Latest Results: Hi, I had some missing results... - Thyroid UK

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Molly139 profile image
19 Replies

Hi, I had some missing results from Thriva so I did another test. Please see my results attached. I’m a bit worried about the abnormal ranges. Please can you help? Previous results that are not on today’s results are below from my test done 8.7.20. I don’t know why Thriva missed these off today’s results!

Vitamin D 43 (75-175) Low

Ferritin 194 (13-150) High

Folate 15.2 (8.83-60.8)

Thank you x

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Molly139 profile image
Molly139
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SlowDragon profile image
SlowDragonAdministrator

So your high thyroid antibodies confirms autoimmune thyroid disease also called hashimoto’s

Presumably you knew you had Hashimoto’s?

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 did this test ?

Your conversion of Ft4 to Ft3 is very poor

Ft3 is only 35% through range

But Ft4 is over range

Improving low vitamin levels can improve conversion

Vitamin D needs improving to at least around 80nmol and around 100nmol maybe better

Molly139 profile image
Molly139 in reply toSlowDragon

Hello again slow dragon 😄 I did NOT know I had Hashimoto! I need to google as I have no idea what it is.

Do you think this is why I’ve been feeling so poorly for the past couple of years? had 2 visits to A&E lots of doctors appointments and 2 emergency GP appointments.

Yes I fasted for more than 8 hours and my last dose of thyroxine was 24 hours prior to bloods x

SlowDragon profile image
SlowDragonAdministrator in reply toMolly139

Well medics tend to dismiss the autoimmune aspect as they have nothing specific to offer for treatment

Only levothyroxine to treat the subsequent hypothyroidism

However...there’s much we can do to help improve symptoms ourselves

Principally getting all four vitamins optimal as first step

Folate looks reasonable and B12 high

Are you supplementing any B vitamins?

Ferritin is often high due to inflammation of Hashimoto’s

GP could/should do full iron panel test to check if iron is also low

Iron and ferritin are complex. Iron can be low even if ferritin is high

Molly139 profile image
Molly139 in reply toSlowDragon

My GP now tells me he cannot interpret the tests that he has not decided to do. I will need to either have NHS bloods and follow up or private bloods and follow up.

I didn't reduce levothyroxine to 100mcg from 125mcg as suggested by GP as my Thriva test was incomplete and did another one on 21.7.20.

Lora7again profile image
Lora7again in reply toMolly139

My GP would not accept my Medicheck results and insisted on using the NHS lab where they only test the TSH. I did however manage to get him to put my high antibodies of 4000 on my GP records. He did say that antibodies are not used to diagnose thyroid disease and that is why he refused to give me any treatment because my TSH was within NHS guidelines. I showed him my hair that had dropped out for the last week and my nails that were lifting off their beds but he was only interested in the TSH blood test. I then decided to self medicate because he refused to help.

SlowDragon profile image
SlowDragonAdministrator in reply toMolly139

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)

You do NOT need any obvious gut symptoms

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

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.

Molly139 profile image
Molly139 in reply toSlowDragon

Ok so I’ve just sent my recent results to the GP who should get back to me today.

From my previous results (no antibodies tested) he told me to drop from 125mcg to 100mcg. I kept taking 125mcg until I did the second test.

What dose would you advise now? Thanks

fuchsia-pink profile image
fuchsia-pink in reply toMolly139

There are LOTS of posts about Hashi's - see "topics" on the right. Not all hypos have it, but it's the single biggest cause. - so very common.

And greygoose gives a very good description of what it involves and may pop along later to explain further.

SlowDragon profile image
SlowDragonAdministrator

Low vitamin D obviously needs improving and GP should prescribe 1600iu everyday for 6 months

However it’s probably easier to self supplement vitamin D yourself

GP will often only prescribe vitamin D 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, with hashimoto’s we frequently need higher dose than average

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...

All Patients with autoimmune thyroid disease should have vitamin D tested annually ...but many GP’s are reluctant to do so

ncbi.nlm.nih.gov/pubmed/286...

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.

endocrine-abstracts.org/ea/...

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.

Molly139 profile image
Molly139 in reply toSlowDragon

Thank you 🙏thanks to all of you. This is the start for me and I’ll probably need your help again x

SlowDragon profile image
SlowDragonAdministrator in reply toMolly139

Keep reading posts every day...learn as much as possible about Hashimoto’s

Molly139 profile image
Molly139 in reply toSlowDragon

Hi SD, my doctor has all my results, and yesterday wanted to see me. Following this he’s took lots of notes and is going to get back to me. The only issue that was addressed was my low vitamin D (and that was because I brought it up!). He’s told me to take 2 12.5mcg daily which I started yesterday, is this OK?

greygoose profile image
greygoose

A brief description of Hashi's:

OK, so Hashi's is an autoimmune disease, where the immune system attacks and slowly destroys the thyroid. It is diagnosed by testing Thyroid Peroxidase (TPO) antibodies and Thyroglobulin (Tg) antibodies.

