Hello I’m wondering if people can help me with comparison between results 12 months apart. I took t4 earlier in the year and found no difference and have been taking 100mcg of T3 and noticing only small difference around energy levels. Weight has increased further.
Results August 2018
Iron 96 ref 49-151
Ferritin 29.22 ref 13-150
Folic Acid 2.3 ref 4.6-18.7
Vit D 24.45 ref 21-29
TSH 3.46 ref 0.27-4.2
Free T3 4.53 ref 3.95-6.80
Free T4 14.7 ref 12.0-22.0
B12 274.7 ref 191-663
Anti Tg ab 512 positive ref <115
Anti Tpo ab 279.5 positive ref <34
August 2019 attached
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Jh4rnb
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Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If/when on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
Is this how you did the last test?
Your high antibodies confirm you have Hashimoto's
TSH usually suppressed on T3
FT4 very low - as expected
FT3 - result interpretation depends on when last dose T3 was before test
Vitamin levels are all on low side.
Are you taking vitamin supplements? If so what?
Ferritin has improved a bit, but still too low
Vitamin D has got worse, so has folate
B12 has improved, but not enough
You need to improve all vitamins
See SeasideSusie many detailed replies on how to improve these
Your problem is that you have poor nutrient levels and no thyroid hormone can work properly unless they are optimal.
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Although your Serum Iron is OK, your ferritin is on 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.
I've seen it said that for females a good level is 100-130. 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
Your Vit D result has notes explaining that it is below the desirable level. The Vit D Council recommends a level of 50ng/ml (125nmol/L) and the Vit D Society recommends a level of 40-60ng/ml (100-150nmol/L).
To reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 4,900iu D3 daily (nearest is 5,000iu)
As you have Hashi's then for best absorption an oral spray is recommended (eg BetterYou) or sublingual liquid as these bypass the stomach and are absorbed through the mucous membranes in the oral cavity.
Once you've reached the recommended 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. If you are in the UK you can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
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).
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Your B12 is on the low side at 432.6pg/ml. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Your folate is below range therefore you are folate deficient and you should discuss this with your GP. He may prescribe folic acid. Once your folate is within range it would be a good idea to change to a good B Complex containing methylfolate and methylcobalamin (B12) as this will continue to improve your folate level and the methylcobalamin will improve your B12 level. Good brands are Thorne Basic B or Igennus Super B, both of which contain the bioactive forms of ingredients.
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Your raised antibodies suggest that you are positive for autoimmune thyroid disease aka Hashimoto's which is where the thyroid is attacked and gradually destroyed. Fluctuations in symptoms and test results are common with Hashi's.
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 can be seen from the results you have posted.
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I don't know why you didn't continue with Levo, your August 2018 results showed that your thyroid was struggling with a TSH of 3.46. Your FT4 was low but you were producing some T3. What you should have done at that time was optimise your nutrient levels and continue with the Levo until TSH was down to 1 or below and FT4 in the upper part of the range, then see where FT3 was - this would have told you if you needed to add T3 to Levo. I don't think 100mcg T3 is actually what you need.
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