The results below are from Oct 2016 and the overview was from Medichecks and mentions
Hashimoto’s disease ?
Overview
We note that you are taking this test to diagnose a condition. Your history of hypothyroidism and use of levothyroxine is noted. Your TSH and thyroxine levels are normal indicating an adequate dose of thyroxine. Your FT3/rT3 ratio is low which could suggest that you are not getting sufficient free triiodothyronine (FT3) into your cells. There is currently little scientific research into the FT3/rT3 ratio, but some experts believe that this could lead to symptoms of hypothyroidism (slow metabolism) even though your thyroid hormones are at normal levels. You may wish to discuss these results with your GP although you should note that it may be difficult to get advice and treatment for elevated rT3 or an abnormal ratio through conventional channels. Your thyroid peroxidase antibodies are elevated. This antibody is commonly associated with autoimmune thyroid disease. It is frequently seen in conditions such as Hashimoto’s disease (where the thyroid becomes underactive) but confusingly can also be seen in Grave’s disease (where the thyroid becomes overactive). Your thyroglobulin antibodies are positive. This can be associated with autoimmune thyroid disease and in particular Hashimoto’s disease. If the autoantibody findings are new then they should be discussed with the doctor overseeing your thyroid treatment. You have elevated levels of B12 and folate. If you are taking vitamin B12 or folate supplements then you may want to reduce your intake slightly. Your vitamin D and ferritin levels are normal. Your CRP is normal indicating low levels of inflammation within the body.
Inflammation
CRP HS 0.4 mg/L (Range: < 5)
Iron Status
Ferritin 78.92 ug/L (Range: 20 - 150)
Vitamins
Folate - Serum X 19.18 ug/L (Range: 4.6 - 18.7)
Vitamin B12 X 801.3 pmol/L (Range: 250.001 - 725)
Vitamin D 64.63 nmol/L (Range: 50 - 175)
Thyroid Hormones
TSH 3.15 IU/L (Range: 0.27 - 4.2)
Free T3 3.45 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 15.13 pmol/L (Range: 12 - 22)
Total Thyroxine 88.0 nmol/L (Range: 64.5 - 142)
Reverse T3 22 ng/dL (Range: 10 - 24)
FT3 : rT3 X 10.21 Ratio (Range: > 15)
Autoimmunity
Thyroglobulin Antibodies X 234.500 kU/L (Range: < 115)
Thyroid Peroxidase Antibodies X 496.9 kIU/L (Range: < 34)
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dparr59
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Thyroglobulin Antibodies X 234.500 kU/L (Range: < 115)
Thyroid Peroxidase Antibodies X 496.9 kIU/L (Range: < 34)
Yes, they confirm Hashi's.
You don't really need another test, once you have a positive antibody result that's it, it's Hashi's. Because antibodies fluctuate then results can be different each time they test, and even show within range, but you still have Hashi's. But if you want the vitamins tested again then the cheapest way is to go for the full thyroid/vitamin panel.
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.
By the way, don't waste money on testing reverse T3 again. The test can tell you if it's high but it can't tell you why it's high. There are many causes of rT3, only one of which is to do with thyroid, and that would most likely be shown by high FT4 and low FT3 anyway.
Also:
TSH 3.15 IU/L (Range: 0.27 - 4.2)
Free T3 3.45 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 15.13 pmol/L (Range: 12 - 22)
Those results showed undermedication. The aim of a treated Hypo patient on Levo, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well. An increase in Levo should have been made at that time.
The test was taken because my wifes GP had lowered dose and she had headaches for over 2 months,
Paid for a blood test and saw privately a Dr Hammond and he wrote to the GP and told them to increase the dose from 100 mg to 125mg.
which she has been on for 4 years but lately had a lot indigestion and feeling sick and a bad taste in her mouth , Had look at her stomach gastroscopy (examination of the stomach) looks ok , Now waiting for a CT contrast scan results of throat , pelvis , abdomen to double check for other things
But i Wonder if its all linked to the Hashimoto's ?
She did have a very bad cough ( December 2019 ) that went on for over a few weeks and that might have caused throat problems along with the stomach acid , plus burping afterwards along with the acid taste in her mouth and a tight chest.
If not, get coeliac blood test before trying gF diet
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
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
Most people with hashimoto’s need Ft4 in top third of range and Ft3 at least over 50-60% through range
Always get blood test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Frequently, when adequately treated, TSH will be suppressed.
Helpful calculator for working out percentage through range
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