Help with results please

[Flecmac]

I have posted here many times. Need some advice.

I have been gluten free for two years and after few months my TPO ab dropped from 1300 (high for many years) to 526. My GP had told me nothing would make them drop. Now my latest results here show that they have gone back up to 1300. I don’t now know whether it’s worth being GF anymore and feel very disappointed. I also had to reduce my thyroxine from 75mcg back down to 62.5 mcg recently as I was having chest pain. Just don’t seem to get anywhere with anything I try. My AST results are over range and GP has booked a Fibro scan. Gastro drs don’t listen either, I had acid coming up in my mouth. Gastro prescribed lanzoprazole which I’ve tried before but had tummy pain , GP stopped it. Seeing nurse about high cholesterol soon, nothing helps with that i.e. good diet and exercise (pain allowing). Just so fed up with getting nowhere. Migraines are bad. Lots of symptoms. Had major op to remove tumour from spine last year, it’s been a crazy couple of years, spinal doc now says she can see what looks like a cyst near coccyx. So many appointments!!

Results :-

FREE T4+FT3+TSH

Serum free T4 level 18.6 pmol/L [10.0 - 20.0]

Serum TSH level 0.14 mu/L [0.5 - 4.4]

Below low reference limit

Serum free triiodothyronine level 5.3 pmol/L [3.5 - 6.5]

Serum thyroid peroxidase antibody concentration

> 1300 iu/mL [0.0 - 60.0]

Above high reference limit

This occurs in autoimmune thyroid disease. In euthyroid individuals, positive antibodies are associated with an increased risk of developing autoimmune thyroid disease in the future.

VITAMIN D

Serum total 25-hydroxy vitamin D level 74 nmol/L [50.0 - 200.0]

<30 nmol/L - Vitamin D deficiency

30-50 nmol/L - Vitamin D insufficiency.

Please refer to local APC guidelines

Serum lipid levels

Serum cholesterol level 7.6 mmol/L

Serum triglyceride levels 0.6 mmol/L [0.4 - 1.5]

Serum HDL cholesterol level 2.0 mmol/L

Serum LDL cholesterol level 5.3 mmol/L

NB the calculation of LDL is valid only for a fasting sample.

Target LDL-C in secondary CVD prevention is <2mmol/L. Please refer to Notts APC guidelines for advice. If LDL-C persistently above 3.5mmol/L, consider referral to lipid clinic.

Serum cholesterol/HDL ratio 3.8

Serum non high density lipoprotein cholesterol level 5.6 mmol/L [< 7.5]

AST- ALT RATIO

AST serum level 32 u/L [0.0 - 30.0]

Above high reference limit

Serum alanine aminotransferase level 16 u/L [0.0 - 35.0]

Aspartate aminotransferase/alanine aminotransferase ratio 2.0

In the presence of risk factors for NAFL (obesity, type 2 Diabetes, metabolic syndrome, or fatty liver on USG), isolated AST/ALT ratio

>= 0.8 may indicate liver fibrosis. Encourage lifestyle modification and consider Fibroscan.

Liver function tests

Serum alkaline phosphatase level 78 u/L [40.0 - 130.0]

Serum alanine aminotransferase level 16 u/L [0.0 - 35.0]

Serum total bilirubin level 7 umol/L [0.0 - 21.0]

Serum albumin level 42 g/L [35.0 - 52.0]

[greygoose]

I don’t now know whether it’s worth being GF anymore

If you're just gluten-free in the hope of reducing antibodies, no it isn't. Yes, your antibodies went down. Then they went up again. Because that's what antibodies do. They fluctuate. And if they drop, it doesn't mean that your Hashi's is less severe, or going away, or anything like that. Hashi's doesn't go away. And, you can have Hashi's without ever having high antibodies.

So, if being gluten-free doesn't make you feel better, then there's no point. Try eating it again, and see what happens. You feel worse? You probably need to be gluten-free. You feel the same? You don't need to be gluten-free.

Gastro drs don’t listen either, I had acid coming up in my mouth. Gastro prescribed lanzoprazole which I’ve tried before but had tummy pain , GP stopped it.

Hypos normally have low stomach acid. However, the symptoms are the same as for high stomach acid. Doctors don't know about low stomach acid, so they prescribe things like lanzoprazole, PPIs, which lower stomach acid even further. What you need to do is increase the acid level, not reduce it.

Seeing nurse about high cholesterol soon, nothing helps with that i.e. good diet and exercise

Well, it wouldn't, would it. Because high cholesterol has nothing to do with diet and exercise. Your cholesterol is high because your FT3 is too low - it's only just over mid-range. Raise your T3 and the cholesterol will fall. But, I very much doubt a nurse would know anything about that.

Whatever you do, don't let her put you on statins or a low-fat diet. Low-fat diets are dangerous and will do nothing to reduce your cholesterol because fat has nothing to do with cholesterol. And statins are useless for women and not recommended for hypos. They only people they help are men who have already had a heart attack. High cholesterol is not a problem, anyway. It doesn't cause heart attacks or strokes.

