Hi I wonder if some of you can help. I have been suffering from many symptoms of under active thyroid for over a year now, having previously been an active 69 year old, my life has been turned upside down. Initially I had sudden onset massive palpitations, feeling of ‘surging’ throughout my body, irregular heart rhythms, followed by acute fatigue and lightheadedness Even though my symptoms now indicate hyperthyroidism, with thinning hair, dry skin, weight gain that won’t shift, pain throughout my joints and muscles and fatigue, my private endocrinologist says blood tests show ‘ in range’ so I am unmediated. These are my private blood tests from a month ago, which I haven’t as yet discussed with my Endo or GP.
TSH 2.150 Range 0.27-4.20
Free T4 13.30 Range 12_22
Free T3 4.5 Range 3.1-6.8
TPO 5.0 Range 0-24
Ferritin 57 Range 13-150
Serum folate 13.05 Range 3.89-26.80
Vitamin B12 472.4 Range 197-771
Magnesium. 0.75 Range 0.7-1.0
Zinc 15.70 Range 9.2-19.2
Selium 1.36 Range 0.66- 1.57
Total vitamin D 77 Range 75-200
Many thanks
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MD49
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Even though my symptoms now indicate hyperthyroidism, with thinning hair, dry skin, weight gain that won’t shift, pain throughout my joints and muscles and fatigue, my private endocrinologist says blood tests show ‘ in range’ so I am unmediated.
Do you mean hypOthyroidism (underactive)?
Your results are in range but they aren't typical for a normal healthy person where one would expect to see TSH no more than 2 and FT4 around mid-range +.
These are my private blood tests from a month ago
Where are the results for thyroglobulin antibodies? Both types of thyroid antibodies should be tested - TPO and Tg - as you can be negative for TPO antibodies but positive for Tg.
Have you ever had a below range FT4?
You do have some problems with nutrient levels:
Ferritin 57 Range 13-150
This 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 a good level for females is 100-130 and for males 150. 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
This is on the low side. 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).
To reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 3,700iu D3 daily (nearest is 4,000iu)
When 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. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
For best absorption from an oral supplement that is swallowed an oil based softgel is recommended, eg Doctor's Best, avoid tablets and capsules. Some people prefer an oral spray (eg BetterYou) or sublingual liquid which are absorbed through the mucous membranes in the oral cavity so bypass the stomach.
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).
Vitamin B12 472.4 Range 197-771
This may be on the low side although you haven't given the unit of measurement.
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."
Serum folate 13.05 Range 3.89-26.80
Folate is recommended to be at least half way through it's range which would be 15.35 with that range.
You can help increase both B12 and folate by supplementing with a good B Complex containing methylfolate (not folic acid) and methylcobalamin (not cyanocobalamin). Two good brands recommended here are Thorne Basic B or Igennus Super B, both of which contain the bioactive forms of ingredients.
Magnesium. 0.75 Range 0.7-1.0
This is low; however, taking magnesium as a cofactor of D3 (as mentioned above) will help.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.
So it's important to get TPO and TG thyroid antibodies tested at least once .
Suggest you improve low vitamins and retest thyroid and vitamins in 2-3 months
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)
Hashimoto's frequently starts with hyperthyroid type symptoms
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