Thyroid results help!

[Jessycat]

Hi there.

I sent for an advanced blood panel with Thriva.

I received the results today as follows:

Not sure if the picture helps.

B12- 104pmol/L - normal range

Ferritin- 51.4 ug/L - optimal

Folate- 7.98 nmol/L - deficient

Triiodothyronine FT3- 5.6pmol/L - normal

Thyroid stimulating hormone TSH - 21.8mlU/L -highly abnormal

Thyroglobulin antibodies TgAB- 39.6kU/L- normal

Thyroid peroxidase antibodies TPOAb -444kIU/L - out of range

Thyroxine T4- 69.4 nmol/L - normal (almost in yellow though)

Free thyroxine FT4- 12.8 pmol/L - optimal (also almost in yellow)

Vitamin D(25-hydroxy) - 49.6 nmol/L - insufficient

I have no idea what any of these results mean. Do I need new tablets. What do I say to my GP? I’ve got an endocrinologist app on 12th July. Shall I try and bring it forward?

Any advice would be great.

Thanks!!

[greygoose]

Sorry, we absolutely need the ranges. Just saying 'in-range' or whatever tells us nothing much.

[Jessycat in reply to greygoose]

Sorry. I thought the numbers were the range. I’ve got pictures but can’t post more than one. What do you mean by the ranges?

[Jessycat in reply to greygoose]

I have loaded a picture. Thank you!

[greygoose in reply to Jessycat]

OK, good. There, you see, you have the result, followed by the range.

Goodness! Your TSH is very high. You didn't even put that in the list you gave. You are very hypo. Your FT4 is rock bottom. The lower the FT4, the higher the TSH, which is trying to stimulate your thyroid to make more hormone.

Your FT3 isn't too bad because the high TSH is stimulating the conversion of T4 to T3, plus - probably - your thyroid is producing more T3 that T4 to keep you alive.

Your TPO antibodies are very high, so you have Hashi's. And, your nutrients are low, which one would expect with Hashi's.

Are you on levo? If not, you should be. If you are, then you need an increase in dose.

[Jessycat in reply to greygoose]

Oh god did I not. I was half asleep last night haha. I’ve been reading about hashi’s. I suspected I had it. Do I need to take anything other than Levothyroxine? I’m on 200 Levo. Doesn’t seem to be doing much though.

Do you think these results is why I’ve felt so tired and awful recently? I love going to the gym but I haven’t wanted to at all.

Thank you for your help!

I was diagnosed 2 years ago and just haven’t been given any information or anything. I’ve got my referral in a month to endo

[greygoose in reply to Jessycat]

You're on 200 mcg levo and you still have a TSH of 21.8? I imagined, given your results, you weren't on anything at all. How do you take your levo? Do you take it on an empty stomach and wait at least an hour before eating or drinking anything other than water? Do you take any other supplements or medication at the same time?

[Jessycat in reply to greygoose]

Yes I’m having a complete nightmare! I take it first thing in the morning on an empty stomach, also wait an hour. I’ve been taking omeprazole and sertraline at the same time but I’m going to switch and take those at nights instead.

[greygoose in reply to Jessycat]

Ah. OK. Taking omeprazole will lower your stomach acid, so will make absorbing anything difficult. As you are hypo/Hashi's, you probably have low stomach acid, anyway, so taking omeprazole will make things worse. Unfortunately, the symptoms of high and low stomach acid are the same, and doctors never bother to find out which you have, just hand out the PPIs like sweeties. But, that will be your problem, and why you feel awful: low stomach acid, made worse by omeprazole, causing low nutrients and malabsorption of thyroid hormone.

Are you taking the sertraline for depression? Depression is a hypo symptom, and you are very hypo. Sort out your absorption problem and it's doubtful you will need either the omeprazole or the sertraline.

[Jessycat in reply to greygoose]

I’m taking the omeprazole because they put a camera down and found that I had gastritis. Although I’ve been on the omeprazole for over a year now and my stomach still swells and burns a lot. I’m questioning now if all these stomach problems are largely linked to my thyroid. The sertaline is for anxiety. I’m a worrier but it’s definitely worse when my thyroid is worse so I know I’d be fine off them when my thyroid is in check. I’m going to start with the thyroxine early mornings and just completely stop the other tablets all together.

You’ve been extremely helpful. Thank you. Can I be cheeky? Do you have any idea if thyroid medication and the pill can clash? I’m currently on another method of contraception but it isn’t working for me at all so I’m thinking I need to switch.

