Last thyroxine was 25hrs before bloods and I only drank water. Blue Horizon:- Blood drawn 9:35am...Phlebotamist 11am. Only had water before both tests. I take Igennus Super B Complex and Vegavero K2 + D3 Spray and 25,000 iu's of InvitaD3 every 4 weeks (invitaD3 prescribed by Dr about a year ago). I've only had B complex plus K2/D3 spray since Weds 13/05/20 that's when I received them through post. I've never been on any diet in my life....I don't gain weight though. During pandemic and relying on 'online deliveries from Supermarket' not sure how to start with gluten free...thank you for knowledge/reply
“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”
“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”
TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.
Previous post has detailed advice on how to improve low vitamin levels
high antibodies Confirms cause of your hypothyroidism is due to autoimmune thyroid disease also called Hashimoto's, (Only usually known by medics here in UK as autoimmune thyroid disease).
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. Dairy is second most common.
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)
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 gluten free diet for 3-6 months. If no noticeable improvement then 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
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Just an inability to tolerate increasing levothyroxine, low vitamin levels, joint pain, brain fog , anxiety, insomnia, rashes/blisters on feet, elbows, around mouth
More Classic symptoms are irritable bowel, diarrhoea, constipation, weight loss, fatigue
Majority of Hashimoto’s patients are gluten intolerant rather than coeliac....result is same ...strictly gluten free diet helps thousands of patients
Spend a week or two considering what you would eat instead at every meal option
Very important to get coeliac blood test while still eating high levels of gluten
Once you get results....assuming coeliac test is negative you can immediately try gluten free
There’s zero point being “almost“ gluten free
To be effective gluten free diet must be absolutely strictly gluten free
Some gluten free bread is pretty good, especially toasted (in a separate designated gluten free toaster - or coeliac uk sell toaster pouch you can use in a standard toaster)
Read all food labels carefully...though these days lots of things like certain sausages are labelled gluten free
M&S very good, lots of their ready meals are gluten free.
I have had 2 flexible sigmoidoscopies in the past year due to pain in lower left groin and blood in stool. Result was polyps and haemmoroids. In Feb 2020 I was told I had 'diverticular disease' but not diverticulitis
Looking at previous posts you are currently only taking 200mcg levothyroxine per WEEK....that’s only 28mcg per day
Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).
Bloods should be retested 6-8 weeks after each dose increase
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
I take 50mcg levothyroxine on alternate days. The reason is on the day I take them I have (after approx 1-2 hours) diahorreah/agitation/very tired....go toilet at least 10 times...!! Started on Actavis, tried Teva, Eltroxin (former 2 yellow rash around mouth, felt like lump in throat, I carried out some research as my Endo told me I'm allergic to fillers....I bought Tirosint from Switzerland (local pharmacy ordered it for me) at a cost of £150 for 50 gel capsules. Very unfortunately they made my heart palpitate into my throat plus pulse went far too high (another nasty experience) so still have 47 left!! They are 25mcg but I'm hanging on to them maybe try again in future. Difficult to explain but on occasion I haven't taken any for approx 3 weeks and have felt better in myself after a few days, also there is very little difference in TSH/FT4 after abstaining for 3 weeks...Doesn't make sense. However, my Sister has been on levothyroxine for approx 25 years and takes 125mcg daily and she varies from hypo to hyper...She also warns me the impact of not taking levo...e.g. affects all major organs etc ..unfortunately we live over 200 miles apart so only phone/text...
Today, I have received a letter from Endo saying to take 50mcg one day, 25mcg the next day and so forth....He obviously doesn't know Actavis (now called Accord) don't make 25mcg and I cannot take Eltroxin Teva Wockhardt arrrgh. I only have a cup of tea and a slice of toast 2 hours after taking levo oh and only for last few days Super B Complex with it
I've tried Eltroxin, Teva, Wockhardt and Tirosint....1st 3 not good...give me rashes lump in throat and worse diahorreah (endo tells me I'm allergic to the fillers/excipients in them). He also said he's had minimal other cases like me and must start off with low dose and only build up very very slowly..Tirosint (which I had to pay for £3 per gel capsule 25mcg did not give me rashes nor diahorreah but made my heart palpitate up into my throat, pulse very rapid etc etc) was scary.. I was only diagnosed with hypothyroidism 8 years ago within weeks/Months of periods ceasing. I have read up on hypo in past year but always get conflicting reports...e.g. People over 60 have longer longevity if TSH is higher than 'the norm' on ncbh website etc..sorry to waffle but just agitated/frustrated
Allowing for time difference and that nothing is static, you expect some fluctuation:
TSH
BH: 6.08 (0.27-4.20) mIU/L
Phlebotomist: 4.75 miu/L (0.27 - 4.2)
TSH is highest early morning and lowers throughout the day. You'd expect a higher TSH at 9.35am and that it would be lower at 11am. See graph of daily rhythm of thyroid hormones here:
BH: 4.27 (3.1-6.8) pmol/L (they putnormal for this) - Yes it is within range so they will say normal
Phlebotomist: 3.8 (3.1-6.8)
There is a small difference of 0.47 so I would say they're close enough if you take natural fluctuation of hormone levels into account, again check the graph linked to above.
