Advice Please

[SAUK]

Hi all.

I've been having significant hypo symptoms for about a week now. Had blood tests done 2 weeks ago and showed this:

Serum Ferritin (15-250)

29/05/19- 28ug/L

17/11/17- 42.6 ug/L

8/11/18- 36 ug/L

FT3 (3.5-6.5)

29/05/2019- 2.7pmol/L

22/02/2019- 4.2pmol/L

7/01/2019- 3.9 pmol/L

FT4 (10-20)

29/05/19- 8.5 pmol/L

22/02/19- 9.6 pmol/L 7/01/19- 10.8 pmol/L

TSH (0.35-5.5)

29/05/19- 0.08miu/L

22/02/2019- 0.03 miu/L 7/01/19- 0.05 miu/L

Only change I can think of is my diet. I've had to have gluten for the last 4 weeks as planning to do a celiac test in 17/06/19.

I didn't take Lio or levo day before blood test (so 24 hrs)

My current meds are Levo 75mcg + Lio 10mcg am and 10 mg midday. Endo suggested I increase Levo to 100mcg but not to touch Lio dose.

GP won't test iron as says ferritin is an indicator for iron absorption so not sure.

Vit D is great.

Any ideas?

Thanks

[radd]

SAUK,

Although ferritin (which is a protein that stores iron, releasing it when your body needs it) isn’t the same thing as iron, it is usually used by doctors as the first indicator of iron levels.

And yours is low at 28ug/L (15-250). You should be aiming for somewhere around half-way through range as iron is key for conversion of T4-T3 and low levels may decrease deiodinase activity, diminishing intracellular T3 levels (active hormone bringing well-being).

Latest test results show both your FT3 & FT4 to be well under-range and TSH as low.

TSH is often low when medicating T3, and your thyroid hormone results evidence a deficiency. I think your endo's suggestion of raising Levo to 100mcg is good, as coupled with the 20mcg T3 you are already taking, this will encourage further conversion of T4, so you end up with more T3 that you are actually medicating (page 134, Dr P's book).

You will get a better picture of FT3 levels if you only leave 8 -12 hours between last dose & blood draw but yours is so low, there is no risk of a dose raise taking you over.

What about folate & Vit B12 gets results ?

[SAUK in reply to radd]

Hi Radd. Thanks. This makes total sense.

8/11/2018 results for

Folate 10.8 (2-17)

B12 325 (200-900)

I can ask my GP to retest the above, but not sure they would have dropped since Nov. Should I ask for Iron?

[radd in reply to SAUK]

SAUK,

Folate is ok but Vit B12 is low and needs supplementing. I use methylcobalamin.

You don't require iron to be retested. Based on your ferritin results, you need to supplement iron to raise levels. I don't need to supplement iron but members have found that Ferrous Fumarate (taken with 500mg-1,000mg vitamin C to aid absorption and minimise constipation) to be beneficial.

Not sure if the 25mcg Levo raise is enough to restore a euthyroid status but it is a start, and optimising iron and nutrients will help thyroid hormones work better.

[SAUK in reply to radd]

Thank you

[Angel_of_the_North]

It's your free T4 which is really low, so I'd increase T3 and falling, not levo. You will have conversion problems with that low ferritin anyway. You also need to do something about that ferritin (also falling fast) - if you haven't just gone vegan, I'd ask for a referral to gastroenterology to see where all that iron is going.

[SAUK in reply to Angel_of_the_North]

Thank you

[Hidden in reply to SAUK]

Sauk. Low iron is common in us thyroid people, low stomach acids prevent absorption and especially if still having periods this is very likely the cause of low iron. The gluten may well be the cause of current symptoms but your health will benefit from some iron and some vitamin B12. Ferrous fermerate is very cheap to buy from local chemist. If you are going to supplement B12 patches or under the tounge lozenges best.