects FT4.
I'm afraid I know nothing about FODMAP so can't help there.
Also surely a Low FODMAP diet could eliminate some of the actual good things that are helping?
There's an App that you can download to your phone that can help with low fodmap diet. I found it useful when I was asked to go on it by the dietician. For some people it helps with gas and bloating but it's not a long term solution as it's quite restrictive
Thank you . I have two and they are very helpful although the low FODMAP isn’t doing anything for the bloating yet after 10 days or so. Will give it a bit longer then will have to go back for another idea to get rid of the bloat !
Don't know if this will help, but when I had bloating and a lot of flatulence I checked my diet. It appeared to be linked to potatoes (and other starchy veg - not bread, strangely) so thinking SIBO I gave up (just) potatoes for 2 (I think) years. Things settled and last summer I ate my first chip. While I still don't have them regularly I can eat them again!
Please, don't go looking for other problems. I am pretty sure I have some intolerances. But the potato thing really has improved: sweet potatoes + parsnips were a also bit iffy which is what made me think SIBO.
I did not think IBS was a runner as I had / have no pain.
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