help with latest blood tests

[maxpoppy2007]

Hi please could I have some advice on my latest blood results

bit of background after partial thyroidectomy and being really ill, I started to self medicate with Thyroid S for approx over 2 years

bloods taken 14/01/2020

Serum TSH level 0.01 (0.27-4.2) was 0.01 on 18/02/2019

Serum free T4 level 19.3 pmol/L (12.0-22.0) was 19.6 on 18/02/2019

Serum free T3 level 9.5 pmol/L (3.1-6.8) was 7.3 on 18/02/2019

Serum vit B12 711 ng/L (197-771)

Serum folate 9.7 ug/L (3.3-19.3)

Serum ferritin 123.3 ug/L (15-150) was 138.5 on 18/02/2019

[SlowDragon Administrator]

How do you feel?

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 .

If/when also on NDT make sure to take last small dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Vitamin levels look good.

Do you supplement?

Do you also test vitamin D?

vitamindtest.org.uk

[maxpoppy2007 in reply to SlowDragon]

Thank you for your reply

I feel so much better since I started self medicating. I am sleeping better, lost 2 stone so back to my normal weight, migraines have reduced, tiredness has reduced and mood is better.

I still suffer with IBS attacks have one at the moment so about to start Symprove probiotics tomorrow.

My TSH previously was 4.9 (0.5 before my op)and was rising and still doctors and edso's refused to treat me. So took matters into my own hands. I wanted to check my results to make sure I am dosing correctly noticed my Free T3 was out of reference so wasnt sure if this was a problem. Think my TSH isnt an issue?

I dont regularly supplement with vitamins - do you think I should?

Havent tested for Vit D, and always ensure I havent dosed before my blood tests and always have am tests. My doctor has been helpful in doing my blood tests , he said he couldnt medicate me as TSH wasnt high enough ! needed to be over 10!, but understood that I was determined to self medicate, so would support with blood monitoring.

[SeasideSusie Remembering]

maxpoppy2007

When was your last dose of NDT before testing?

Taking NDT tends to lower, even suppress TSH and also tends to lower FT4, so when on NDT one would expect to see FT4 lower in range with FT3 in the upper part of the range. Your results look like you may be a bit overmedicated. However, if you took your NDT before the test, rather than last dose being 8-12 hours before test, that would give you a higher FT3.

If you don't supplement with any vitamins then your levels are good. However, you do need to check Vit D as in the UK low Vit D is very common.

[maxpoppy2007 in reply to SeasideSusie]

I wondered if I might be slightly overmedicating lookingat my results, although I do feel fine no tremors or any other hyper symptoms.

I did have a 12 hour gap before the test well just over 12.

[SeasideSusie Remembering in reply to maxpoppy2007]

I did have a 12 hour gap before the test well just over 12.

In that case I would say that you are overmedicated. You may not feel it but some sources say that FT3 should be kept in range, so maybe you could experiment, drop your dose by 1/4 of a grain, retest in 6-8 weeks and see what difference it has made to your results and how you feel. Personally I would want my FT3 into range or maybe just slightly over the top at most. I take Levo plus T3.

[maxpoppy2007 in reply to SeasideSusie]

thank you that is good advice much appreciated

[SlowDragon Administrator in reply to maxpoppy2007]

I would get your vitamin D tested first before changing NDT

If vitamin D is low you may find you don’t need to reduce NDT as vitamin D levels improve with supplements

Also if not on strictly gluten free diet that’s likely next step to try

IBS is frequently gluten related

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...

Have you ever had both TPO and TG Thyroid antibodies tested for hashimoto’s?

[maxpoppy2007 in reply to SlowDragon]

thank you I will check my vit D and try a gluten free diet

never had TPO and TG Thyroid antibodies tested for hashimoto’s

[SlowDragon Administrator in reply to maxpoppy2007]

Hashimoto’s is strongly linked to gluten intolerance

NHS will only test TG antibodies if TPi antibodies are high. Most hashimoto’s patients have high Tpo or high TPO and high TG antibodies. But a significant minority only have high TG antibodies

Testing privately via Medichecks or blue Horizon may be necessary

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

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)