I'm a 69 year old woman and have been continually exhausted for 4 years. I've had bi-polar disorder for 40 years and also suffer with sleep apnea. I'm currently waiting for ME/CFS testing. I had a private blood test for an underactive thyroid (I take a 100mcg Levothyroxine tablet daily) as I was told this could be a cause for my exhaustion. My GP said the results didn't show anything abnormal. I was advised by an acquitance to post my results on here in case any Wise Ones can enlighten me. Thanks in anticipation.
Can anyone help with my Test results? - Thyroid UK
Can anyone help with my Test results?
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Poppyfaery
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Hi and Welcome !
Your FT4 level is good - slightly over range. When did you take your last dose of Levo prior to your test ?
The T4 is inactive and needs to convert into the ACTIVE T3. As you can see this is low in range and can be the cause of your symptoms - including bi-polar.
VitD would be better around 100 ++. Ard you taking any other medications or supplenents ?
Hi, thanks for getting back so quickly. I'm so drained I feel suicidal at times. Took Levo early, can't remember exactly when but the blood sample was taken at 9.20. My other meds are 20mg Omeprazole twice a day, 200 mg Lithium at night, 20 mg Atorvastin and Adcal D-3. I also regularly take Forceval vitamin supplements (prescribed by GP), as well as 25mg Zinc tablets, Aspirin and MSM, Borax and Vitamin C powder daily. Thanks again for your interest, wishing you well.
The PPI you are taking will inhibit the uptake of B12 - which if below 500 can be the cause of neurological issues. Wake up Doc ! PPI'S should be a short course of 8 weeks.
Statins are not suggested for Hypos. NHS website says Thyroid should be properly treated first. Wake up Doc ! Your low T3 will be slowing liver metabolism and raising cholesterol in the blood.
VitD with calcium - am assuming this was prescribed by your GP. Wake up Doc ! - VitD improves the uptake of calcium from foods so extra calcium is NOT good. How much are you taking and what was your last test result ? Your dose should be based on your result.
Am off to check out Forceval vitamins.
SlowDragonAdministrator
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)
Is this how you do your tests?
Like many many people on just levothyroxine you have high Ft4...but very low Ft3
Ft4 is above top of range
Ft3 only 17% through range
We need Ft3 at least 50% through range
Helpful calculator for working out percentage through range
Which brand of levothyroxine are you currently taking
Do you always get same brand
Many people find Levothyroxine brands are not interchangeable.
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
Teva and Aristo are the only lactose free tablets
healthunlocked.com/thyroidu...
Teva poll
healthunlocked.com/thyroidu...
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
What other medication are you currently taking?
I did for 30 years stopped for around 8 years then been on 4 now,
SlowDragonAdministrator
Despite negative thyroid antibodies you can still have Hashimoto’s
Sleep apnea and Hashimoto’s linked
thyroidpharmacist.com/artic...
Mental issues including Bi-polar and link to Hashimoto's
drknews.com/when-hashimotos...
holtorfmed.com/mental-illne...
thyroidpharmacist.com/artic...
drknews.com/when-hashimotos...
hypothyroidmom.com/miss-dia...
ncbi.nlm.nih.gov/pmc/articl...
ncbi.nlm.nih.gov/pmc/articl...
Strictly gluten free diet frequently helps if cause is autoimmune thyroid disease
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
healthcheckshop.co.uk/store...?
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.
Bipolar linked to gluten intolerance
verywellmind.com/gluten-and...
psychologytoday.com/gb/blog...
Thank you so much for all the info. I'll wade through it but I'm feeling a bit daunted by it all. I am very grateful though. Again, a very big THANK YOU.
