My 21 year old daughter who has had hashimotis since age 10 and been on T4 since then (was on 150 mcg) started on NDT 2 months ago she was at 2 and half grains when this test was taken 2 weeks ago . She has since gone down to 2 grains as was unable to sleep for a whole week she felt hyper and exhausted .
She is still not feeling great ..exhausted, anxious, no motivation etc.
She had an Iron infusion last October and wants a Vitamin D infusion . She is taking vitamin supplements but they are doing no good .
Her TSH level is the lowest it's ever been ...0.024. (0.27-4.2)
Vitamin b12 active..25.8 (37.5-188)
Folate serum..3.65 (>3.89》
Vitamin D...20 (50-175)
Ferritin...145(13-150)
CRP hs....3.76 (<5》
Thyroglobulin antibodies..185 (<115》
Thyroid peroxide...74.9 (<34》
Can anyone interpret the results please?
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LMJ65
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Is it possible to edit your post to add in the ranges. The reason being that labs differ and it makes comments easier.
To edit, click on 'More' and select edit and add ranges.
The following maybe helpful as your daughter is taking NDT. NDT contains all of the hormones a healthy gland would do, but blood tests wont correlate as they were introduced along with levothyroxine (T4) alone and NDT contains T4, T3, T2, T1 and calciton. The doctor who wrote the article would never prescribe levothyroxine, only NDT or T3. Increasing dose is always gradual and I hope you find the following helpful.
Hi sorry to hear your daughter is poorly. Yes please can you add the ranges -they are the figures in brackets next to the result.
Base on the lab ranges in my area her vit D stands out as extremely low. This would cause fatigue, exhaustion, aches and pains and greater likelehood of infections/viruses that may take longer to get over.
She needs to be on a course of treatment to raise her vitamin D levels. She will need D3 with k2. And to get her levels up to over 80 preferably around the 100 mark. If you are in the uk I would go back to the GP and raise this issue showing the results if done privately.
Her vitamin D level will need to be retested evey 3months until its brought up to the correct level.
My vitamin D level was just 3 when I was diagnosed. I could barely walk or think. I felt dreadful. Insomminia is a symptom as ir non restorative sleep.
Please be careful though vitamin D3 needs to be given with checks as your body stores it and cannot get rid of any excess so periodic blood tests are very important.
Still post your results with the ranges though as Its really inportant we know where she is on the ranges for your lab area.
The range is usually about 37.5-188. This result is absolutely dire. Anything below 70 suggests testing for B12 deficiency. She should see her GP ASAP and ask for testing for B12 deficiency/pernicious anaemia. She should check for signs of B12 deficiency here, list any that she may have and show them to her GP.
She should not take any B12/B Complex/Folic acid supplements before further testing as they will skew results and mask signs of B12 deficiency.
Folate serum..3.65
I think this may be below their low limit (is it <3.89?)
Again, this is probably folate deficiency and she needs to discuss with her GP. Folic acid may be prescribed, do not start until further testing of b12 has been carried out.
Vitamin D...20
As the unit of measurement is nmol/L this is Vit D deficiency. She needs to speak to her GP and ask for loading doses according to NICE treatment summary for Vit D deficiency: cks.nice.org.uk/vitamin-d-d...
(click on Management > Scenario:Management)
"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)."
Each Health Authority has their own guidelines but they will be very similar. She should see her GP and ask that he treats her according to the local guidelines or this summary and prescribes the loading doses. Once these have been completed she will need a reduced amount so sheshould make sure that she is retested after she has finished the loading doses so that she knows how much she should then take going forward. 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 new result at the time for members to suggest a new dose to bring her level up to what's recommended by the Vit D Council/the Vit D Society.
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).
Once she's 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. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
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 -
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).
Ferritin...145
Fine.
As she has such dire nutrient levels it suggests possible malabsorption issues. SlowDragon is good with gut/absorption problems so hopefully she'll be along soon.
Thyroglobulin antibodies..185
Thyroid peroxide...74.9
These are raised and confirm autoimmune thyroid disease aka Hashimoto's, does she already know that?
Her TSH is low because she's taking NDT, because of the T3 element this tends to lower, even suppress, TSH and it can also lower FT4. FT3 is the most important test and as long as this is in range she's not overmedicated.
Thanks for all the info I will look at all the guidelines and try the GP again but they only offer tablets and my daughter csnt tolerate them so thsts why she wants injections or infusions . She is not able to travel to London and that's the only place for transfusion ..we have found out Newwastke do injections ..it's just a nightmare .
You state "My 21 year old daughter who has had hashimotis since age 10 and been on T4 since then (was on 150 mcg) started on NDT 2 months ago she was at 2 and half grains when this test was taken 2 weeks ago . She has since gone down to 2 grains as was unable to sleep for a whole week she felt hyper and exhausted ."
Your daughter was taking 150mcg of levo and 1 grain of NDT would be around 100mcg of levo 'in its effect' so 2 grains might just be a bit too high at present. I shall give you a link and read 'Safely Getting Well on Thyroid Hormones'. It is by an Adviser to Thyroiduk who never prescribed levo, only NDT or T3 for thyroid hormone resistant patients.
p.s. blood tests were introduced for levothyroxine only. Therefore if we take NDT or add T3 to T4, the results wont correlate and it is by 'relief of clinical symptoms' which is the best judge.
Thanks I saw that link in your last reply I had a look at it ...my daughter has lost all faith in the NHS and particularly GPS as she has had problems for so long and she feels no doctors take her seriously . She is traumatised from when she first took ill as it took a year to be diagnosed and she was told to cut her food down and go for long walks and none of it was true ...all.along she had gained weight and was so unwell as she had a severely underractive thyroid and hashimotis thyroiditis ..she was bullied and is deeply affected from the experience.
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