Can anyone interpret these results for me? - Thyroid UK

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Can anyone interpret these results for me?

owl_trousers
owl_trousers

Hi everyone, I posted here last year when I originally got my thyroid checked after experiencing hypothyroid symptoms. I hope maybe I can get some advice after getting my levels rechecked again.

Here are my results below. The top ones are 2020 and bottom is last year's results -

Thyroid Hormones 2020

TSH 2.19 mIU/L (Range: 0.27 - 4.2)

Free T3 5.20 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 15.100 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies 19.600 kIU/L (Range: < 115)

Thyroid Peroxidase Antibodies X 123.00 kIU/L (Range: < 34)

Thyroid Hormones 2019

TSH 1.76 mIU/L (Range: 0.27 - 4.2)

Free T3 4.16 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 14.900 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies 24.100 kIU/L (Range: < 115)

Thyroid Peroxidase Antibodies X 88.8 kIU/L (Range: < 34)

So I have the antibodies that point to hashimotos I believe, and they have grown. From my levels I believe I won't get treatment from my GP?

I've been severely fatigued, depressed, cold all the time, experiencing muscle fatigue at nothing. I've also had 3 very early miscarriages in a year, wondering if this is linked.

Any advice very much welcome.

Thank you 😊

17 Replies
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SlowDragon
SlowDragonAdministrator

Yes high antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common with Hashimoto’s

Ask GP to test vitamin levels or test privately

Low vitamin levels tend to lower TSH

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 .

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

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

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

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

monitormyhealth.org.uk/thyr...

Come back with new post once you get vitamin results

Thank you for the reply, I also had my vitamin D and b12 tested 6 months ago, both low.

Vitamin D was 42

B12 was 168 (range 145 - 569)

Yes I took this test at 10am before any food or drink.

SlowDragon
SlowDragonAdministrator in reply to owl_trousers

Please add ranges on B12

SlowDragon
SlowDragonAdministrator in reply to owl_trousers

So B12 is EXTREMELY low

What about folate level?

Low B12 extremely common result of Hashimoto’s

But before starting on any supplements GP should test for Pernicious Anaemia

Low B12 must be improved before TTC

Likely to need B12 injections, certainly B12 supplements

SlowDragon
SlowDragonAdministrator in reply to owl_trousers

Low vitamin D obviously needs improving and GP should prescribe 1600iu everyday for 6 months

Vitamin D

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

With your Vit D, are you also taking it's important cofactors - magnesium and Vit K2-MK7?

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

SlowDragon
SlowDragonAdministrator in reply to owl_trousers

Important to test ferritin too

Getting all four vitamins optimal...then retesting thyroid

Likely to see increase in TSH so that you can get levothyroxine started

SlowDragon
SlowDragonAdministrator in reply to owl_trousers

Low B12

What’s your diet like, are you vegetarian or vegan?

Were you/are you taking any pre-natal vitamin supplements?

GP may refuse to do further testing on B12 as B12 is within range....though right at very bottom of range

B12 and folate work together, so important to know what folate level is

You can test B12, MMA and homocysteine here

nutris.viapath.co.uk/pages/...

Likely to need at least B12 supplements, very likely B12 injections

If you start B12 injections via GP it’s recommended also to supplement a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help improve B12 levels between injections too

If GP only prescribes B12 supplements, then still recommended to take vitamin B complex 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 any blood tests, as biotin can falsely affect test results

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

endocrinenews.endocrine.org...

Low B12 symptoms

b12deficiency.info/signs-an...

With such low B12 result taking a B12 supplement and a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/vitamins/vit...

B12 injections should be offered during Covid crisis

pernicious-anaemia-society....

ncbi.nlm.nih.gov/pubmed/186...

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms

Thank you. No I'm not vegetarian, I eat a good balanced diet so unsure why it's so low.

SlowDragon
SlowDragonAdministrator in reply to owl_trousers

Ok...just checking

When hypothyroid we almost always have low stomach acid

Stomach needs high acid to breakdown foods. So low stomach acid leads to low vitamin levels

medicalnewstoday.com/articl...

Low stomach acid can be a common hypothyroid issue

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Web links re low stomach acid and reflux and hypothyroidism

nutritionjersey.com/high-or...

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

healthygut.com/articles/3-t...

naturalendocrinesolutions.c...

Protect your teeth if using ACV with mother

healthunlocked.com/thyroidu...

Ask GP for test for H Pylori too

Ok interesting. I suffer from acid reflux almost daily.

SlowDragon
SlowDragonAdministrator in reply to owl_trousers

What, if anything are you prescribed or taking for this?

Nothing!

SlowDragon
SlowDragonAdministrator in reply to owl_trousers

Ok....at least not been prescribed omeprazole or other ppi ....which lower stomach acid even more

Strictly gluten free diet may help

Getting vitamin levels optimal will certainly help

Likely iron/ferritin low too if low stomach acid

Thanks so much for your help. I'm going to work on getting my vitamin levels up and may try cutting out gluten too. Ferritin was actually ok last time I had it tested.

SlowDragon
SlowDragonAdministrator in reply to owl_trousers

GP should have started vitamin D prescription 6 months ago ....did they?

Plus started investigating low B12

Only add one vitamin supplement at a time...then wait at least ten days to assess before adding another

Suggest you start with Better You vitamin D that includes vitamin k

betteryou.com/vitamin-d-k2?...

Then look at adding magnesium supplement

Meanwhile push GP to test folate, retest B12 and for Pernicious Anaemia....plus coeliac blood test and H Pylori

SlowDragon
SlowDragonAdministrator

Poor gut function with Hashimoto’s 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.

Thanks for all the information. Do you think my GP is likely to pay any attention if I approach her with my results? Last time we spoke she just said that some people have antibodies but it doesn't mean anything.

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