[Fruitandnutcase in reply to Jessycat]

I wouldn’t stop all of your other tablets suddenly, especially anything you are taking for anxiety.

I was prescribed omeprazole a few years ago and after reading the leaflet that came with them decided they weren’t what I wanted to take long term.

I gradually phased them out and at the same time went totally gluten free and started to clean up my diet.

I cut out all junk food - including chocolate - and concentrated on eating fish, chicken, eggs, nuts and seeds and a variety of vegetables. I gave up on diet / fizzy drinks too, I mainly drink water plus very weak tea and decaf coffee

[Jessycat in reply to Fruitandnutcase]

Thank you! My issue is I don’t drink enough at all. I’m going to change my diet. Why did you go totally gluten free? I love veg. It just panics me because you can’t eat certain ones with your thyroid and I get so confused. I need to get a steamer

[Hidden in reply to Jessycat]

Hi Jessy

You've already been given a lot of good advice so can't add much to it except a bit of personal experience.

I was on Omeprazole for several years, though didn't need to take it regularly. Also statins. When I was finally given thyroxine (though still officially "Subclinical") as a result of an infection that made me like a zombie even after the fluey feeling went, I realised that Omeprazole could interfere with thyroid supplements (it said on the leaflet) so stopped taking it. Apart from needing an occasional Gaviscon (well away from the Levo) my digestion is much better. Advice on here and reading Dr Malcolm Kendrick's book (The Great Cholesterol Con) convinced me to get off statins too.

As for other problems, I don't know how anyone could survive with a TSH of 21! Mine never quite got above 6, but that was bad enough.

[Jessycat in reply to Hidden]

Hi Jnetti!

Thank you. Everyone has been so helpful. I asked so many times at the doctors if they’d interfere and they said no. Aggravating!

I’ll read that. I’m going to have to order a few books haha.

I know it sounds silly because it’s my health but I have no idea what a TSH of 21 means. Is that high or low? Sorry I sound so ignorant.

[Hidden in reply to Jessycat]

It's a steep learning curve!

TSH is Thyroid Stimulating Hormone. It's produced by the pituitary gland, not the thyroid, and its job is to give the thyroid a push to produce more hormone. If the thyroid isn't working properly it can't respond properly to the TSH. More and more TSH is produced as the pituitary tries to kick the thyroid into action. 21 is very high. Most of us with Hashimoto's (autoimmune thyroiditis) feel best with a TSH of under 1. Mine never went over 6 and I still felt rotten!

[Jessycat in reply to Hidden]

It really is! Right okay thank you. My GP is calling tomorrow so I’ll have a good chat. I’ve weirdly felt worse than this before. I’m just so tired and achy at the moment! Did it take you a long time to get the right amount of thyroxine?

[Hidden in reply to Jessycat]

It's been just over a year now, but some get sorted more quickly. Most of the folks on this forum are here because they have difficulties.

Many people are fine once the dose is adjusted (which does take at least several months). But (as you will have read on here) some of us don't fit the official guidelines. My TSH went down to 0.01 on 100mcg Levo, and my thyroid hormones were fairly high. They mostly go by the TSH and tend to get worried if it goes below range (the bottom of range is around 0.27 depending on where it's tested). So my Levo was reduced.

I gradually began to feel worse and recently started to get breathless and have slightly swollen ankles. Sent for heart tests and hopefully they will agree to an increase this time (going to doctor's tomorrow). If an increase is still refused I will have to go it alone and find my own ideal level

TSH is sometimes suppressed on the optimal dose of thyroxine - especially with Hashimoto's because it fluctuates so much, especially if you take T3 as well. It's like the Pituitary can't cope with all the changes and gives up producing TSH. Other people need a bigger than normal level of T3 for other reasons.

[Hidden in reply to Jessycat]

What I've found helpful is to make a bullet list of your main hypo symptoms, and how they are affecting your life (and in my case how they have got worse since the decrease).

Occasional episodes of palpitations and an irregular heartbeat are fairly common (though for different reasons) with both hypo and hyperthyroidism, and not necessarily anything to worry about. So are episodes of breathlessness. But if they are frequent, painful or begin to increase something needs to be done. So in a way I am thankful because it has hopefully got results!

