2nd blood test results and vitamins - please interpret

[ZeilaJee]

Took your advice Seaside Susie (thank you) about B12 and Vit D. Still taking D but stopped B12.

Sleeping badly, headaches 3/7 days mornings only, feeling ok but tired in late pm, constipated for first time ever and beginning to lack control ‘down there’. Libido awful for years new problem with tendinitis - tennis elbow, 2 rotator cuff and one hip.

When I took slightly higher dose NDT I had palpitations, shaky legs. Have dry skin and hair. Otherwise, I’m fine! Your advice welcome please, all.

[SlowDragon Administrator]

Previous post here

healthunlocked.com/thyroidu....

What vitamin supplements are you currently taking?

Can see vitamin D is improving

Are you also taking magnesium and vitamin K2?

Folate on low side

Are you supplementing a good quality daily vitamin B complex?

Ferritin is too high. GP should do full iron panel test to rule out high iron too. High ferritin can be linked inflammation of autoimmune thyroid disease (hashimoto’s)

Did you know you had Hashimoto’s?

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

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.

Why gluten intolerance can upset cortisol levels

kalishinstitute.com/blog/gl...

What time in morning did you do this test?

Cortisol is rather low

Was last 1/3 of daily dose NDT 8-12 hours before test?

TSH is rather high for someone on NDT

Ft4 is often low

Ft3 looks too low

You might benefit from adding 25mcg levothyroxine

Only make one change at a time

Work way through list

Retesting FULL Thyroid And Vitamins again in say 3-4 months

[SlowDragon Administrator]

Calm vitality Magnesium powder can help improve constipation

Best taken afternoon or at bedtime. (Must be four hours away from levothyroxine or NDT)

Starting on low dose and increase until get desired effect. Too much can cause diarrhoea.

Good quality daily vitamin B complex might help improve bladder control.

express.co.uk/life-style/he...

Vitamin B complex with folate in (not folic acid) may be beneficial..This can help keep all B vitamins in balance and will help maintain optimal B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[ZeilaJee in reply to SlowDragon]

Thank you for all these. Info is taken on board. Here are replies and some questions.

I'm taking better you Vit D /K2 as you advised. 2 squirts a day

I am gluten free completely since about 9 months and was low gluten (avoiding) for about 2 years before that. I confess I am worried about the high anti-thyroidperoxidase and thyroglobulin readings and didn't know that I had Hashimoto's. How worried should I be and advice? Does it ( and I) get worse over time?

The time of the blood test was 10.30am and I had taken a 1/4 dose (22.5mg Armour) the night before as I didn't want the T3 reading to be off. I had not taken any supplements at all for a week. (I am on 45mg armour/day).

Vit B12: did not resume this when the blood results above came back as it said I was overdosing (it was intermittent anyway - 500ug supplement. I am eating alot of green garden veg at the moment - any impact?)

B-complex vitamins: what are best B levels to aim for? Vit contents of various brands all wildly different and don't want to do the wrong thing (especially as eating garden veg...). Igennus seems to be much stronger than all of them (note your 1/2 or even 1/4 dosage though). Is there a risk of too much? Thank you for mentioning the other makes as well.

I have Gilbert's Syndrome which is genetic - I believe it is lack of an enzyme that digests fats - does this relate to MTHFR you mention? The Gilbert's doesn't cause me any problems. I am an allergic person and also cannot eat melon, fresh parsley, avocado, spinach but OK on everything else. Is Gilbert's related to thyroid problems? What sort of tests if any do I need if this needs to be addressed?

Thank you for your help - much appreciated and, I'm sure, by everyone reading this site. Invaluable support.