The continuing saga

[Pictur]

I have the results from my latest blood work. I did increase the dosage to 100 mcg from 50mcg, without consulting my doctor My TSH is 0.88. (0.35 - 5.00), Free T3 is 4.2. (3.4 - 5.9) and Free T4 is 13 (12 - 22). It seems like my T4 seems low. My question is does it really matter if it is the T4 is low if it is the T3 that causes the symptoms. I am also taking vitamin B12, magnesium and 2 Brazil nuts a day.

[SlowDragon Administrator]

How long have you been on 100mcg ?

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you did the test

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels and thyroid antibodies

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

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 you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

[Pictur in reply to SlowDragon]

I did not take any thyroid medicine the day of my blood test until after it was done. Mt vitamin levels were all tested in Sept. and they were all good so they were not retested. I increased the dose to 100mcg after the response from my Sept posting said that I was very undermedicated and would get quite ill. I do not see anywhere on the blood requisition sheet about thyroid antibodies. Is this a test that is done by endroconologists?

[Pictur in reply to Pictur]

I would like to understand what testing,the thyroid antibodies would show.

[SlowDragon Administrator in reply to Pictur]

If either TPO or TG 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 .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

[Pictur in reply to SlowDragon]

Thank you so much for explaining about the antibodies. I had no idea why it was important to have these tested. I feel like I have such a better understanding of thyroid disease now thanks to people like you. I am having my levels tested again in 3 months so will for sure ask specifically for those tests as well as my vitamin levels. Is there any other vitamins I should be taking besides B12, magnesium and selenium. My gut feeling is that I do have Hashimotos’s. I have issues with acid reflux and have been using apple cider vinegar for years.

[Lalatoot in reply to Pictur]

The antibody testing will tell you if you have an autoimmune thyroid disease. This is helpful as it can guide your treatment or your understanding of what is happening with your body.

[Pictur in reply to Lalatoot]

Thank you for helping me understand. it is certainly becoming clearer.

[Lalatoot in reply to Pictur]

If you have autoimmune hypothyroidism aka hashis or hashimotos in simplified terms the body's autoimmune system attacks the thyroid causing it to release a higher level of thyroid hormones. This causes temporary symptoms caused by the high levels of hormones. The thyroid is slowly being killed off so at other times your hormone levels will be dropping and you will be undermedicated. This is really too simplified but it gives you the idea. You can google and read up on it. I don't have hashis.

[SlowDragon Administrator in reply to Pictur]

When you say vitamin levels were good, do you mean they were high within ranges?

We need OPTIMAL Vitamin levels

[Pictur in reply to SlowDragon]

my Vitamin B12 was 612 (more than 220), Ferrititin was 138 (12-289), my iron was 22 ( 6-27),. Those were the results taken in Sept,

[SlowDragon Administrator in reply to Pictur]

Yes these look good

What about vitamin D and folate?

When supplementing B12 it is often better to supplement a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

Rather than just B12

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Igennus Super B complex are nice small tablets. Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

As you have gut issues have you tried strictly gluten free diet?

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

[Pictur in reply to SlowDragon]

Thank you so much for the info. I will buy the Vitamin B with the folate in it. it doesn’t like like my Vitamin D or folate was tested. I will ask to have done in my 3 month follow up. after reading all the information on Hashamitos I think I am going to try going gluten free to see if there is any difference. I am also a type2 diabetic with high chloresterol and am on medication for both.

[Pictur in reply to Pictur]

I am so impressed with how much knowledge you have to share on thyroid issues. I did switch to a Vitamin B with folate. I also started a gluten free diet. Within days my energy level was soaring.. The itchy patch on my stomach has cleared up. I find that in itself amazing cause I have had it for years, it moves around to different areas but ultimately ends up back on my stomach. If I remain gluten free for the three months prior to my next blood tests, will it screw up the antibody test or will they still be able to tell if I have Hashamotos?