Help interpreting results

[Khr-17]

Hi everyone,

I am hoping someone can help. I have been following the Thyroid board for almost a year and have found it really helpful.

In July 2019 I was diagnosed with subclinical hypothyroidism. My TSH at that time was 11.26 mU/L (0.30-4.20) and serum T4 10.5pmol/L (9.0-23). The diagnosis came about as I have been struggling to conceive a second child. After pushing my GP I later found out I had elevated Thyroid Peroxidase Antibodies at a level of 300 IU/L (0-75) indicating Hashimotos.

I am currently on 100mg levothyroxine and I have completely removed gluten from my diet. In terms of supplements, I am taking 50mg Zinc, B Complex, weekly 25,000 IU D3 booster, Methylfolate and BioKult Probiotic.

I recently did a Medichecks blood test for the first time as my GP still insists on testing TSH only. Test taken first thing in the morning before medication and several days after stopping biotin (contained in B complex).

TSH - 0.575 mIU/L (0.27 - 4.2)

Free T3 - 4.35 pmol/L (3.1 - 6.8)

Free Thyroxine - 20 pmol/L (12 - 22)

Thyroglobulin Antibodies - 169 kIU/L < 115

Thyroid Peroxidase Antibodies - 369 kIU/L < 34

I have been trying to work out if I am converting T4 to T3 at an optimal range. Can someone help me on this?

Also I was disheartened my TPO has increased albeit not massively. I am not naive and was not expecting miracles but really hoped it would have reduced slightly as I have tried to reduce inflammation by removing gluten, reducing dairy, refined sugar and so on. I fear this could be the reason I am still struggling to conceive. I would really appreciate some advice.

I also recently did the Genova Adrenal Fatigue test and waiting on results on this.

I hope I have given enough detail, please let me know if not.

[fuchsia-pink]

Your doctor will probably say that your results are now perfect, as your TSH is much lower and free T4 and free T3 are in range, But while your free T4 is nice and high (80% through range) your free T3 is lagging somewhat at 33.8% through range, and this indicates that you don't convert very well.

So if you haven't already got it, I would email Dionne at Thyroid UK - tukadmin@thyroiduk/org for the list of T3-friendly endos, and put up a new post asking if anyone can recommend an endo near where you live - and see if you can have a trial of lio. Your GP may be happy to refer you to a consultant who can address conception issues with hypothyroidism anyway. You don't have to see the nearest person to you geographically, but it needs to be someone reasonably convenient.

Finally, don't worry about your antibodies going up and down - that's just what they do if you have Hashis. You can't "cure" it, just be aware of it, and by going gluten-free you have probably helped

Good luck x

[Khr-17 in reply to fuchsia-pink]

Thank you Fushsia-pink. I am really keen to see an Endo now as I feel my GP is no longer concerned with regards my thyroid. I am having further fertility tests later this month as we are now at 18 months of trying without success.

K x

[SeasideSusie Remembering]

Khr-17

Why you were originally diagnosed with subclinical hypothyroidism with a TSH of 11.26 is beyond me, that is overt hypothyroidism, as in anything over 10. And, of course, your raised antibodies tell you that the cause of your hypothyroidism is autoimmune.

As you take a B Complex, this will contain Biotin. Did you leave this off for 7 days before doing this test? Biotin is used in the testing procedure at most labs (including Medichecks) and when we take Biotin as well this can give false results for any blood test.

Your B Complex will also contain either methylfolate or folic acid. Why are you also taking a separate methylfolate supplement?

I have been trying to work out if I am converting T4 to T3 at an optimal range. Can someone help me on this?

Your conversion isn't that good.

Free T3 - 4.35 pmol/L (3.1 - 6.8) = 33.78% through range

Free Thyroxine - 20 pmol/L (12 - 22) = 80% through range

They should be more or less in balance when you convert well.

Optimal nutrient levels are needed for good conversion - did you have Vit D, B12, Folate and Ferritin tested?

Supplementing with selenium l-selenomethionine, or a yeast-bound selenium, can help with conversion.

[Khr-17 in reply to SeasideSusie]

Thank you SeasideSusie.

I had also read that about overt hypothyroidism being over 10. Another GP in the practice asked why I wanted my TPO checked as there was no point as I was now being 'treated'. At that time they wouldn't refer me to an Endo but my husband and I have decided to pay for one privately.

I stopped taking the biotin several days before doing my medichecks test. With regards folate, I may be taking too much. I read somewhere that methylfolate was easier for the body to absorb.

Vit D, B12, Folate and Ferritin tested - I have some further fertility tests coming up at the end of June and beginning of July so these should be tested then. When they were lasted tested the results in Nov 2019 were as follows

Vit D - 55.4 mnol/L (70-150) - abnormal hence the weekly D3 booster

Serum Ferritin - 22 ug/L (10-120) - in range but very low

Serum B12 - 271 ng/L (160-800)

Serum Folate - 6.1ug/L (>2.7)

I am due to run out of my D3 booster and the GP said I can buy a D3 supplement over the counter going forward, do you have one you recommend?

[SeasideSusie Remembering in reply to Khr-17]

Khr-17

I am due to run out of my D3 booster and the GP said I can buy a D3 supplement over the counter going forward, do you have one you recommend?

You would need to test after your last booster from the GP. Your follow on dose will be based on your new result. GP probably wont test but you can do one with an NHS lab that does this for the general public:

vitamindtest.org.uk/

You are aiming for 100-150nmol/L which is the range recommended by the Vit D Council/Vit D Society.

As for the others, they're certainly not optimal. See what the new levels are when tested, post on here for comment.