Take it one step at a time
Ask GP for coeliac blood test before considering trialing strictly gluten free diet
Or buy a coeliac blood test online if GP refuses
Hi spoke to doc its no to getting a blood test for coeliac do you know of any over the counter ones you could recommend many thanks
It's a waste of time with the nhs, i hate to say that but I've had enough upsetting yeh gods I'm remembering the good stuff now, im of to clear up some mess thanks for info thanks for your time
A psychiatrist can prescribe T3 alongside levothyroxine.....if you have to remain on lithium
But you may find once your Ft3 results improve after several months/ year on T3 you might be able to stop lithium
Psychiatrist should be well aware of interactions of levothyroxine and lithium
Thanks for the info I'm whacked with the help I'm receiving how to cope god knows
Come back each day ...read a few posts ...you will learn little by little...what’s important and what might help you personally
This is an incredibly supportive helpful forum.
I'm currently waiting for ME/CFS testing.
There is no test for ME/CFS. It is a diagnosis of exclusion i.e. basically the doctor does a few basic tests, can't find anything wrong , and then tells the patient they have ME/CFS. Once that diagnosis is on your medical records you'll struggle to get treatment for anything because you will be told any problem you have is because of your ME/CFS.
As far as I know I haven't been diagnosed with it and I would vigorously reject it as much as possible if it was ever mentioned to me.
Took Levo early, can't remember exactly when but the blood sample was taken at 9.20.
Taking Levo in the morning before a test is definitely not recommended. It will explain your over the range Free T4 result.
Advice given by SeasideSusie (copied from one of her posts) is :
When doing thyroid tests, we advise:
* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
Also, take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc, and water only for an hour either side, as absorption will be affected. Take any other medication and supplements 2 hours away from Levo, some need 4 hours.
CRP-hs
This is fine, and doesn't suggest any major issues with inflammation.
Ferritin (iron stores)
This is fine and suggests that your iron levels are okay.
Magnesium This is not really worth measuring. Only about 1% of the body's magnesium is found in the bloodstream. If the level in the blood gets rather low the body steals it from other cells. So people can get a good result in a blood test but be deficient everywhere else.
Most people are deficient in Magnesium and should supplement it as long as they have reasonably healthy kidneys. If you take too much the kidneys should excrete any excess.
For more info on magnesium supplements, read these links and choose one that appeals to you. You need to take about 300mg - 400mg magnesium per day.
drjockers.com/best-magnesiu...
naturalnews.com/046401_magn...
ncbi.nlm.nih.gov/pmc/articl...
Magnesium supplements can be sourced easily online on sites like Amazon. Do shop around though.
Cortisol
Your level is fine. It needs to be at or near top of range first thing in the morning.
Free T4 24.5 (12 - 22) 125% of the way through range
Free T3 3.75 (3.1 - 6.8) Approx 17.6% of the way through the range
As already mentioned your Free T4 is artificially high because your blood sample was taken soon after you'd taken your Levo, so I can't really comment on that.
Your Free T3 is too low. Take a look at the graphs on this link :
healthunlocked.com/thyroidu...
You can see that your Free T3 is dropping at 9am and stays lower than your result throughout a large part of the day, and only starts to go up again around 9pm. I would suggest that ideally you would start taking some T3. Unfortunately the chances of getting this from the NHS are very low because it is more expensive in the UK than anywhere else in the world. Some people do manage it, but it's rare.
It is quite common for people to cope well with Levo for many years, but the body becomes less able to convert T4 to T3 as it ages. And T3 is the active hormone - too low and we feel hypothyroid, too high and we feel hyperthyroid.
I got some t3 from the lady who turned me on to the thyroid website, it's out of date but assured me it will be fine, how much to take is what I can glean from all of you who try to help, dosnt sound very sensible, she goes to Greece for it.
Thank you! I'll go through this, it all seems very helpful. To be honest and feeling quite overwhelmed (and grateful) for all the comments I've recieved, I think I need a rest right now.
Vitamin D 56 (50 - 175)
Optimal for vitamin D is either 100 - 150, or 125, depending on source. I notice you are taking Adcal D3.
According to the Patient Information Leaflet I found :
medicines.org.uk/emc/produc...
your tablet contains 1500mg Calcium and Vitamin D3 400 iU.
Did your doctor test your calcium level before prescribing the Adcal D3? Unless your calcium level is shown to be low it is not recommended to take calcium at all. It could end up lining your arteries or being deposited in places it does you no good. If you need the calcium that's fine, but I wouldn't take it without knowing I needed it.
