Active B12,81.3 pmol/L 37.5-188
Ferritin 57 ug/L 44-150
Folate 13.8 nmol/L 8.83-40
FT3 3.98 pmol/L 3.1-5
TSH 2.8 miu/L 2.5-4.3
TgAb 350 KUL out of range 0-300
TPOAb 12.4 Kiu/L 0-34
T4 104 nmol/L 66-181
FT4 17.1 pmol/L 12-17-22
vit D (25-hydroxy) 23 nmol/L
some of results are in the light green area??
pabhoo
We can see from previous posts that you have been on 50mcg Levo since 2002.
The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well.
TSH 2.8 miu/L 2.5-4.3 = too high
FT4 17.1 pmol/L 12-22 = 51% through range
FT3 3.98 pmol/L 3.1-5 (actually the range is 3.1-6.8) = 24% through range
[Where there are light green and dark green areas in the results bar, you take the green area as a whole so the range for FT3 is actually 3.1-6.8 which is the same as the other two private labs - Blue Horizon and Medichecks.]
So you can see that you appear to be undermedicated and you need a dose increase of 25mcg now, retest in 6-8 weeks time, repeat increasing/retesting evey 6-8 weeks until your levels are where they need to be for you to feel well.
If your GP is reluctant to increase your dose, here is some evidence that you can use to support your need for a increase:
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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.
You can also refer to NHS Leeds Teaching Hospitals who say
pathology.leedsth.nhs.uk/pa...
Scroll down to the box
Thyroxine Replacement Therapy in Primary Hypothyroidism
TSH Level .................. This Indicates
0.2 - 2.0 miu/L .......... Sufficient Replacement
> 2.0 miu/L ............ Likely under Replacement
**
TgAb 350 KUL out of range 0-300
TPOAb 12.4 Kiu/L 0-34
Your TPO antibodies are in range but your Tg antibodies are elevated. This can suggest autoimmune thyroid disease aka Hashimoto's, but raised Tg antibodies can be caused by other reasons. It's likely that yours are thyroid related (but I am not medically qualified so that's only my opinion).
Assuming that you do have Hashi's, this is where the thyroid is attacked and gradually destroyed. Fluctuations in symptoms and test results are common with Hashi's. Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Gluten/thyroid connection: chriskresser.com/the-gluten...
stopthethyroidmadness.com/h...
stopthethyroidmadness.com/h...
hypothyroidmom.com/hashimot...
thyroiduk.org.uk/tuk/about_...
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies.
**
Active B12,81.3 pmol/L 37.5-188
If your Active B12 level was <70 this would suggest testing for B12 deficiency. You are not in that category and your level is OK but you may want it higher, I certainly would want mine in 3 figures, but that's my opinion.
**
Folate 13.8 nmol/L 8.83-40
Folate is recommended to be at least half way through range so that would be 25+ with that range, so yours is on the low side. Folate rich foods can help raise your level, and you could also supplement with a good quality B Complex containing methylfolate and methylcobalamin (which will help raise your B12 level). Good brands recommended here are Thorne Basic B and Igennus Super B, both contain the bioactive forms of ingredents.
When taking a B Complex containing Biotin (B7) or Biotin as a stand-alone supplement, leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it will give false results. Medichecks definitely use Biotin, they have confirmed this and the amount of time to leave the supplement off.
The private testing companies often use the same labs so Biotin is likely to be used, and many NHS labs are likely to use it, so it's always best to err on the side of caution and leave B Complex/Biotin off for 7 days before testing.
**
Ferritin 57 ug/L 44-150 - again you have taken only the dark green bar and should have included the light green bar, which I believe makes the reference range 13-150.
This is low the low side. 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.
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
apjcn.nhri.org.tw/server/in...
**
vit D (25-hydroxy) 23 nmol/L
This is Vit D Deficiency and you ideally should discuss this with your GP who should follow the NICE treatment summary for Vit D deficiency: cks.nice.org.uk/vitamin-d-d...
"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 25 nmol/L
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.
Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
Your GP should agree but if not you have two choices, either see a different doctor or treat yourself following the above protocol.
Once these loading doses have been completed you will need a reduced amount so you should make sure that you are retested after you have finished the loading doses so that you know how much you should then take going forward. Some doctors wont retest. Most doctors, if they continue prescribing, only give 800iu daily which isn't enough.
