Advice on test results

[Lubylost]

Hi, Not been diadnosed by my Gp for Hypothyroidism but have had symptoms of both hypo and hyper if thats possible , on and off for 12 years which they said is CFS. I have been quite well for some of it but seem to get triggered by stress and lately as in the last 5 months ive been feeling unwell ...massive fatigue, gut issues, skin rashes, headaches, dizzyness, fuzzy vision, what feels like low blood sugar episodes.

I have discovered I have low ferritin but that has risen over the last 2 weeks since ive been taking Gentle Iron and Spatone from 15 to 45 ug\l (11-150)

So my tests from Medichecks, yes taken early in fasted state.

Inflammation: CRP HS 0.64 mg/L (Range: < 5)

Ferriton 44.8 ug/L (Range: 13 - 150)

Active B12 >150 pmol/L (Range: > 37.5)

Vitamin D 90.5 nmol/L Deficient <30

Insufficient 30 - 50Consider reducing dose >175

(Range: 50 - 175)

TSH 1.92 mIU/L (Range: 0.27 - 4.2)

Free T 34.16 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine *** 11.800 pmol/L (Range: 12 - 22)**

Thyroglobulin Antibodies 66.300 kIU/L (Range: < 115)

Thyroid Peroxidase Antibodies *** 58.2 kIU/L (Range: < 34)***

SoLow T4? and raised TPO?

The anitbodies point to Hashimotos?

Is the low T4 worrying?

Anyadvice so welcomed, thanks

[Lubylost]

PS heres the DRs notes from Medichecks.

Doctor's Overview

Hello L,

Thank you for monitoring your health with Medichecks.

I see you are wishing to investigate some symptoms.

I'm pleased to report you have healthy levels of ferritin, vitamin B12 and vitamin D.

Your thyroid shows that your free thyroxine is slightly low however your thyroid stimulating hormone is normal which suggests a healthy thyroid function. The low thyroxine is likely to be a transient finding and not a cause for concern. Very occasionally it can be an

early sign of a developing underactive thyroid. If you are experiencing symptoms such as weight gain, fatigue and skin/hair changes, I recommend repeating this test in 3 months to review the result and discussing this with your doctor if it continues to be low.

Your thyroid peroxidase autoantibodies are positive.

Up to 25% of people with a normal thyroid function will test positive for thyroid antibodies. The presence of thyroid antibodies does increase the likelihood that they may develop thyroid problems in the future, however many people do not. I suggest monitoring your

thyroid function on an annual basis, or more frequently if you develop new symptoms of an underactive (weight gain, tiredness, cold intolerance) or overactive (weight loss, heat intolerance, tremor) thyroid gland.

In summary this is an overall great set of blood results.

If you are having persistent or troublesome symptoms then I recommend you discuss these in more detail with your GP. I hope this information has been useful.

[SlowDragon Administrator]

Your above range (just) of TPO antibodies confirms autoimmune thyroid disease

Ferritin is rather low

Low iron and/or low ferritin frequently linked to hair loss

Never supplement iron without doing full iron panel test for anaemia first

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

GP unlikely to agree to starting any levothyroxine with low TSH

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists.....even they are unlikely to agree to treat as TSH is low .....

But you could be looking at central hypothyroidism as a TSH is low despite low Ft4

Recommend wearing a Fitbit to record activity levels and resting heart rate

Ultrasound scan of thyroid might be helpful.

Also need folate tested at next test

You might consider trying strictly gluten free diet, helps many with Hashimoto’s .....but coeliac blood test online first just to rule it out

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/signs-symptom...

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private

[e-mail]

[Lubylost in reply to SlowDragon]

Yes ferriitn is low and i am supplementing with Solgars gentl Iorn and Spatone and liver weekly, Gp gave me some perscription iron but would rather use gentler methods.

So despite 12 years of symptoms and high antibodies Gps wont recognise i am hypothyroid and refuse to help because TSH is normal...correct??

Folate normal from GP test, also negative for Coeliac from Gp.

Had ultrasound of thyroid last year, yes I have 2 nodules but the Endo said of no importance.

"But you could be looking at central hypothyroidism as a TSH is low despite low Ft4 "...sorry please can you explain this a little? I thought as raised antibodies it was Hashis?

Many thanks

[SlowDragon Administrator in reply to Lubylost]

Well with Hashimoto’s TSH is especially unreliable because levels hop about so much ...so TSH can simply not reflect how hypothyroid you are

But central hypothyroidism is where the mechanism to raise TSH is not working correctly

Rarely diagnosed....certainly a GP wouldn’t know enough

Link about Central hypothyroidism

academic.oup.com/jcem/artic...

Low or high cortisol can affect levels too

Are you on strictly gluten free diet or tried it?

[Lubylost in reply to SlowDragon]

Not not at all GF......

[Lubylost in reply to Lubylost]

Can one have hashis and central at

the same time then?

[SlowDragon Administrator in reply to Lubylost]

Yes....long time Hashimoto’s....can lead to long slow reduction in metabolism...yet this isn’t reflected in TSH

Medics tend to think TSH is GOD

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

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...

Wearing a Fitbit can be helpful

[Lubylost in reply to SlowDragon]

wow...thanks for all that! So on another forum I am being advised to start self treating with NDT....any thoughts? I am trying to at least get a diagnosis from DR's first but seems impossible.

[SlowDragon Administrator in reply to Lubylost]

I would try optimising all four vitamins FIRST

Ferritin is too low

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Never supplement iron without doing full iron panel test for anaemia first

Also get folate tested

And coeliac test FIRST while still eating high levels of gluten

Thyroid disease is as much about optimising vitamins as thyroid hormones

Trying strictly gluten free diet for 3-6 months

Retesting FULL Thyroid and vitamins in say 2-3 months