A few days ago i had my bloods done for TSH , T4 , T3 and Iron levels . I managed to ask for the ranges this time and my doctor marked as no action. I intermittently still get a goiter small , but it effects my ability to swallow properly particularly late afternoon and evening when i take my levo at around 7.30am. I have found taking my levo around 4pm helps with evening meal and the ability to swallow normally.
Can any of you explain what the following mean ?
TSH 0.01 range 0.034 - 5.6
T4 4.9 range 4.0 - 6.6
T3 15.8 range 7.9 - 20
Iron (ferritin) 28 range 11-307
I have underactive thyroid and hashimoto's and currently on 150mg levothyroxine
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Ferritin is too low
Iron (ferritin) 28 range 11-307
Ask GP for full iron panel test for anaemia
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.
Thankyou so much SlowDragon, i have learnt more from you than i have in three years of having this disease GPs although mine are always helpful they dont seem to understand or have full knowledge with Hashimotos , i am going to read through the addtional information and links below also , thankyou very much! , its strange as my hair has been falling out more than usual and i have been really tierd again lately which may be because my iron is on the low side. Thanks again for all you help 😁😁
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
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.
Trying strictly gluten free diet and improving low vitamins may improve your low Ft3
You could probably have small dose increase in levothyroxine too ....though GP highly unlikely to agree...they just look at low TSH
Most important result is Ft3...and that’s currently too low
Helpful calculator for working out percentage through range of Ft4 and Ft3
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor
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