Blood results

[Carrie97]

Had private bloods done as I’m feeling a bit iffy.. currently on 175mcg thyroxine, I have hashi since 2007. Now I’m baffled.

[SlowDragon Administrator]

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

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 this test?

Ft4 is 80% through range

Ft3 only 37% through range

Assuming you didn’t take Levo before test you are very poor converter

Likely low vitamin levels

[tamina786]

R u on t3 as well or only levothyroxine

[greygoose]

Why are you baffled?

[Carrie97 in reply to greygoose]

Cause they look ok although my tsh is always 0.01 but I’m having all my usual issues that tell me something is up.

[greygoose in reply to Carrie97]

Your TSH isn't 0.01 there. It's rather a little too high, actually. But, then, you FT3 is low, because you're a poor converter. I wouldn't say your results look ok at all.

[SlowDragon Administrator in reply to Carrie97]

That’s what happens with poor conversion

High Ft4 lowers a TSH

But you feel and are hypothyroid because Ft3 is low

When were vitamin levels last tested?

What supplements do you take?

Do you have Hashimoto’s?

Ask GP to test vitamin D, folate, ferritin and B12

Or test via Medichecks

Have you had thyroid antibodies tested?

[Carrie97 in reply to SlowDragon]

All vitamins etc are normal, yes I’ve hashimotos. I’ve been on Levo for 13 years and I’ve never really felt well. Surely there’s something else I can try?

[SlowDragon Administrator in reply to Carrie97]

Can you add the actual results and ranges

First step is to make sure all vitamins are optimal and keep them optimal

Optimal vitamin levels are

Vitamin D at least over 80nmol and around 100nmol may be better

Folate at least over ten

B12 at least over 500

Ferritin at least half way through range (usually that’s a result over 70)

Have you ever had thyroid antibodies tested?

Do you know if the cause of your hypothyroidism is due to autoimmune thyroid disease, also called Hashimoto’s?

If you do have Hashimoto’s ....Are you on strictly gluten free diet?

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

Low vitamin levels affect Thyroid hormone working

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

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to 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 strictly gluten free diet for 3-6 months

If no noticeable improvement, 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...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

[Carrie97]

No just levothyroxine