Blood test help please. not quite what I was expecting!

[HashisKate]

Hi all, hope everything is keeping well & safe.

I was hoping to enlist the help of our blood test experts once again. I have been on a journey to raise my vitamin levels due to incredibly poor conversion (see previous posts)

I’ve written my August results compared to my November results after 3 months of supplementation as advised below:

Here are my results:

Ferritin (13-150) Aug: 75.4 Nov: 47.1

Folate (>3.89) Aug: n/a Nov: 9.15

Active B12 (>37.5) Aug: 64.2 Nov: 81.7

Vitamin D (50-175) Aug: 65.1 Nov: 77.1

TSH (0.27-4.2) Aug: 0.18 Nov 0.13

Free Thyroxine (12-22) Aug: 19 Nov: 19.8

T3 (3.1-6.8) Aug: 3.82 Nov: 4.43

I can add antibodies results too, generally they’re high but had dropped a little.

Supplements taken:

Better you vitamin d & k2 spray (3000)

Igennus b

Magnesium

Selenium 2-3 times a week.

I’m glad to see things are moving in the right direction, but vitamin d seems to have barely increased considering I’m taking such a high dose? Does anyone have any insights into this?? I fell down a google rabbit hole and am now worried there could be something wrong with my liver.

Also seems to have been a sharp drop in my ferritin, what does this mean??

On the whole I have felt a lot better this last 3 months, so was expecting some higher increases. Is this normal?

As a side note - I wondered if it’s common for my TSH to be low despite my T3 & 4 being well within normal range? I’m worried this will mean a battle when I have my NHS blood test in the new year.

As always so appreciative for any help / reassurance or insights!!

[Nanaedake]

3000iu of vitamin D is not actually a very high dose, it's pretty average on this forum. We're heading through winter when vitamin D levels often drop as you utilise your stores of vitamin D which have been collected in the summer months some people need more in Winter. It's good yours hasn't dropped. I would definitely test at the end of winter to check what the level is and then you'll know if you need to take more vit D in the winter.

A lot of people find TSH is low when their FT4 and FT3 are in the upper range. Your FT3 is going in the right direction but others can advise. If you're feeling better I would carry on with what you're doing. Vitamins improvement can take quite a few months.

To improve ferritin you might include iron rich foods which may be more effective than supplements or can be an additional boost.

[MCR77 in reply to Nanaedake]

Have you looked into magnesium? I was on high dose D3 for months and it just wasn't absorbing, stumped my endocrinologist. After a bit of research and some magnesium my Vit D levels were good. Just be careful as too much magnesium is a laxative.

[HashisKate in reply to MCR77]

Can you recommend a magnesium supplement? I have the better you spray but it made my skin really dry! I have taken a vitamin version on and off that I have in the cupboard but no idea if they’re any good as I lost the packaging! Thanks for taking the time to reply 😊

[MCR77 in reply to HashisKate]

I use Solgar Magnesium Citrate 400mg but no more often than one every other day. Never tried a spray.

[HashisKate in reply to MCR77]

Thank you

[MCR77 in reply to HashisKate]

Forgot to say, once Vit D is good one magnesium a month seems to do me well along with daily D3 spray.

[jjyankee in reply to HashisKate]

I love this one- plus capsules are really small amazon.com/gp/product/B076S...

[HashisKate]

Just to add the test was done in the morning, first thing etc etc as recommended 👍🏻

[Nanaedake in reply to HashisKate]

Have you had iron levels tested?

[HashisKate in reply to Nanaedake]

Thanks for reply. I get what you’re saying about the vitamin d, but research indicated it should have risen a great deal more even I winter??

In terms of iron, only the ferritin and folate as above.

[SlowDragon Administrator in reply to HashisKate]

Many of with Hashimoto’s find 3000iu is only a maintenance dose (all year including summer)

Personally I found I needed 5000- 6000iu daily to increase levels and 3000-4000iu as maintenance dose

There’s some research suggests our obsession with daily showers/baths significantly reduces any vitamin D made on skin in summer

[HashisKate in reply to SlowDragon]

Thanks for reply. Interesting theory! I spent the whole summer outside, so was shocked my vit d wasn’t higher.

Perhaps I should just carry on and retest in another 3 months then? Did you have a calcium test at all?

[SlowDragon Administrator in reply to HashisKate]

No never had calcium tested ...

I always make sure to take vitamin K2 as well as vitamin D

On 3000iu I use the same Better You vitamin D spray

betteryou.com/vitamin-d-k2

When on higher dose, I add the plain Vitamin D spray

[HashisKate in reply to SlowDragon]

I’ve been doing 3 sprays of the same better you with k2.

[SlowDragon Administrator in reply to HashisKate]

Suggest you buy the blue one as well (1000iu spray)

Add in 2 sprays extra per day

Retest in Jan

[SlowDragon Administrator in reply to HashisKate]

The DNA issue is interesting

I did Ancestry DNA - for family history reasons rather than health

But subsequently had DNA health analysis done via here (not expensive)

mthfr-genetics.co.uk

There are about 10 different DNA snips involved in vitamin D

This showed nearly all my vitamin D related DNA snips have genetic polymorphisms

chriskresser.com/the-role-o...

[SlowDragon Administrator in reply to HashisKate]

Are you now absolutely strictly gluten free.

No wheat, barley or rye. Reading all labels and watching for cross contamination. No shared jam, butter, etc

Ferritin is obviously a lot worse now

Presumably you aren’t vegetarian or vegan?

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

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

drhedberg.com/ferritin-hypo...

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.

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Post discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first

Thyroid disease is as much about optimising vitamins as thyroid hormones

On plus side......your conversion of Ft4 to Ft3 is IMPROVING as you get vitamin levels nearer optimal levels

[HashisKate in reply to SlowDragon]

I’m not strictly gluten free, no. I avoid it and have gluten free products where I can.

I have no idea why ferritin has dropped.I had my period when I tested, could that make a difference?

No, not vegetarian or vegan. In fact, I have plenty of meat and variety in my diet.

Yes I was heartened to see Ft3 was improved. I almost wish that was all I had tested as I feel a bit stressed about the rest now!! 🙃

[SlowDragon Administrator in reply to HashisKate]

Gluten intolerance is a HUGE issue for large numbers of Hashimoto’s patients

You do not need need any obvious gut symptoms

In several previous posts you mentioned going strictly gluten free

There’s little point in cutting back, you can’t be “almost” gluten free

To be effective it has to be 100% absolutely strictly gluten free

As explained by Chris Kresser here

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

[HashisKate in reply to SlowDragon]

Sorry, I should have said I have gone strictly gluten free before, around a year ago for 3 months plus. I didn’t feel any better at the time for it. I still avoid it, but have found I can feel well with gluten now and again. It seems to be cumulative for me.

[Nanaedake in reply to HashisKate]

Slowdragon has good advice. Vitamin D is very individual and you have to find out how your body absorbs it and maintain levels accordingly.

In terms of iron levels, ferritin may not reflect iron levels so might be worth a full iron panel including Tibc although I'm not sure if GP would do it as ferritin is probably not low enough.