Advice on latest test results please

[Molly161018]

I'm confused...and looking for some advice on my blood test results I've just got back from medichecks, which are as follows...

TSH 0.315 mIU/L (0.27 - 4.2)

FreeT3 6.41 pmol/L (3.1 - 6.8)

Free Thyroxine 20.8 pmol/L (12 - 22)

Thyroglobulin Antibodies 33.200 kIU/L (< 115)

Thyroid Peroxidase Antibodies - 60.1 kIU/L (< 34)

Inflammation CRP HS 1.27 mg/L (< 5)

Ferritin 49.3 ug/L (13 - 150)

Folate - Serum - 2.93 ug/L (> 3.89)

Vitamin B12 - Active 93.9 pmol/L (> 37.5)

Vitamin D 157 nmol/L (50 - 175)

These results seem to give quite a rosy picture, with low TSH and both thyroid hormones in the upper part of the range...as far as I understand Thyroid hormones anyway!

I'm not surprised my antibodies are elevated, as I've had this result before, which I know confirms that I have hashimotos.

I would appreciate some input on the other aspects (vitamins etc), as I'm not so clear on these...Maybe I've got the wrong end of the stick re thyroid hormones too...but I don't think so...

I take 125mcg thyroxine and the only supplements I take are vitamin C and vitamin D.

I have had two increases in thyroxine in the past year due to worsening symptoms and low T3 (and T4 at one point) - I was on 87.5 mcg this time last year and I gained 3 stone in 10 months. I have only stopped gaining weight since the increase to 125mcg (in August).

It probably sounds crazy, but I feel strangely disappointed with these thyroid hormone results, as I've had T4-T3 conversion issues in the past, so I was expecting to have low T3 again... and having heard a lot about T3/liothyronine on this forum, I was convinced that this is what I needed, and was the reason why in 10 years of T4 only treatment I hadn't ever felt optimally medicated...

And if it's not obvious from my tone...I don't feel optimally medicated now, even though these results (to my understanding) seem to suggest I should be fine!

I feel permenantly exhausted, demotivated and sometimes a bit down...my whole body aches sometimes, especially when I am a bit more active...and my feet kill when I'm on them for a while, as well as my back and shoulders aching.

Is this just because I'm now overweight and unfit, and I just need to pull myself together, or is there more to be read into these results? Sometimes I feel like a complete hypochondriac!!

I would be very glad of some advice from this amazing forum, as it's the only place I really feel I'm understood, as we all battle with with similar issues...

And lastly...we had been thinking of trying for a baby towards the end of this year...but due to my health and weight gain we have 'placed it on hold' for now... please could I have some feedback on these results in the light of trying to conceive? I think I recall something about folate being important so I'm guessing I have some work to do...

Many many thanks in advance to the lovely kind people out there who support us and share advice freely!!

[Molly161018]

Thanks for your reply Lora7again - these Vitamin levels are on my post too! It's so long and waffley that you must have missed them!!

[greygoose]

You have Hashi's, as you know. And, it rather looks like you're just coming down from a Hashi's 'hyper' swing. And, that is the problem with Hashi's, in the early days, you never know what's real and what's a swing. I would think your FT3 isn't always that high. The levels will, with time, come down again, and the TSH rise.

If you put on three stone so quickly, that's not fat-weight, it's water weight. But, in any case, never take dietary advice from someone who suggests you lower your fat intake. That's very bad advice. Eating fat doesn't make you fat.

[Molly161018 in reply to greygoose]

Thanks greygoose,

I don't feel like I've had a hyper swing...not in the last year anyway...or were you meaning before that? That's more likely as I was flat out with the hype of getting married!! And what makes you deduce that if you don't mind me asking...?

You say "in the early days" but I was diagnosed 10 years ago!! The last 3 years have definitely been more of a rollercoaster with various stresses and strains...prior to that I never felt great but I kept going better.

I agree re the diet side of things...I definitely get on better low carb than low fat. It's interesting what you say about water weight. Do you have any advice on how to lose this?

Thanks so much for your reply I greatly appreciate it and would be glad if you could clarify these points as I'm trying to get my head around it all...

