Medichecks blood test results advice greatly appreciated.

[Jalisi]

Hello there, I have just received my test results, could you please take a look, still a rookie on this forum.

Bloods were taken on 26.04.19 at 8:15 fasting. Unfortunately due to my autopilot I took my levo 4 hrs before 🤦‍♀️ this is the time my other half gets up for work so I automatically reached for my meds. Will do better next time.

My previous NHS results :

12.11. 18 TSH 14.7 [range 0.35-5] Started supplement vit D 4000IU daily.

14.01.19 TSH 6.8 [0.35-5], TPO 180 [0-50], T4 12.7 [9-24] suggestive of autoimmune thyroid disease.

18.02.19 started on levothyroxine (Teva) 25 mcg

21.02.19 Thyroid ultrasound - The thyroid is diffusely enlarged but with no focal abnormality.

13.03.19 TSH 3.4 [0.35-5.5]

11.04.19 Endo consultation - slight goitre visible. TSH 2.5 T4 14 [no ranges quoted]. Diagnosis autoimmune hypothyroidism.

18.04.19 levothyroxine (almus) 50mcg prescribed. Goitre - tender neck, lump in throat - feeling, post nasal drip, choking on food, cough, unable to sleep - having to sit up in bed, waking due to coughing, choking on mucus.

Thank you, my guardian angels.

[SeasideSusie Remembering]

Jalisi

To be honest, your thyroid results are much good.

Because you took your Levo 4 hours before the test then you have a false high FT4 so that result is meaningless.

If you increased your dose of Levo on 18th April and took the test on the 26th, then there hasn't been enough time for the increased dose to take effect so again the results are meaningless. We need to leave 6-8 weeks after a dose change for levels to stabilise.

Vit D is still too low. The Vit D Council recommends a level of 125nmol and the Vit D Society recommends a level of 100-150nmol. I would continue with your 4000iu D3 daily. Are you taking D3's important cofactors magnesium and Vit K2-mk7?

Ferritin could do with being nudged up to half way through range, eating liver, liver pate or black pudding regularly will help.

B12 and Folate are good.

Are you gluten free and supplementing with selenium l-selenomethionine 200mcg daily to try and help reduce the antibodies?!

[Jalisi in reply to SeasideSusie]

Hi Seaside Susie, just makes me think how inaccurate all my previous test are. All done at random times of day while taking levo. TBH I wasn't looking for meds increase, it came about out of desperation due to my symptoms. I didn't think about rescheduling my bloods after the increase

I am taking magnesium citrate 200 mg daily, no yet on vit K. Might look into Iron supplement, I eat patte, but not a big fan of liver.

Not gluten/dairy free just yet. My diet is fresh meat, veg and fruit heavy. No milk, bread occasionally.

Are brazil nuts enough for selenium - I eat 2 daily?

Thank you for your reply, really appreciate it.

[SeasideSusie Remembering in reply to Jalisi]

Are brazil nuts enough for selenium - I eat 2 daily?

There are some people who say you get selenium from brazil nuts. That's true to a certain extent; however, the nuts need to be grown in selenium rich soil and the packet needs to say this. But the selenium content of soil varies and only certain areas are high in selenium, and it's doubtful any packet would tell you exactly the region they were grown in

honey-guide.com/2012/11/19/...

If you want to know how much you're taking, the best way is to buy a decent supplement.

[Jalisi in reply to SeasideSusie]

Thank you for the link, I will follow your advice. Is selenium ok to b taken with other supplements?

[SeasideSusie Remembering in reply to Jalisi]

Is selenium ok to b taken with other supplements?

No problem with that. I take mine after my evening meal with a couple of other supplements.

[SlowDragon Administrator]

The choking on mucus is possibly due to dairy intolerance.....almost as common as gluten intolerance with Hashimoto's

thyroidpharmacist.com/artic...

ncbi.nlm.nih.gov/pubmed/240...

Gluten intolerance

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

Assuming test is negative you can immediately go on strictly gluten free diet




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




Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

[SlowDragon Administrator]

50mcg Levothyroxine is only a starter dose.

Bloods should be retested 6-8 weeks after each dose increase

Absolutely no point testing any earlier

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range

Vitamin levels all need to be optimal

[Jalisi in reply to SlowDragon]

Hi SlowDragon,

Thank you for your reply.

The increase in levo was unexpected - also me not realising I needed to reschedule my blood test appointment. Not good at planning with my brain fog.

I have been feeling better since on 50 mcg. My throat is better, I am not coughing anymore, have been sleeping really well lately.

I don't drink milk, however I eat slice of cheese daily and have a natural set yogurt with fruit 3 days per week.

I'm not coeliac. I don't eat bread, have gluten free pasta and cereal, but I'm not 100% gluten free.

I will look at my vit D and iron.

Thank you, your help is greatly appreciated.

[SlowDragon Administrator in reply to Jalisi]

Most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

So further dose increase is likely

Initially when dose is increased sees improvement. As your body gets use to the 50mcg dose, then symptoms can begin to slowly return, indicating getting ready for next dose increase

If gluten is an issue, then to be effective gluten free does need to be absolutely strictly gluten free