Your vit D is much too low.

I wouldn't have thought your AST was anything to worry about, it's only just over-range.

You need your ferritin, B12 and folate tested.

[Flecmac in reply to greygoose]

Thanks. How can I increase my stomach acid, and wouldn’t that make reflux worse?

Last B12 was >2000 (191-663) on supplement.

I am taking Vitamin D in spray and have increased since end of summer.

Last Folate was 10.0 (3.3-19.3)

Re Cholesterol, my Mum had high cholesterol and took statins, so could be hereditary, although she was overweight, I am not.

Re antibodies:- I was told on here that GF lowered TPO ab, so when it seemed to with GF I thought it was working.

Thanks 😊

[greygoose in reply to Flecmac]

There are various ways of increasing stomach acid, but basically, you just take something acidic before a meal, like vit C or Apple Cider Vinager.

If you have low stomach acid, what happens is, the food doesn't get digested and passed on into the gut. Instead, it sits in the stomach and ferments. And, then you get a reaction like a volcano erupting, sending acid up into your oesophagus. If your acid level is higher, the food is digested faster and doesn't stay in the stomach fermenting. So, no volcanic action.

People who have high cholesterol for genetic reasons usually have higher levels than yours. If your mother was also over-weight, it's possible that she too was hypo. And, I doubt very much the statins did her any good, and probably did her harm. The cholesterol won't kill you, the statins might.

I was told on here that GF lowered TPO ab, so when it seemed to with GF I thought it was working.

Yes, people used to believe that - some still do. But, the question is: even if it worked, what's the point?

I can understand that you thought it was working, but I'm really not surprised the level went back up again, because antibodies fluctuate.

[shaws in reply to Flecmac]

If you don't find ACV helpful you can also take one or two tablets of the following before eating,

Digestive Enzymes

amymyersmd.com/2016/04/dige...

[Flecmac in reply to shaws]

Thank you. I do struggle swallowing tablets and with all that I need to ideally take it is very difficult. 😊

[SilverAvocado in reply to Flecmac]

Mcdermott, I have a little ACV in a small glass of water 15 mins before every meal. It stops my reflux very successfully. A few months ago it started coming back, and I realised it was because I'd been getting stingy with how much ACV I put into the glass. I increased my gluggs and the reflux has gone again

[shaws in reply to Flecmac]

ACV then mixed with water or juice.

[SlowDragon Administrator]

75mcg Levothyroxine is a very small dose.

Results didn't suggest over medication. FT4 and FT3 were within range

Reducing dose is likely making all your hypothyroid symptoms worse

How much vitamin D are you taking?

Is it 1000iu or 3000iu spray ?

Have you had folate and ferritin tested ?

Chest pain can be linked to low iron levels

Are you also supplementing magnesium?

Or vitamin B complex ?

Antibodies may have risen coincidentally or possibly because dose Levothyroxine was reduced

High cholesterol is linked to being hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

[Flecmac in reply to SlowDragon]

Yes, use 3000 iu in spray and make my own mag spray with mag flakes.

Last folate result:-

Last Folate was 10.0 (3.3-19.3)

Last ferritin was 112ug/L (12.0 - 300.0) and taking supplement.

[humanbean]

Regarding the chest pain...

Personal anecdote : Low iron gives me chest pain. I need to keep it as close to optimal as I can.

This link explains "optimal" for iron and iron-related tests :

rt3-adrenals.org/Iron_test_...

It isn't terribly precise on the subject of ferritin, but many of us on here feel best with ferritin around mid-range or a smidgen over.

[Mozzymoo22]

I have suffered from reflux for year's and was prescribed omeprazole. It made things worse. Tried apple cider vinegar but I found it too harsh. I now take digestive enzymes and the reflux has gone. My cholesterol was high until I t3 sorted. Now my cholesterol is not just normal it's optimal. So many things improve once you get your thyroid sorted out. I was also given statins before and which made me ill. I was in so much pain I couldn't get out of bed. Now the only medication I take is for my thyroid, the rest are vitamins.

[Flecmac in reply to Mozzymoo22]

Thank you so much! Could you message me with the digestive enzymes you use please? I struggle taking tablets unless very small, what are yours like? Thanks.

[humanbean in reply to Mozzymoo22]

I'm curious about which digestive enzymes you take too. It doesn't have to be kept private.

[Mozzymoo22]

It's called zymerite. It works for me 😀

[Flecmac]

Thank you, that’s what I thought and yet my Endo says I need to see a specialist nurse re: familial hyperlipodeamia, I cancelled the original appointment, but he says I should see one. However with the thyroid (I have Hashimotos) I have struggled to get very far, still have all same symptoms whether on 75mcg or 62.5mcg. Don’t know whether I need T3, but he says not.

[Flecmac]

Oh dear! Yes I’ll try to remember, could be a while as it’s nhs, so feel free to remind me xx