I had a blood test on Tuesday and the results back today, the Dr has said no action needed on my thyroid medication, I was expecting for it to increase perhaps as I’ve been having some symptoms worsen recently. I’m currently on 25mg Levothyroxine.
I was diagnosed three years ago with Hashimoto’s and I have been up and down with the meds highest was 100mg daily lowest 25mg. I was settled at this level but feeling off and was hoping it was my thyroid as an easier to identify and treat then finding what else it could be.
Thanks in advance.
Serum TSH level 0.6 mu/L [0.2 - 6.0]
Blood haematinic levels
Serum iron level 10 umol/L [5.0 - 33.0]
Serum transferrin level 2.75 g/L [2.15 - 3.8]
Serum TIBC 63 umol/L [36.0 - 77.0]
Saturation of iron binding capacity 16 % [15.0 - 50.0]
Serum vitamin B12 level 389 ng/L [180.0 - 910.0]
Serum folate level 7.27 ng/mL [> 5.4]
Serum ferritin level 30.0 ug/L [10.0 - 291.0]
Blood haematinic levels Note. Borderline low iron, although ferritin and Hb remain within
normal limits suggests recent mild iron deficiency.
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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 do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Vitamin B12, folate and ferritin levels are all low...likely due to being on extremely low dose levothyroxine
What vitamin supplements are you currently taking?
Are you on 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 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, or buy test online BEFORE trying strictly gluten free diet
Assuming test is negative you can immediately go on strictly gluten free diet
If coeliac test is positive you will need to remain on high gluten diet until endoscopy, with 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
Well your TSH is nice and low, but we don't have free T4 and free T3 results, and these are arguably more important. Do you have blood results for vit B12 and D? As you suggest, 25 mcg of levo [assume you mean micrograms] is a very small dose - what hypo symptoms do you have?
I have old symptoms pre meds basically resurfacing and worse than usual, a cloudy brain, terrible heavy periods, dry skin and hair, Feeling ridiculously cold even in the recent warmer weather.
I also noticed that I’m tired earlier in the day than usual a kind of heavy limbed tiredness not exactly a brain tiredness if you see what I mean.
I shall wait and go back to Dr and ask for the T4 & Free T3 testing. No but D testing but the B12 was above
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.
Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit.
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
Serum iron: 55 to 70% of the range, higher end for men - yours is 17.86%
Saturation: optimal is 35 to 45%, higher end for men - yours is 16%
TIBC: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is at the higher end of range
Ferritin: Low level virtually always indicates need for iron supplementation - yours is 7.12% through range
Your results seem to suggest iron deficiency and you would need a full blood count to see if it's anaemia.
Serum vitamin B12 level 389 ng/L [180.0 - 910.0]
Your B12 would be better higher in range. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Serum folate level 7.27 ng/mL [> 5.4]
Folate, although over the low limit, is quite low, it would be better in double figures.
A good, bioavailable B Complex will help raise both B12 and folate. Consider Thorne Basic B or Igennus Super B. When having any blood tests (including thyroid) always leave off B Complex for 7 days before testing, this is because it contains Biotin and most labs use Biotin in the testing procedure and it can give false results if you take Biotin as a supplement.
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Blood Test Results
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Blood results in. Can anyone help please?
Help with test results
Ferritin blood test result
