Hi have my results. just a reminder that I had hyperthyroid 20yrs ago, had radioiodine therapy and carbimazole. I had levo for a few years until I had a reaction and my doc took me off saying my thyroid was around normal limits. I have since been diagnosed 9yrs ago with b12 def. my results
CRP 1.39mg/l normal ranges 0-150
Ferritin 46.1 ug/l 13-150
Folate now normal 14.61 as I have been taking 5mg daily since I was found to have levels of 3.8 about 6 weeks ago
Vit B12 289 I am on 8 weekly injection
Vit D 25.7mmol/l 50-175 advised to start high dose of supplements which I am doing
TSH 1.99 mlu/l 0.27-4.2 6 weeks ago it was 3.37
Free T3 4.18 pmol/l 3.1-6.8
Free Thyroxine 13.6 pmol/l 12-22
Thyroglobulin Antibodies 46.4 kiu/l 0-115
Thyroid Peroxidase Ant 237 under 34 is normal
I have been advised to have yearly bloods to check my thyroid due to the very high antibodies.
any help with the interpretation of these results will be most helpful. thanks
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lesbud1
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Your ft4 and Ft3 levels are low in range. As you have had rai etc I would think that you need some levothyroxine. That would bring your levels up. Your tsh would go to 1 or lower. After 6 to 8 weeks get bloods tested. See how you feel. Then consider options if you are not optimal. Ferritin looks low to me but I am not an expert. Glad you are supplementing others.
Ferritin is too low. 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
Folate now normal 14.61 as I have been taking 5mg daily since I was found to have levels of 3.8 about 6 weeks ago
Vit B12 289 I am on 8 weekly injection
Looks like you're due your B12 injection for your level to be that low.
Is your folic acid pescribed? Now that your folate level is classed as normal, has your folic acid been stopped? You now need to maintain your level. As you are having B12 injections, as with any B12 supplement then a good B Complex is necessary to balance all the B vitamins. I'd suggest either Thorne Basic B or Igennus Super B, both contain the bioavailable forms of active ingredients with 400mcg methylfolate at the suggested dose which should maintain your folate level.
Vit D 25.7mmol/l 50-175 advised to start high dose of supplements which I am doing
How much D3 are you taking and in what form - tablets, capsules, softgels, oral spray, sublingual liquid?
You are actually 0.7 off Vit D deficiency, if your level was 25 then your GP would provide loading doses totalling 300,000iu over a number of weeks. In your position, with your current level, I'd follow the NICE Clinical Knowledge Summary for Vit D deficiency and take loading doses yourself. 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)."
As you have Hashi's (confirmed by raised TPO antibodies - see below) then for best absorption an oral spray is recommended (eg betterYou) or a sublingual liquid. I would suggest you take 5,000iu daily for 2 months then retest. Come back with new result for further comment.
The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L. When you have reached this level 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:
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).
TSH 1.99 mlu/l 0.27-4.2 6 weeks ago it was 3.37
Free T3 4.18 pmol/l 3.1-6.8
Free Thyroxine 13.6 pmol/l 12-22
Thyroglobulin Antibodies 46.4 kiu/l 0-115
Thyroid Peroxidase Ant 237 under 34 is normal
Your Thyroid Peroxidase (TPO) antibodies are raised and confirm autoimmune thyroid disease aka Hashimoto's. 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.
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, which is very likely why you have such a dire Vit D level, had such a poor folate level and also why you need B12 injections. All these need to reach optimal levels and be maintained there.