If GP wont retest then do this privately (link below) and post your new result at the time for members to suggest a new dose to bring your level up to what's recommended by the Vit D Council/the Vit D Society - which is 125nmol/L and 100-150nmol/L respectively - and then you'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. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
When you buy your own Vit D supplement, for best absorption when Hashi's is present it's recommended to use an oral spray (eg BetterYou) or sublingual oil based drops (eg Vitabay Organics).
Your GP won't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3 as recommended by the Vit D Council -
vitamindcouncil.org/about-v...
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.
naturalnews.com/046401_magn...
thefamilythathealstogether....
drjockers.com/best-magnesiu...
Check out the other cofactors too (some of which can be obtained from food).
thank you for all that. . I'm not very good with making sense of all things like that but I do gather I'm undermedicated .its a lot to take in.
I'll b making appointment t asap. although i will probably have a massive fight on my hands with doctors attitudes .
Just keep re-reading it until it sinks in. It's all important and the only people who can help make us well are ourselves, we can't rely on doctors unfortunately. You absolutely must get that Vit D Deficiency treated one way or another, and your other nutrients need attention too. Nutrient levels need to be optimal for thyroid hormone to work. At least you can treat all your low nutrient levels yourself, you don't need your doctor for those.
I have just started taking vit d
vitabiotics ultra vit d1000iu
if my doctor point blank refuses. can I insist on going to see endo consultant??
You can't insist. You can ask but there's no guarantee that your GP will agree to a referral, nor is there any guarantee that an endo will agree to see you. When results are in range, endos tend to refuse to accept referrals. You can but try, you have the evidence to support your request for an increase, start there. If necessary see a different doctor. Take someone to your appointment with you who can advocate for you if necessary.
pabhoo
That's nowhere near enough. Look at what I wrote about how much Vit D you need. 1000iu D3 is barely a maintenance dose and will do nothing for your Vit D deficiency. You need to start with loading doses that total 300,000iu over a few weeks as per the NICE Summary. Please read what I have said and you also need the important cofactors mentioned.
Also that is a tablet, the least absorbable form of Vit D supplements. I've suggested what are the best absorbable, and if you don't want to take either of those then try a D3 softgel containing extra virgin olive oil which will help absorption (eg Doctor's Best), not a tablet or a capsule.
ah I see. I'm a bit thick. sometimes I run before walking if u get the drift. I've had these tablets in house for a few weeks.where do I get the stuff you suggested
erm. would all this underdosing and high anti bodies could b causing the allergies I get specially round throat and face at all...
But your GP should prescribe LOADING dose of vitamin D - 300,000iu over 6-8 weeks see these Local CCG guidelines
clinox.info/clinical-suppor...
GP will only prescribe to bring vitamin D up to 50nmol.
Aiming to improve vitamin D by self supplementing to at least 80nmol and around 100nmol may be better .
Vitamin D mouth spray by Better You is good as avoids poor gut function.
Vitamin D mouth spray by Better You is widely available in health shops or on internet
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Retesting twice yearly via vitamindtest.org.uk
It's trial and error what dose each person needs.
Frequently with Hashimoto's we need higher dose than average
thank u....
I'm gonna have t get myself clued up on these nmol and other stuff miu kiu etc
right. have looked on Amazon found an oral spray by better you ? 3000iu is that right .
also a spray with d +k2 3000iu 75ug
pabhoo
Are you not going to see your GP about your Vit D deficiency first and see if he will prescribe the loading doses? If not, and you are going to treat yourself, follow the protocol I quoted in my previous reply. All the amounts are there.
yes I have tried ri ginger this morning in. but as per usual engaged.... I know I will b waiting a few weeks t see dic as ne e a y appointments. they do operate a system whereby u ring at 8 a.m and if u r very very lucky they mite have a spare slot at t time
So tell them that you need an urgent appointment, that you have taken a test and it shows Vit D deficiency which needs treatment.
Other than that, just buy your own, follow the protocol outlined above and remember to follow ALL the advice given above about retesting, adjusting to a maintenance dose when you have reached the recommended level, important cofactors, etc.
The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol.