The amount of D3 in your supplement is very small and unlikely to keep your vitamin D level anywhere near optimal (as your vitamin D3 results shows).
If you use this link :
grassrootshealth.net/projec...
you can find out the required Vitamin D3 supplement level to raise your result to optimal.
Taking vitamin D3 actually raises the body's absorption of calcium from the diet, which is another reason for not taking calcium unless you need it.
Magnesium (already discussed) is needed to help the body make proper use of vitamin D3 and calcium.
Another supplement needed to make any calcium you have go into your bones and teeth rather than lining your arteries is vitamin K2. Search the forum for info on vitamin K2.
Hi Poppy and welcome to the forum. I am so sorry for the very poor treatment you are receiving 😢 It’s happened to us all. I have had to reject many many diagnosis. CFS, fibromyalgia and bi polar. I’m so glad I did and that I found a private Endo that was able to prescribe me T3. Your T3 is so so low and it sounds like it is causing you some serious mental health issues. I was the same and now I don’t have those issues. If you can get yourself a private blood test then do so esp as it sounds like you took your Blood test too soon after your Levo but I doubt the GP will repeat them.
Private blood test
Private Endo
Make yourself well 🤗
I've just had a private blood test I put it on page, had a nhs one then doc said fine, im a bit wobbled as I can't concentrate to start with,
See I am jumbled glad your feeling better, I need to rest
Vitamin B12 440
Serum Folate 24.3 (8.83 - 60.8)
These two vitamins are related. The body can't make efficient use of vitamin B12 without sufficient folate.
Neither of your results are disastrous but they aren't optimal. For folate the recommended level is in the upper half of the reference range, which is (roughly) between 35 - 60 with the range you've been given.
For vitamin B12, suggesting that top of range is 569 is absurd in my view. I've read that the Japanese consider anything under 500 to be deficient and the top of their range is about 1300. Personally I always keep my vitamin B12 over 1000. Vitamin B12 is not poisonous and having a level over the top of the range is not a problem if it is caused by supplementation.
Some links on the subject of folate and B12 :
My other meds are 20mg Omeprazole twice a day, 200 mg Lithium at night, 20 mg Atorvastin and Adcal D-3. I also regularly take Forceval vitamin supplements (prescribed by GP), as well as 25mg Zinc tablets, Aspirin and MSM, Borax and Vitamin C powder daily.
Regarding the Atorvastatin it really won't be doing you any good. Side effects are very common, for a start. And lowering your cholesterol will be reducing your life expectancy.
You will find lots of useful links on the subject of statins on this link :
healthunlocked.com/thyroidu...
...
The Forceval multivitamin and multimineral won't be doing you much good either. The Patient Information Leaflet shows what it contains :
medicines.org.uk/emc/files/...
It contains Vitamin D2 which is a poorly absorbed type of vitamin D. The best form is vitamin D3.
It contains Biotin which can skew the results of many blood tests (although the amount is so small in this case it probably won't make much difference).
It contains folic acid, when the best form is methylfolate.
It contains calcium and iron which stop the body absorbing lots of nutrients.
I could go on for quite a bit longer, but I won't. greygoose has written lots about multivitamins.
...
I don't know what MSM is, and I know nothing about Borax.
...
Sorry if this is overwhelming.
But your treatment is absolutely classic - in terms of nutrients you are taking a few things you don't need, the doses of various things you do need are too low, and they may be in a form you can't absorb.
You're also taking things that will do you no good but will do harm instead (e.g. the calcium and the statins).
You need T3 and yet your chances of getting it are very slight. So, in the meantime you have to do what you can to improve what is possible and it may improve your conversion of T4 to T3 and help you feel better that way.
Since you are taking a PPI (Omeprazole) this suggests your gut is not working well. I don't know if taking lithium requires people to take PPIs as well.