Contrary to popular belief, it is not the TPO/Tg antibodies themselves that attack the thyroid:

"When lymphocytes infiltrate the thyroid gland, mistakenly taking it for a foreign bacteria invader, they damage the thyroid gland and release thyroid peroxidase &/or thyroglobulin into the blood stream. These don't belong outside of the thyroid gland so antibodies are developed to mop them up.

The antibodies are a result of the attack on the thyroid gland, the antibodies don't cause the attack."

thyroiduk.org.uk/tuk/about_...

After every immune system attack on the thyroid, the dying cells release their stock of thyroid hormone into the blood stream, causing the levels of the Frees to shoot up - FT4 to around 30 something, FT3 around 11/12 - and the TSH therefore drops to suppressed.

There is no knowing how long these high levels will persist, but eventually, they will drop by themselves as the excess hormone is used up or excreted, and not only will you become hypo again, but slightly more hypo than before, because there is now less thyroid to make hormone.

(NB: A Hashi's 'hyper' swing is not true hyperthyroidism in that your thyroid is over-producing thyroid hormone. It's physically impossible to 'go hyper' if you are basically hypo. The thyroid cannot regenerate itself to the point of over production of hormones - or even normal production. Very few doctors appear to know that.)

Therefore, it's very important that your doctor does not reduce your prescription, because you’re going to need it again! If you start to feel over-medicated at that point - some do, some don't - the best thing is to stop levo for a few days, then, when you feel hypo again, start taking it again. It's very important to know one's body, and how it reacts.

There is no cure for Hashi's - which is probably one of the reasons that doctors ignore it - apart from the fact that they know nothing about it, of course!

However, between the 'hyper' swing, and the descent back into hypothyroidism, there can be a phase - quite a long one, sometimes - of normality, where the person is neither hypo nor 'hyper'. This is where people sometimes start talking of having 'cured' their Hashi's, by whatever means. But, it doesn't last. Eventually, you will go hypo again.

But, there are things the patient can try for him/herself to help them feel a bit better:

a) adopt a 100% gluten-free diet. Hashi's people are often sensitive to gluten, even if they don't have Coeliac disease, so stopping it can make them feel much better. Worth a try. Some say that going gluten-free will reduce antibodies – I’ve never seen conclusive proof of that, but, you should be aware that even if you were to get rid of the antibodies completely, you would still have Hashi's, because the antibodies are not the disease. It is not the TPO/Tg antibodies that do the attacking.

b) take selenium. This is not only reputed to reduce antibodies, but can also help with conversion of T4 to T3 - something that Hashi's people often find difficult.

c) the best way to even out the swings from hypo to 'hyper' (often called Hashi's Flares, but that doesn't really sum up the way it works) is to keep the TSH suppressed. This is difficult because doctors are terrified of a suppressed TSH, for various false reasons, and because they don't understand the workings of Hashi's. But, TSH - Thyroid Stimulating Hormone (a pituitary hormone) - tries to stimulate the thyroid to make more hormone, which also stimulates the immune system to attack. So, the less gland activity there is, the less immune system activity there will be, meaning less attacks, gland destruction slowed down and less swinging from hypo to hyper and back.

in reply togreygoose

I just joined this forum tonight after a Thriva blood test. I've had Hashi's for 14 years and read up a fair bit on it, but I honestly think that might just have been the best advice I've ever seen.

This is the first time that I'm looking at my antibodies and seeing if going gluten free might reduce them a bit. The medication seems to be doing the job, as everything is in range, but I've had a lot of joint pain and IBS symptoms in the last six months.

greygoose profile image
greygoose in reply to

Have you had your vit D tested? Low vit d can cause joint pain. I doubt the antibodies are responsible for your symptoms, but gluten could be. So, it would be a good idea to try gluten-free to ease your symptoms. :)

in reply togreygoose

Not recently, but they were okay in December. I take the Better You spray and have been doing so for a few years. I have had low iron recently, I only found out when I went to give blood and was refused. I was surprised, as my iron levels have always been very good and I have an iron and VitC rich diet. I had been having digestive problems, so I wonder if the two things are related.

Anyway, when I get my next Thriva test done, I have added B12, Vit D, iron and liver function, as well as thyroid.

greygoose profile image
greygoose in reply to

Don't forget folate! You need to test that as well.

Yes, digestive problems and Hashi's go hand in hand. Hypothyroidism causes low stomach acid, which means you cannot digest your food properly and absorb the nutrients. And, you're not what you eat, you're what you absorb. So, that needs working on.

Also, if you are taking vit D, you need to take magnesium, as the two work together. Vit D probably won't do you much good if your magnesium is low - and most people do have low magnesium because soils are depleted.

And, with vit D, you need to take vit K2-MK7 - if it's not included in the spray - because taking vit D increases absorption of calcium from food, and the K2 makes sure it goes into the teeth and bones, rather than building up in the soft tissues.

in reply togreygoose

Ah, yes folate! I take a magnesium spray that is external, but I've been quite bad at remembering to do it and my VitD spray has K2 in it too - I thought it was worth the extra few £s, although I didn't realise that about calcium. Vitamins are so complex!

greygoose profile image
greygoose in reply to

Oh, they are indeed! :)

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