Blood results advice please

[Bunny12345678]

I've just received my results from Blue Horizon, which was amazingly quick. I'd appreciate someone's opinion please.

[SlowDragon Administrator]

There’s nothing on your profile

Do you have Hashimoto’s?

Are you on levothyroxine?

If so, how much

Do you always get same brand of levothyroxine

What vitamin supplements are you currently taking?

[Bunny12345678 in reply to SlowDragon]

I haven't yet been diagnosed with anything, I've been off work since December due to ill health, gp's tried to tell me I have anxiety. I have a strong family history of thyroid disease and seem to have a lot of symptoms that fit. Shortness of breath, pleuritic aches, head fog, palpitations, just feeling so ill.

[SeasideSusie Remembering in reply to Bunny12345678]

Bunny12345678

I have a strong family history of thyroid disease and seem to have a lot of symptoms that fit. Shortness of breath, pleuritic aches, head fog, palpitations,

All those are symptoms of B12 deficiency - see this list:

b12d.org/submit/document?id=46

Print it off, mark everything that is applicable to you, show it to your GP and insist on testing for B12 deficiency/pernicious anaemia. Even though your B12 is in range it is very low and many people with a level in the 300s have been found to need B12 injections. Doctors should go by symptoms not numbers with B12.

Do not start taking a B Complex for your low folate until further testing of B12 has been carried out, it will mask signs of B12 deficiency and skew results.

[Bunny12345678 in reply to SeasideSusie]

Thankyou very much for your advice, I'll study everything that you and SlowDragon have recommended.

[SlowDragon Administrator in reply to Bunny12345678]

Anything happen in last year that might have upset things

Head Trauma or whiplash

Prolonged stress

Menopause

Quit smoking

Started other medication

Gut issues

Ft4 is extremely low

Ft3 low

But TSH is not high

Perhaps looking at central hypothyroidism

Cortisol is also low

Perhaps consider a cortisol and DHEA saliva test

regeneruslabs.com/products/...

cdn.shopify.com/s/files/1/0...

Ask for ultrasound scan of thyroid (or arrange one privately - PM me for info)

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

[Bunny12345678 in reply to SlowDragon]

Thankyou very much, I've had bowel problems since February, to the point I've requested to see a colorectal surgeon. I've asked for a scan on my neck which has finally been requested after numerous times of asking

[SlowDragon Administrator in reply to Bunny12345678]

Well gluten intolerance is extremely common when hypothyroid

Poor gut function seems to be directly linked to low Ft3

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

Presumably GP already done coeliac blood test???

If not

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

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

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

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

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

restartmed.com/hashimotos-g...

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.

Why gluten intolerance can upset cortisol levels

kalishinstitute.com/blog/gl...

[Bunny12345678 in reply to SlowDragon]

Thankyou very much, that's a lot of information crikey...my gp said they've tested me for coeliacs and it was normal..I'm still awaiting copies of my results too

[SlowDragon Administrator in reply to Bunny12345678]

Vast majority of GP’s and endocrinologists would deny gluten intolerance is an issue. This is definitely not the experience of patients

[Bunny12345678 in reply to SlowDragon]

I've started having to look at tests privately because my gp's and cardiologist basically say they might never diagnose me. I have been found to have inappropriate sinus tachycardia this year and had a vit d level of 27 in April, I was given high strength supplements which I haven't taken for about a week now until I got my results. I've seen a private ENT because my tinnitus has increased and is now pulsatile.

[SlowDragon Administrator in reply to Bunny12345678]

Tinnitus often linked to low B12

Low B vitamin symptoms can get worse after starting to correct low vitamin D

Low vitamin D and low B vitamins may be linked as explained here

drgominak.com/sleep/vitamin...

In YouTube video when Dr Gominak talks about vitamin D levels ...vitamin D at 40ng/ml (USA units) is equal to 100nmol (UK units)

youtu.be/74F22bjBmqE(Not working as expected?)

Likely to need ongoing maintenance dose of vitamin D

As you have high thyroid antibodies and symptoms and TSH just nudging top of range ...you could/should be offered trial of levothyroxine

See flow chart top of page 2

gp-update.co.uk/Latest-Upda...

[SlowDragon Administrator]

Vitamin levels are all on low side

B12 is particularly low

Do you have any Low B12 symptoms

b12deficiency.info/signs-an...

Ask GP for full testing for PA before starting any B vitamins

Vitamin D and magnesium are both on low side

Vitamin D

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need,

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Importance of vitamin D for fighting Covid

moxafrica.org/post/the-vita...

Ferritin should be at least half way through range ....so you just scrape through

Thyroid results....depends if you are on levothyroxine or not

[SeasideSusie Remembering]

Bunny12345678

I'm not good with blood cortisol results, but that looks low to me.

Hidden knows a lot about cortisol, hopefully she may pop along with some information.

[Hidden]

Before I can comment on the cortisol result I need to know what time of day it was taken?

[Bunny12345678 in reply to Hidden]

10am prior to eating

[Hidden]

Okay, it is slightly on the low side, but not radically so. It could be affected by the low B12 & Vit D, plus getting your thyroid sorted out as well. Have you lost weight at all? It's best to have cortisol taken between 8-9am to get a more accurate result. You could look at info on adrenal insufficiency to see if you have any of the symptoms.

[Bunny12345678 in reply to Hidden]

I've packed weight on tbh...I'm not eating low calorie but I'm not troughing all day...it doesn't make sense