FT4
BH: 11.9 (12.0-22.0) pmol/L
Phlebotomist:12.4pmol/L (12-22)
These results are within 0.5 of each other so minimally different.
As FT4 has a long half life of 7 days, compared to FT3 which is much more quick acting, I think the difference in your FT4 and FT3 results are within acceptable limits and not unexpected.
B12
BH: 266
Phlebotomist: 359 (180-914)
You haven't given a range for BH's result.
Also, there are different units of measurement for this Total B12 test - pmol/L, ng/L and pg/ml. They would have to be the same unit of measurement to compare the result. Do you have this unit of measurement for both tests?
Folate
BH: 17.80 (8.83-60.8) Normal?? - again they're saying normal because it's within range.
Phlebotomist: 8.9 (3.0-20.0)
Here we have two vastly different ranges so you can't compare the numbers, you have to work out the percentage through range and compare that.
BH result is 17.26% through range.
Phlebotomist result is 34.71% through range
This can't be explained, maybe ask BH why there is such a difference.
They use the same labs to process the tests - County Pathology, The Doctor's Laboratory, possibly others, those are the two that I've had my tests come back from with both Medichecks and BH.
TSH 4.75 miu/L (0.27 - 4.2) To high, should be around 1 or under.
T4 level 12.4pmol/L (12-22) Much too low, only 4% through the range.
Ft3 3.8 (3.1-6.8) 18.92% through the range, should be at least mid-range.
Blue Horizon:
TSH HIGH 6.08 (0.27-4.20) mIU/L Higher result than the local lab, but the time difference could account for this. TSH is highest early morning and drops throughout the day.
Free T4Low 11.9 (12.0-22.0) pmol/ Below range, but not much difference from the local lab - not enough to be significant, anyway.
Free T3 4.27 (3.1-6.8) Once again, slightly higher than local lab - 31.62% - but, once again, the time difference could possibly account for that. You can only really compare results if the blood is drawn for both at the same time.
So, I'll get back to this, later. I've forgotten what the question is, and I've got to cook dinner!
And, I would say: not at this point, no. You cannot tell how well you convert until you get your FT4 higher. At the moment you are under-medicated - TSH much too high. When that gets down to 1 or under, then you will get a better idea how well you convert, and whether you need T3 added to your levo.
Your FT4 is much, much too low at the moment - on both tests. But, your doctors are just showing their ignorance when they say you don't need T3, because they cannot possibly know at this point. So, I wouldn't take much notice of them, just keep an open mind.
Thank you for interpreting the Results. What you say makes sense. At the moment I take 50mcg on alternate days (200mcg a week). I'll start taking 50mcg 1 day, 25mcg 2nd day and so forth for 6 weeks then have retest. That means I would be taking an extra 75mcg per week. From past experience upping the dose will no doubt have several side effects akin to Hyper.....but needs must so I'll try aforementioned. It should hopefully balance things out 'a little'. Depending on results in 6 weeks I will probably try 50mcg Daily and build up slowly. Hopefully, when the selenium and Magnesium arrives this week that may possibly help also.
I much appreciate your knowledge and advice as always. Hope you enjoyed the Sun and Dinner etc...
Sure thing. I leave 2 hour gap after levo to take B complex, can selenium be taken with B complex...Magnesium I ordered is body spray type to save me popping another pill
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Blood results back from Blue Horizon. Advice required on what to say to GP!
Back with test results, please advise!
Latest Test Results - Where do I go from here?