Yes, but first see GP to be prescribed high loading dose of vitamin D on NHS
Any vitamin D result under 25nmol requires high dose replacement and testing of calcium and parathyroid levels after 4 weeks on high dose
clinox.info/clinical-suppor...
Once you have completed loading dose you will need ongoing maintenance dose. That's when you should use Better You vitamin D mouth spray
Personally I buy my vitamin K2 Mk7 separately
Yes can use the combined Better You vitamin D plus K2 Mk7 if you are not on any blood thinners (including aspirin)
read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D
betterbones.com/bone-nutrit...
articles.mercola.com/sites/...
healthy-holistic-living.com...
sciencedaily.com/releases/2...
articles.mercola.com/sites/...
betterbones.com/bone-nutrit...
This article explains should discuss with specialists before taking any vitamin K if you take any blood thinning medication
drsinatra.com/vitamin-k2-su...
Vitamin D research and Hashimoto's
healthunlocked.com/thyroidu...
easy-immune-health.com/magn...
naturalnews.com/038286_magn...
brilliant I will read your links later as just got to work...
my diet also is reasonably healthy although I do succumb t chocolate etc now and again.
When hypothyroid it's not how good our diet it, but how gut function is often affected and nutrient absorption is often poor
Low vitamin D is extremely common with Hashimoto's
I dont know much about hashimoto.. could you give me a bit of info on it please .
Link about antibodies and Hashimoto's
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/about_...
List of hypothyroid symptoms
thyroiduk.org.uk/tuk/about_...
About 90% of all hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.
Hashimoto's affects the gut and often leads to low stomach acid and then low vitamin levels are common
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
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
While still eating high gluten diet 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...
healthcentral.com/article/t...
ncbi.nlm.nih.gov/pubmed/286...
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
endocrine-abstracts.org/ea/...
Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.
ncbi.nlm.nih.gov/pubmed/300...
ncbi.nlm.nih.gov/pmc/articl...
Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's Gut connection is very poorly understood
I've read quite a bit on my work break.
could the fact I have a lot of acid reflux have anything to do with it
and also would pins n needles in hands have anything t so with thyroid?
theory in my mind
I have not of flem in my lungs and sinus problems
because my tgab is out of range would that be a cause of said problem.i suffer a lot of sinus headaches
Dairy intolerance is EXTREMELY common hypothyroid problem.
Dairy intolerance is Frequently a cause of sinus and phlegm
thyroidpharmacist.com/artic...
ncbi.nlm.nih.gov/pubmed/240...
Headaches are symptom of being hyperthyroid and still on too low a dose of Levothyroxine
Acid reflux is common when hypothyroid and is almost always due to LOW stomach acid
This should Improve as dose of Levothyroxine is slowly increased
Literally thousands of posts on here about low stomach acid
healthunlocked.com/search/p...
Guidelines on dose Levothyroxine required is
1.6mcg Levothyroxine per kilo of your weight
So you weight yourself in kilo and multiply that by 1.6
Eg if patient weighs 10 stone = 63.5 kilo x 1.6 = 101.6mcg Levothyroxine
So likely to need to increase dose up slowly in 25mcg steps until at 100mcg Levothyroxine
I'm 13 stone no idea what that is in kilo.also over last couple yrss my weight has crept up
So 13 stone is 82.5 kilo x 1.6mcg = 132mcg Levothyroxine
So if your thyroid has failed completely and you need full replacement dose you would need about 132mcg Levothyroxine per day
Getting vitamins much better is first step
Vitamin D is extremely low at 23nmol
Local CCG guidelines
clinox.info/clinical-suppor...
GP should prescribe loading dose of vitamin D.
Have you seen GP yet about this?
have appointment on 22nd July.... taking results from thriva and printing literature off here
hi... and good morning.... my appointment with doc is tomorrow... I want him/her to increase my levo as per what I have been told on here
I'm useless wen it comes t saying what I want,usually end up bowing down. I'm not a strong person when it comes t seeing doctors,I can describe symptoms but normal reply is' o u may b stressed etc .'.. would someone please put links on to show the doctor why I should have my levo increased .I have my private results ,printed out I would be eternally grateful if someone could put the relative links to pages on this so I can print and take them
Help with understanding test results
My Thyroid test results
Thyroid blood test results - very low vit d and high TgAB
New Results
Recent results feedback appreciated 
