Thank you for all your help so far with my daughters suspected thyroid problem & severe acne. We have just had the results from Medichecks & the Dr has written as follows:
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.
If you take medication for an underactive thyroid gland the fact that your TSH is normal means that your dose is likely to be appropriate.
Your thyroid peroxidase antibodies are elevated. This antibody is commonly associated with autoimmune thyroid disease. It is frequently seen in conditions such as Hashimoto’s disease (where the thyroid becomes underactive) but confusingly can also be seen in Grave’s disease (where the thyroid becomes overactive.
Do you think this report warrants a visit to the GP & If my daughter presents the numbers & report to him is he likely to take any notice? She doesnt take any medication at present for thyroid & her free thyroxine has been low for over a year but GP hasnt been concerned about it.
Also as my daughter is lacto intolerant is there such a thing as lacto free levothyroxine or something similar?
Thank you so much in advance.
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Irismay
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Did she have the full thyroid/vitamin panel as advised in response to your previous post?
Can you post all results, including reference ranges plus units of measurement for Vit D and B12.
In your post of a couple of weeks ago, it was mentioned that her Folate and ferritin were very low, plus B12 was on the low side. Has anything been done about these?
This is fine, it's an inflammation marker and it's nice and low.
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Ferritin - 20.9 range 13-150
This is dreadful, as mentioned in previous post. GP should do an iron panel and full blood count. Iron panel will show if there is iron deficiency, full blood count will show if there is anaemia.
Ferritin is recommended to be half way through range.
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Active B12 - 79.9 range >37.5
This is just about OK. Below 70 suggests B12 deficiency. Could do with boosting, over 100 would be much better. A good B Complex such as Thorne Basic B or Igennus Super B will help.
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Vit D - 55.3 range 50-175
This is far too low. The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L.
To reach the recommended level from her current level, based on the Vit D Council's suggestions she could supplement with 4,000iu D3 daily.
Retest after 3 months.
Once she's reached the recommended level then she'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. She can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3 as recommended by the Vit D Council.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
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TSH 1.9 range 0.27-4.2
Free T3 - 4.41 range 3.1-6.8
Free thyroxine - 11.2 range 12-22
Thyroglobulin antibodies 22.4 range <115
Thyroid peroxidase 132 range <34
Her raised thyroid peroxidase antibodies suggest autoimmune thyroid disease (know to patients as Hashimoto's) which is where the immune system attacks and gradually destroys the thyroid.
Normally an enlightened doctor would diagnose and prescribe Levo for Hashi's when TSH is over range with raised antibodies. Her TSH is within range but her FT4 is below range and this should be pointed out to the GP and a prescription for Levo requested.
Some information about Hashi's:
Fluctuations in symptoms and test results are common with Hashi's.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies so possibly the reason for her poor results.
Wow thank you so much for that wonderful in depth report. We will study this & start supplementing bit by bit as you suggest.
Katy will make an appt to see GP to get appropriate levo treatment. I hope she can get a fbc to check her iron but some GPs dont like being asked to do things no matter how nicely you put it!
She is gluten & dairy free already so its good to know that is a positive thing.
I cant thank you enough for your fantastic help with this - I had no idea it was so complicated.
Sorry to trouble you. I am writing regarding previous post about my daughter Katy to which you gave us excellent advice which we are working through.
Regarding the supplement magnesium citrate - are you able to advise the daily amount she should be taking? We cant seem to find an answer.
Katy saw a private endo today who is going to carry out a full hormone profile. He also said she has an enlarged thyroid & has prescribed levothyroxine.
Thanks to your advice we have started introducing the supplements you have suggested with a couple of weeks between. We are a bit at a loss for the amount of magnesium citrate needed.
I take it that magnesium citrate was the form best suited to her needs, i.e. it's usually most suitable for people who suffer with constipation.
The pack usually suggests the dose, most magnesium doses are between 350 and 450mg.
I take magnesium citrate and use Natural Calm Original powder, I started low and built up to the dose needed to give a comfortable BM daily. I find this better than taking a tablet or capsule with a fixed dose which may not be enough or could even be too much, and too much mag citrate will cause diarrhoea.
Yes that's what she thinks is best for her - she does suffer badly with constipation. Can I ask what brand you use? Also is natural calm original powder readily available- I have never heard of it.
This is where I usually buy mine although they have no stock at the moment (they are usually the cheapest and offer discounts for a multibuy so I always order 2 at a time and cost just less than £29 each)
There are flavoured versions buy I don't buy them because I want a pure product, no additives.
There are other sellers but be careful and look at the weight. The ones I buy are 453g per pack and other sellers are charging between £23 and £29 for a 226g pack. You can find it on Ebay and Amazon. powerbody.co.uk is another one who sells at a reasonable price but again they are out of stock. It is a supplement from the US and I think the pandemic has affected supply of a lot of supplements from there.
I dissolve the powder in a little warm water then add some orange juice, it makes quite a pleasant little drink and, as I said, you use as much or as little as you need.
Can see SeasideSusie given you excellent vitamin advice already
Ferritin is terrible and vitamin D too low
No folate test
Clearly your daughter needs starting on levothyroxine...her Ft4 is BELOW RANGE
(Medichecks Doctor needs to go to Specsavers)
But Medics are TSH obsessed ....that’s all they look at
Getting vitamin levels optimal is first step and trying strictly gluten free diet
Hashimoto's 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
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.
I cant thank you enough for the wonderful advice we have received here. Katy did gave a celiac test over a year ago & it was negative but she decided to drop it from her diet anyway - I am gluten free too so it was quite easy for her to change & then she dropped dairy soon after because of her severe acne & hoped it would make a difference. It hasnt but she still remains dairy free.
Katy has made appt to see GP about her ferritin level & to ask for levo. I dont think her GP will be interested in taking the iron levels further as the last time she spoke with him he told her to eat some dried apricots! Which she has been doing but she is still sleeping here on the sofa most of the day & her hair is falling out literally in handfuls.
Thank you again for your invaluable help & getting katy back on her feet!
GP needs to understand that eating the right thing does not mean it is absorbed.
I was diagnosed with Macular Degeneration and entered into chatting via email with a Professor of Opthalmology who had written a book on the topic. He advised I needed an Ancestral Diet and when I explained my diet he was still adamant. I then explained having had lots of gut removal with TB and then Crohns I suggested an absorption issue as crucial bits were missing !! Oh damn - was the reply - I didn't cover that in my book !!!
Amazing! Everyone has different needs & GPs are only trained for the"norm" unless you get a good one prepared to do the extra but they dont get time I guess. You have to research & heal yourself as I have found out thanks to this forum. I wish you good health - my mum had Macular Degeneration & it is very challenging. Take care.
Yes you are right - we have to read and learn for ourselves. You can click onto my username and have a read of the edited version of my journey to wellness ! Still reading and learning. My MD is at the early stage and my venetian blinds are only a little bit wavy !!! Sorry to read about your Mum ... 🌻
Push GP to do full iron panel test for anaemia, if not had one
Or test privately
Low iron and/or low ferritin frequently linked to hair loss
Never supplement iron without doing full iron panel test for anaemia first..Low ferritin doesn’t necessarily mean low iron too
Heavy periods are often classic sign of being hypothyroid and will lead to low iron and ferritin
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
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.
Thank you for that I am a bit perplexed as to why she has low ferritin. She is 21 and never had a period but GP again doesnt seem worried about that either. Hopefully, thanks to you all on here, we can get going with the supplements & see what develops.
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