Please can I ask for help with test results

[S-lly]

Hello, I ve been on 75mg levo for 3 months and had a retest this week, the results show all changed to normal except for the antibodies which are still sky high. All vit D, iron, magnesium ok, just the antibodies. I have also piled on half a stone in 3 months. Does anyone else have any experience of this please?

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

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

Low vitamin levels are extremely common, as you have Hashimoto’s (autoimmune thyroid disease) confirmed by high thyroid antibodies

Ask GP to test vitamin levels now

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?

Ft3 is still low. Suggests low vitamins likely

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...

[SlowDragon Administrator]

Hashimoto's 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.

[jimh111]

Your thyroid hormone levels are good but sometimes this isn't enough for some patients.

Your antibodies are very high and there is some evidence that having high antibodies is linked to symptoms. Antibodies tend to come down after the thyroid dies away or is removed. There is little evidence that dietary interventions have much effect on antibodies, the only evidence I've seen is a small trial of helicobacter pylori eradication.

It usually takes at least three months for people to recover from hypothyroidism. I wouldn't try increasing your levothyroxine much as experience is it doesn't help much once fT4 has gone high. You might be able to presuade an endocrinologist to prescribe some liothyronine, this has been shown to avoid weight gain and improve cognitive function.

What were your blood test results when you were diagnosed with hypothyroidism?

[S-lly in reply to jimh111]

Thank you for this, the results were TSH 4.88. Free Thyro 16.2, Free T3 4.9, antibodies >4000 before. My private gp has said that the thyroid has responded well, but need to investigate gut issues because of the antibodies.

[SlowDragon Administrator in reply to S-lly]

Poor gut function frequently results in low vitamin levels

Gluten and/or dairy intolerance common with Hashimoto’s

Getting coeliac blood test done BEFORE trialing gluten free diet recommended

[jimh111 in reply to S-lly]

Your thyroid levels were good before diagnosis apart from a mildly elevated TSH . This tells us that trying to get hormone levels 'perfect' is unlikely to solve the problem. As I noted some patients have symptoms with just elevated antibodies and yours are sky high.

A small percentage of thyroid patients do better on gluten free and as advised it makes sense to get a coeliac blood test first. I would investigate helicobacter pylori first and if you have the infection see how you go after it is erradicated as this has some evidence to support it sci-hub.do/https://doi.org/... .

[S-lly in reply to jimh111]

Thank you very much, I will read all your information and get the tests, much appreciated