[greygoose in reply to Molly161018]

I wasn't putting a time scale on it. You just seemed surprised that you levels were that high. So, that's the interpretation I put on it. I don't think getting married causes 'hyper' swings though.

Water-weight is, in a lot of ways, more difficult to lose than fat. I don't have any suggestions to make, except maintaining your levels at optimal. Sorry.

[Molly161018 in reply to greygoose]

Yes I am surprised because the blood test results don't reflect how I feel symptomatically!

Sorry yes I wasn't very clear - it wasn't so much getting married as the lead up to the wedding and refurbishing our house at the same time that was stressful!

I'm going to try to lose weight with a low carb diet and exercise, and hopefully I can do this without sending my thyroid hormones haywire...

It's a delicate balance and I don't really feel like I've got there yet ...

[Molly161018]

Thanks Lora7again,

I could do with cleaning up my diet although I don't eat loads... probably just the wrong things. When my hormone levels are haywire I tend to just crave the wrong things!

[SeasideSusie Remembering]

Molly161018

Ferritin 49.3 ug/L (13 - 150)

Ferritin is recommended to be half way through range so you should try to improve your level. 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

apjcn.nhri.org.tw/server/in...

Folate - Serum - 2.93 ug/L (> 3.89)

As you can see this is below range so technically folate deficiency. You should speak to your GP, he may prescribe folic acid. Come back and let us know what he says.

Vitamin B12 - Active 93.9 pmol/L (> 37.5)

When Active B12 is below 70 this suggests testing for B12 deficiency. Yours level is OK.

Vitamin D 157 nmol/L (50 - 175)

This is a good level, the Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L. You just need a maintenance dose to keep it there, what dose of D3 are you taking at the moment? Are you also taking D3's important cofactors :

vitamindcouncil.org/about-v...

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.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

Check out the other cofactors too (some of which can be obtained from food).

[Molly161018 in reply to SeasideSusie]

Thank you for taking the time to reply SeasideSusie - your insight on vitamins etc is very valuable.

Re increasing Ferratin, liver etc doesn't agree with me, but I was on a liquid iron supplement at one point - I guess it would help to go back onto it?

Re folate, I will speak to my GP, but did I read somewhere on this forum that hashimotos patients often don't absorb folic acid properly? Is this what he will prescribe as standard, and was there a better alternative?

Vitamin d3 - I take 5000 in liquid form. I normally have it with breakfast though, which wouldn't be my fattiest meal - I should probably be taking it with dinner then. As to D1 and D2 I didn't know they existed... I don't take vitamin K2 or magnesium either.

Do you have any recommendations on supplement brands etc? I did used to take various supplements when I was under a nutritionist, but it became too expensive, so I don't want to waste money on low quality supplements.

[SeasideSusie Remembering in reply to Molly161018]

Ferritin - I can't make any suggestions re iron supplements. Iron is complicated and if you take iron supplements and already have a good level of serum iron then an iron supplement could cause serum iron to go too high. Iron rich foods can help raise Ferritin so that is all I can suggest for low Ferritin.

Folate - I don't remember seeing anything about Hashi's patients not absorbing folic acid very well. Some people, not necessarily Hashi's patients in particular, don't do well with folic acid and need methylfolate. So if you were prescribed folic acid and it wasn't right for you then your GP should look into that and if methylfolate isn't available on prescription you may have to buy your own. But you can try folic acid first.

Vit D - I would suggest you reduce your D3 to a maintenance dose which you have to find by trial and error. Continuing with 5000iu daily may take your level too high and excess D3 gets stored and can lead to toxicity. Maybe reduce to 2000iu D3 daily (or average it out over the week) and retest in 3 months to see if you are maintaining your current level with that dose.

A good Vit K2-mk7 is Healthy Origins, an oil based softgel.

You will need to choose the form of magnesium most suited to your needs so I can't recommend anything for that.

I don't know what you mean by

"As to D1 and D2 I didn't know they existed.."

as that's not something I've mentioned in my previous reply.

[Molly161018 in reply to SeasideSusie]

Thanks for your recommendations...I must have got confused about folic acid...and as for D1 and D2 I don't know what made me think it said that...blame the brain fog I suppose! 😣