[Hidden in reply to Jessycat]

For you, the first step may be to get vitamins and minerals sorted and take your Levo pat the best time (nowhere near any food, drink or other medication. Some things like tea, coffee, iron tablets and vitamin D (I think) or anything containing calcium (milk, yoghurt, cheese etc) need a longer gap 4 hours is recommended. I take mine at bedtime so as to enjoy my morning cuppa and cereal.

Sorry for so many posts but keep thinking of more to say, lol.

That's all for now lol

[Jessycat in reply to Hidden]

Thanks so much! I just can’t cope with this tiredness and weight gain. I could fall asleep just about anywhere right now. I’ll have to set an alarm for the middle of the night to take them 😂

[greygoose in reply to Jessycat]

That's a myth. The only thing you really shouldn't eat is soy. You can eat all veggies. Don't worry about it.

[Fruitandnutcase in reply to Jessycat]

I probably drink quite a lot, certainly I always order large drinks when my friends all seem to go for small.

I went gluten free when I developed inflammatory arthritis some years ago - yet another autoimmune condition.

I found from home fingerprint testing that my thyroid antibodies reduced over time and now although I still have some there aren’t many at all.

Good that you like vegetables, I’m not really a massive vegetable lover, I eat them because they’re good for me and I try and eat a rainbow of colours. I’m sure there are lots that you can still eat.

I use a microwave steamer, in fact I ended up buying a second one (they’re cheap!) because we eat so many veg.

As for worry - I’m a gold medal winner in worrying 🥇 think it goes with thyroid problems. I’ve found a sort of meditation that seems to work, basically I count from 1 - 10 while breathing in and out, if I lose track because my mind has wandered onto other things then I start again. It works well to stop my mind from running riot.

Hopefully once you get your folates and vitamin D sorted out you will feel a lot better.

I have always done what someone else suggested with keeping bullets points - bullet points are good because you are less like.y to ‘lose’ your doctor than if you write an essay.

I also used to keep a daily diary with notes on how I was feeling - again just bullet points, blood test results, the medicines I was taking plus any questions I wanted to ask and any interesting articles about the thyroid - especially if they were in my own interest - like justifying why I should stay on anti thyroid drugs rather than have rai or a thyroidectomy should I relapse and become hyper again. It was really helpful for focusing my mind before hospital / doctor visits.

Good luck with it all, hopefully your GP will do something about all the results that are shown in red - especially your TSH. Your folates and vitamin D are really low, your ferritin has scraped into normal but it isn’t great and your B12 is ‘normal’ but it’s not too high either. You want B12, D, folates and ferritin towards the top of their ranges to help your thyroid.

Just take your time and don’t stop the omeprazole or your anxiety med too suddenly.

[Jessycat in reply to Fruitandnutcase]

Thank you so much for all your advice. I’m going to make a list for the doctor tomorrow. I just want to be able to lose weight. It’s getting me down that I’ve piled on about 2 stone.

Thank you for advice for worrying. I’ll definitely take that on board. You’ve been so helpful!

[greygoose in reply to Jessycat]

Well, you shouldn't stop omeprazole cold turkey. You should wean off it. But, yes, you more than likely have low stomach acid due to your hypo. As I said, the symptoms are the same. And, you really shouldn't be on PPIs long term, they are intended as a temporary measure while the doctor finds out the root of the problem! Not many do. Have a read of this article about stomach acid and try the acid test at the end:

healthygut.com/articles/3-t...

Anxiety is a hypo symptom, as well. But, sertraline should also be weaned off slowly. But you should certainly take them at a different time to your levo, because they will block absorption.

[hemp66]

Yes take it with you any information you have or feeling write it all down the more info he has the better diagnosis he can make

[Jessycat in reply to hemp66]

Thanks! I’ve printed everything off!

[Lovecake]

It actually says in the instructions for my Thyroxine that omeprazole etc shouldn’t be taken at the same time.

I was on it, stopped when started Thyroxine.

Cut out dairy (I know I’m slightly intolerant as did a food intolerant test years ago). I have coconut milk and oat milk now.

I found that as you get your vitamins and minerals more optimal you do gradually feel better.

Getting your vitD level to at least 100 should help too.

SeasideSusie has invaluable advice if you look her up on here.

If you haven’t read anything by Izabella Wentz, she is a good source of info too. You can find her on Facebook or her website. (Not all the American stuff is relevant, but she’s spot on with helpful advice).

Take it slowly, change one thing at a time. Am sure you’ll get there by Christmas 🎄

[Jessycat in reply to Lovecake]

Thank you so much! I’ll have a look into it more once I’m home from work.