Your FT4 (free thyroxine) is very low in range, your FT3 is also low. You need to be back on Levo, if you reacted to it previously then you need to try different brands until you find one that suits.
thanks for all this info, although I have to admit I am a bit confused as this is all new to me. I am supposing that my doctor will not think anything of my results and will not consider levo so where does that leave me. I will get some cofactor supplements but I am not too sure I will be able to go gluten free. the medicare doc recommended I take 80mcg of vit D daily for 12 weeks then to get retested and then maintain on 10mcg daily and just have yearly thyroid tests as they think the thyroid function is normal at present. I will read up on Hashi's but I am not too sure what else to do next?
sorry forgot to say I am taking 75mcg D3 daily at the moment, tablets. I also suffer with carpal tunnel syndrome and I see that this is thyroid related?
the medicare doc recommended I take 80mcg of vit D daily for 12 weeks then to get retested and then maintain on 10mcg daily
sorry forgot to say I am taking 75mcg D3 daily at the moment, tablets
I assume you mean Medichecks. Their comments are supplied by doctors who are trained by the NHS so have the same sort of knowledge about nutrients as most GPs - little to none because it's not studied in med school. I think the Vit D Council and the Vit D Society give far more informed advice that any doctor will.
Your 75mcg of D3 = 3,000iu which is not enough. You need the loading doses as explained above. And the maintenance dose recommended by the Medichecks doctor of 10mcg = 400iu wouldn't help a sunburnt flea. Most people require 1000iu +. I am within the recommended range at 140nmol/L and I need 5,000iu D3 daily to maintain my level.
Also tablets are the least absorbable of D3 supplements so as you have Hashi's, which causes poor absorption, you would be better changing to an oral spray, sublingual liquid or even oil based softgels.
As mentioned, Hashi's causes low nutrient levels. You need to optimise your D3 and your ferritin level and you need to maintain your B12 and folate levels.
Within the following article is a list of symptoms of low ferritin:
You could give gluten free a trial for a few months. If you are unsure whether you can manage it make a new post and ask for advice from people who have done it. You wont know if it helps or not unless you try it.
You can see an endo privately but there's no guarantee they will agree to Levo with your current results. What you need, as you have Hashi's, is your TSH to go over range. Primary hypothyroidism is diagnosed in the UK when TSH reaches 10. When antibodies are positive, an over range TSH should trigger a prescription for Levo from an enlightened doctor.
To get the highest possible TSH result, the test should be done no later than 9am after an overnight fast (have evening meal/supper as normal the night before then no food until after the blood draw), drink water only in the morning before the blood draw as coffee (and other caffeine containing drinks) will affect TSH.
However, because you have been on Levo previously, you could use this as a lever and suggest a trial of Levo be given.
You can send for the list of thyroid friendly endos from Dionne at ThyroidUK:
tukadmin@thyroiduk.org
Then ask on the forum for feedback by private message on any that you can travel to.
Well you have had a very detailed answer from SeasideSusie, and I can't and wouldn't dream of ever being able to " top that " !!
There's some work to be done, building up your core strength and I'm sure you will become stronger as your knowledge and confidence grows.
Your TPO antibodies are high so it appears that you have autoimmune thyroiditis.
Basically these antibodies are attacking your thyroid and during these episodes it can cause you symptoms associated with either an overactive or underactive thyroid.
Ultimately your thyroid will become worn down by these attacks, leading to you becoming hypothyroid.
You should benefit from being on some T4 thyroid medication now.
Your T4 isn't even 20% through it's range.
Most people feel better when their T4 is in the upper quadrant of the range.
Your TSH needs to be lower and your T3 higher - both should be achieved with a prescription for some Levothyroxine.
I understand you stopped Levothyroxine as you had a bad reaction.
There are several brands available, with different fillers, and would suggest you talk this all through with your doctor and start the medication again, with follow up appointments, as detailed on the main Thyroid uk website.
thanks. no point in talking with my GP as she thinks the levels are fine and antibodies are not important. I didn't stop the levo myself I had protein in my urine, high blood pressure and severe headaches with that, so taken off them many years ago. just so worried about were to go to get myself sorted as I really have no idea what I am doing. will read all the info and hope that helps.
Is there a different doctor within the surgery who might be more informed on the treatment for Hashimoto's auto immune thyroiditis ?
Once your vitamins and minerals are optimal you will starting feeling stronger and more able to take more control yourself.
A thyroid friendly endocrinologist is a good idea to help you get started and hope the detailed list available from Thyroid uk gives you some choices of doctors in your area.
If you can't find a doctor to help you, you can source thyroid hormone replacement yourself, but initially I think having a doctor " on side " the most sensible first step.
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