As people age their stomach acid output reduces. Low stomach acid is also a known symptom of being hypothyroid. Indigestion is usually (but not always) caused by having too little stomach acid rather than having too much. Doctors make the problem worse by giving people PPIs which shut off any remaining stomach acid you have when what you need is more acid not less.
I'm not suggesting that you should come off the PPIs at the moment, and it might never be possible. You need to take one step at a time and learn a lot more about the gut before you even consider such a thing. It might not be feasible.
Wow I don't know if I can cope or where or how to start, many thanks for your time and effort.
You need to create a plan.
1) Read the stuff you've been told about and linked to about statins. If you feel comfortable doing so you could then decide to stop taking them.
2) You should also ask your surgery about having enhanced online access to your medical records i.e. you want access to all the possible records and all possible blood test results. Search the forum for info on how to go about that.
3) It would be worth knowing if you ever had your calcium tested before you were put on Adcal D3. If you've been tested and your level was fine then taking the Adcal D3 is pointless and you should substitute it with a much higher dose of vitamin D3. No prescription required. (You need more vitamin D3 anyway, even if you decide to stay on the Adcal.)
4) You need a magnesium supplement if you aren't taking a good one already. I gave you plenty of links.
5) You also need to take vitamin K2. SeasideSusie mentions this a lot so take a look at her replies to others on the subject :
healthunlocked.com/user/sea...
Remember not to add new supplements all at the same time. Leave a week or two between adding each one.
6) Once you've got this far you can come back and start tackling whatever is next.
Hi regarding my calcium I must have had a blood test it's so long ago, he said take 3 tablets anyway I've stopped them and omeprozol and I'm cutting down the lithium have I already told you I'm tired now, thanks again
Omeprazole is a PPI as Marz has already mentioned. This reduces the acid in your stomach, assuming that heartburn is caused by acid. It was only on this forum that I discovered that heartburn can also be caused by low stomach acid. Very few doctors seem to understand this, so they keep on trying to reduce your stomach acid and go on prescribing Omeprazole for far too long.
Your stomach needs acid to digest your food and absorb vitamins and minerals.
Here are a couple of links which may explain this.
drmyhill.co.uk/wiki/Hypochl...
healthline.com/health/hypoc...
Many of us here have low stomach acid and need to increase it.
Hope this helps.
My problem was coughing wildly not acid reflux, as I said to human bean I don't know where or how to start I'm so tired and drained
Come back tomorrow and read your thread again after a night's sleep.
Pick one thing e.g. comments about statins, and concentrate on them. Or alternatively read up on magnesium. Start there.
Do you have a friend, partner, relative who is empathetic and sympathetic who can go through the thread with you?
I understand how difficult it is to deal with things when you are running low on nutrients, or under-dosed or wrongly dosed for your thyroid. Brain fog is dreadful to live with and makes life very hard.
...
If you want to start taking T3 and they were bought from Greece then I'm guessing they are 25mcg tablets. Please confirm...
You can cut them into quarters (with a lot of care), or some people even cut them into eighths. The best thing to cut them with is either a pill cutter or a hobby knife or a scalpel. Hobby knives or scalpels can be easily bought from hobby shops or Amazon. This is the kind of thing I'm talking about :
amazon.co.uk/Modelcraft-PKN...
Once you've cut up one tablet, take one eighth or one quarter with your Levo in the morning and see what happens. (If the pill you cut crumbles into powder you can still divide the powder up.) The most obvious thing that might happen is that your heart rate might rise, and if this happens some people panic and make the problem worse. But please be aware that there hasn't been a single death recorded from taking T3 since records began in 1967, which is more than can be said for many other commonly prescribed drugs.
Hi yes the tabs are 25mcg,i spoke with the doc today and all is fine concerning my private blood test,he said, I spoke of all the info ide received from the forum about mixing the drugs but still it's all fine he said, so why do I feel so bad and he said I'm sorry about that, end of story, I've told him I've stopped the statins omeprozol and am reducing lithium actually I didn't mention the lithium, ill get some magnesium and b12 and there's another ill have to go back to see what, i took the levo at night the other day I swear I felt a little better next day, doc says no take in the morning, thanks for your support I'll let you know what's happening
Giving up omeprazole isn't straightforward or easy, and should only be done if you definitely know you don't need it any more and are prepared to deal with the effects of stopping.
