I have received my first thyroid results back from Medichecks. Can someone let me know if this is good or there is room for improvement. I have been feeling fine, just slightly tired and have problems with bloating. I am on 150mg levothyroxine taking alums brand. Thank you 😊
My results:
TSH - 0.119 mlU/L (0.27-4.2)
Free T3 - 4.79 pmol/L (3.1-6.8)
Free thyroxine - 21.9 pmol/L (12-22)
Thyroglobulin antibodies - 76.6 klU/L (<115)
Thyroid Peroxidase antibodies - 200 klU/L (<34)
CRP HS - 1.91 mg/L (<5)
Ferritin - 21.1 ug/L (13-150)
Vitamin B12 active - 68.8 pmol/L (>37.5)
Vitamin D - 51.5 nmol/L (50-175)
Folate serum - sample error
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This is very low. Ferritin is recommended to be half way through range (although your GP will be happy with it anywhere within range). It's low enough to suggest possible iron deficiency anaemia, a full blood count and iron panel is needed to see if there are any problems there before deciding whether an iron supplement is necessary or to just try and raise ferritin with diet.
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Vitamin B12 active - 68.8 pmol/L (>37.5)
A bit low as their range is actually 37.5-188 and anything below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
Reference range:>70. *Between 25-70 referred for MMA
However, it's not dire and it's possible a good, bioavailable B Complex will be enough to raise your level. Consider Thorne Basic B or Igennus Super B.
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Folate serum - sample error
Hopefully they're sending another kit to test this? If it comes back below range then you should discuss it with your GP as he may prescribe folic acid, otherwise the B Complex will take care of any low level.
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Vitamin D - 51.5 nmol/L (50-175)
This is low. The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L. To reach that level from your current level the Vit D Council suggests supplementing with 4,000iu D3 daily.
Retest after 3 months.
Once you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3 as recommended by the Vit D Council.
D3 aids absorption of calcium from food and Vit 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 D3 as 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 magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
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Thyroglobulin antibodies - 76.6 klU/L (<115)
Thyroid Peroxidase antibodies - 200 klU/L (<34)
Your raised TPO antibodies suggest that you are positive for autoimmune thyroid disease aka Hashimoto's which is where the thyroid is attacked and gradually destroyed.
Fluctuations in symptoms and test results are common with Hashi's.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies and this could be the reason why yours are low.
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TSH - 0.119 mlU/L (0.27-4.2)
Free T3 - 4.79 pmol/L (3.1-6.8)
Free thyroxine - 21.9 pmol/L (12-22)
When doing thyroid tests, we advise:
* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).
[These are patient to patient tips which we don't discuss with doctors or phlebotomists.]
Did you do your test this way?
If you took your last dose of Levo too close to the blood draw then you have a false high FT4.
If you took your last dose of Levo 24 hours before blood draw then your FT4 is 99% through range with FT3 only 45.65% through range. This indicates that conversion of T4 to T3 could be better. Optimal nutrient levels are essential for thyroid hormone to work properly and good conversion of T4 to T3, in which case you should work on your nutrient levels, maybe retest in 3-4 months to see what levels are like then and see if it has improved conversion.
Thank you so much for such a thorough explanation. I did the check as suggested without taking supplements and Levo 24 hours prior, took the test first things in the morning. I have started to adopt the gluten free diet. I am having gut problems so hence deficiency in vitamins. My GP is useless as they don’t care about other symptoms and how things can be related.
Have you noticed any improvement in gut since gluten free...or too soon to tell?
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
Ideally ....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
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
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
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