I am 63 and have Hashimotos. I was finally diagnosed 6 years ago, after collapsing with terrible vertigo, vomiting, sweating and very low body temperature. My TSH was above 100, and I was very poorly.
Since then I've been treated with levo at various levels (100 -150) depending how stable my weight and symptoms have been, ranging from just bearable to dreadful. I had t3 added for around a year, until it was withdrawn a couple of years ago. That helped.
Over the last 12 months I have felt progressively worse (on 125mg levo) until I now feel as bad as I did when I collapsed. The one thing that has stayed the same, no matter how I feel or level of prescription, is my TSH has basically flat-lined. It's been around 0.01 pretty much since I collapsed 6 yrs ago. My latest GP only looks at TSH and says I must reduce my Levo from 125 to 100 as I must be too Hyper. I have a wide mix of hyper and hypo symptoms, including over 3 stone weight gain in 7 months. I'm going around in circles and I'm scared.
I had the following blood tests taken around a month ago. Can someone interpret them please? I've attached a photo of the results report too.
Vit D 98 range 75-175 nmol/L
Ferritin 27 range 13-150 ug/L
Active B12 71 range 37.5 - 188 pmol/L
Folate (ser) 7.6 LOW range 8.83-60.8 nmol/L
TSH.. 0.01 LOW range 0.27-4.2 mlU/L
Free T3 4.1 range 3.1-6.8 pmol/L
FT4 22 range 12-22 pmol/L
Thyroglobulin antibodies HIGH 438.2 range 0-115 kU/L
Thyroid peroxide antibodies HIGH 129.7 range 0-34 kIU/L
T4 HIGH 164 range 59 - 154 nmol/L
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Redsusan57
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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
Low iron and/or low ferritin frequently linked to hair loss
Never supplement iron without doing full iron panel test for anaemia first - ask GP to do iron panel test
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.
Thyroid disease is as much about optimising vitamins as thyroid hormones
Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test?
You have very poor conversion of Ft4 to Ft3
Ft3 is only 27% through range
Helpful calculator for working out percentage through range
As you have Hashimoto’s are you on strictly gluten free diet?
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 of 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
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.
Thanks again. The test was taken before food and drink. It wasn't 24hrs since last levo dose though. T3 was prescribed by an endocrinologist at Royal Hampshire County Hospital (SO postcode) around a year after diagnosis. It was only 10mg, and was taken alongside 100mg of levo. It helped, but didn't totally take away symptoms.
Around a year later, the Consultant insisted that it should be stopped as the cost of the 10mg T3 too high v it's impact. I made the decision to buy T3 from abroad (Mexico) instead. I had reviews every 6 months, and at one of these I asked if I could be prescribed T3 again, as I had been buying it myself. He said that he wouldn't be able to see me again, as he couldn't be responsible for my self-prescribing. I've only seen random GPs since for the last 3 years.
One more question....regarding the two high Antibody results. Do you know what the significance is of having results four times above top of range on these? What impact does that have on symptoms?
I would suggest that you need a separate folate supplement in addition to a B Complex supplement, since you are actually deficient. The level you should be aiming for, with the reference range you've given, is the upper half of the range i.e. approx 35 - 61 nmol/L.
The best kinds of folate supplement are described in this link :
Folate supplements of the type described in the above link can be bought from Amazon and other supplement sites. I would suggest you take 1000mcg per day for a couple of months and then re-test. Once your folate is at an optimal level you can stop taking the separate supplement and just continue with the B Complex. Another test a few months after stopping will tell you whether your folate is staying at a healthy level or whether it has dropped. You may find you need to take the B Complex, and in addition take methylfolate a few times a week.
I'm not aware of any dramatic consequences of having excess folate in your system, but I haven't researched this very much so please do your own research. If your kidneys are healthy I think excess folate is disposed of via the urine - but I really must stress I'm not 100% sure.
Personally, I've always found it difficult to maintain my folate levels where I want them and they swing around all over the place, often dropping dramatically for no obvious reason. So, good luck.
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