There is a problem of "rebound hypersecretion" of stomach acid when PPIs are stopped suddenly. See this link :
howtotreatheartburn.com/how...
There are some circumstances when giving up PPIs can't be done safely e.g. when people take NSAIDs (e.g. aspirin, ibuprofen, naproxen and a few others) as pain relief every day, and if you've got gastritis and/or damage to your oesophagus from stomach acid, and/or if you've got ulcers in your stomach or gut.
If you want to understand how the gut actually works, and what happens when stomach acid is too low, and how low stomach acid can arise, this series of articles is very good. I realise it is a lot of reading but I thought it was worth the effort when I read them :
chriskresser.com/what-every...
chriskresser.com/the-hidden...
chriskresser.com/more-evide...
chriskresser.com/how-your-a...
chriskresser.com/how-your-a...
chriskresser.com/get-rid-of...
A couple of articles from the same site but not part of the above series :
chriskresser.com/the-thyroi...
chriskresser.com/the-gluten...
And articles from a different site on the subject of stomach acid :
healthygut.com/articles/hyp...
healthygut.com/articles/3-t...
healthygut.com/articles/how...
healthygut.com/articles/4-c...
healthygut.com/articles/thy...
Hi been trying to find what you said about not having to reply individually to everyone, could you tell me again please, frighten ly I found what you said about ppi s again, I don't know how that didn't sink in that it's not good if you take aspirin and naproxan which I do my right hips on its way out I've had a new left one 12 years ago, i tried opening the links that you sent but they wouldn't open, hubby's out at mo when he returns I'll get help, hope I havnt shocked you telling you I smoke weed no tabbacco I use dried flowers as a mix, onwards and upwards thanks
been trying to find what you said about not having to reply individually to everyone, could you tell me again please,
Sorry, I'm not sure what you are referring to.
it's not good if you take aspirin and naproxan
People who take NSAIDs like aspirin, Ibuprofen, and Naproxen can end up with gastritis and/or ulcers if they don't take PPIs as well. I have personal experience of this. I took lots of ibuprofen in my 20s for untreated endometriosis and ended up with an ulcer and gastritis.
I'm sorry that the links don't open. They work for me.
Obviously I don't know why you were prescribed Omeprazole. How long have you been taking it? If you take it for too long it will reduce the vitamins and minerals you get from your food and that must make you tired.
Do check with your doctor and ask if it is still appropriate for you. Is it making any difference to the symptoms it was prescribed for?
Keep fighting.
Hi ive been taking omeprozol for years now I was coughing madly and consequently peeing myself badly at times, I've told the doc I'm stoping it and statins and I'm going to cut the lithium down, as far as he is concerned my blood tests are fine I told him of all the info about mixing the drugs but it was of no concern to him, why do I feel so bad and have done for 4 years I'm sorry about that he said... End of story I'm going to recommended get b12 and magnesium what the forum has recommended, thanks for your interest it's much appreciated
I totally agree with humanbean. I had heard of the difficulty of giving up PPIs such as Omeprazole. Do be careful.
Can you see a different doctor? This one doesn't seem to be at all helpful (I could say more...). Just say that you need a second opinion. Your GP's practice can't argue with that.
SlowDragonAdministrator
it’s unbelievable the number of serious mistakes made
This stuff makes me so angry. 
Just how many people are there out there, being let down by clueless doctors? We only know about the ones who make it here. But what about all the ones that don’t? :’(
I'll ask hubby how to pm come morn I'm hopeless with phones and computers, i cant concentrate to read and I forget loads is that just old age, I'm sick of it, be well
Hi, at my docs there all locums one supped coke and chewed gum actually rolling it so you could see it, while he was talking to me it's been said ppi s should only be for 8 weeks, i havnt taken all info in and digested yet, i get up tired it's a joke, it's early today ill see how long I last before I'm exhausted, thanks for the interest
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