I wrote a post last year, on behalf of my daughter, who has been experiencing symptoms of hypothyroidism for some considerable time now. Sadly, her GP is adamant that there's nothing wrong with her thyroid and has been dosing her with all sorts of other medication, to try and alleviate the symptoms, to no avail.
I have finally persuaded her to do a private blood test, but although I'm an avid follower of this forum, the skills necessary to interpret the results are still beyond my capability, so I'm turning to you once again, as I'm in awe of your knowledge!
The blood was taken first thing on the morning of Monday 20th May, 2019 before food.
"I note that you are experiencing a variety of symptoms and have concerns about your thyroid.
Your ferritin, which is a good measure of your iron stores, is normal but towards the lower end of the normal range. There is scope to improve it by increasing your dietary iron intake (beans, lentils, tofu, dark green veg, and chicken & lean beef if you eat meat). Orange juice will help you absorb dietary iron better. Over the counter lysine supplements can also help with this.
Your vitamin D levels show that you have vitamin D insufficiency. This may progress to vitamin D deficiency if you don’t take steps to increase your vitamin D levels. We recommend supplementing with 20-50 mcg (800 -2000 iu) of vitamin D per day for twelve weeks.
Low levels of vitamin D can cause fatigue, bodily aches, poor memory and difficulties concentrating.
Outside of the winter months there is enough sun for your skin to make at least part of your daily requirement of vitamin D, so it is worth trying to get 15-20 minutes of midday sun when the sun is out. Vitamin D can also be found in fortified foods such as breakfast cereals, tofu and some fruit juices. The only reliable natural source of vitamin D is in oily fish, although it can also be found in some mushrooms (portobello, maitake, morel, button, and shiitake are particularly good), you can improve this by leaving the mushrooms in the sun before cooking them.
It is important to test your vitamin D levels regularly - most people in the UK are insufficient or deficient in this vital vitamin. We suggest that you repeat your vitamin D test in 8-12 weeks to ensure that your levels have returned to normal. Once your levels have returned to normal then you can decrease your vitamin D supplementation to 10 mcg (400 iu) per day.
I am pleased to report that all your results for your thyroid profile are within the normal ranges. Your thyroid hormones are normal as are your thyroid antibodies revealing no evidence of autoimmune thyroid disease.
Overall some of your symptoms could be down to your vitamin d and iron stores being depleted."
Since then, she's now suffering panic attacks, palpitations, depression and brain fog. We understand that the Vit D and Ferritin levels need to be addressed, but would like to know whether you think that there's an underlying thyroid problem too, that can be taken back to her GP.
I'm really sorry this post is so long! Thank you for taking the time to read it and for any advice you can offer
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NuttyNora
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It's a pity all 3 sets of results weren't done under exactly the same conditions, the time difference between the latest one and February (blood collection 14.23) means that her TSH will naturally be a lot lower than an early morning collection, plus she will have eaten so again that can lower TSH.
Here are graphs that show the difference in the hormone levels during 24 hours
Going by her current resultss, her TSH is higher than one would normally expect to see in a normal healthy person - that being no higher than 2.
Her FT4 is 37% through range, one would expect that to be around 50% or more in a normal healthy person.
Her FT3 is 20% through range which is very low.
Taking into account the big difference in TSH and FT4 between May and February, this could suggest autoimmune thyroid disease, aka Hashimoto's, even with the time difference of blood draw.
THYROGLOBULIN ANTIBODIES - 54.4 kU/L (< 115)
THYROID PEROXIDASE ANTIBODIES - 11.1 klU/L (< 34)
These are in range and don't suggest Hashi's. However, TG antibodies are higher than someone like myself who has tested several times over many years and they're always less than 12. So as you can have Hashi's without raised antibodies, I wouldn't rule it out.
FERRITIN - 19.4 ug/L (13 - 150)
I think this needs discussing with her GP. This is very low and low ferritin can suggest iron deficiency anaemia. A full blood count and iron panel are needed. I wouldn't supplement - definitely not self supplement - nor prescribed iron without further testing because if it is iron deficiency anaemia she'll need more than the possibly one iron tablet a day she may otherwise be prescribed.
Also, she can help raise ferritin 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
These are both low in range but not low enough for GP to do anything. Supplementing with a good B Complex containing methylfolate and methylcobalamin will help raise both levels. Consider Thorne Basic B or Igennus Super B. Both are good quality supplements containing the bioactive forms of ingredients.
VIT D - 39.9 nmol/L (50 - 175) = 15.96ng/ml
Between 25 and 50 a GP may or may not consider prescribing D3. Personally, I'd do it myself, following advice from the Vit D Council, and buy a decent quality D3 supplement.
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).
To reach the recommended from her current level, it's suggested to supplement with 4,900iu D3 daily (nearest is 5,000iu).
Retest in 3 months.
When she has reached the recommended level then she'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. She 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).
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.
Thank you so much, SeasideSusie, your opinion means far more to me, than many, if not most, that are medically trained. We will endeavour to take one step at a time, until she feels much better.
Do you think that she should be taking Levothyroxine, or would it be better to improve her other levels first?
I've also heard much about a gluten free diet, is this recommended?
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Blood test results- please help
Help with blood test results please...
Blood test results - help please x
Help please with blood test results.
Can you help with new thyroid blood test results, please 
