Newbie, questions about possible thyroid issues

[lauriegraham]

hello

I am new to this forum with little understanding of thyroid , so any help and ideas gratefully received. I am male, 63 years old, about 5'8, 150 lbs, relatively fit, lowish carb, lean, but have dips in energy

I have been worried about possible thyroid issues for a while, due to symptoms like raynauds/cold extremities, very little eyebrows/hair on my legs (pretty sure I used to) and other things that feel auto-immune-y, eg runny nose whenever there is some cold

Also other things like lipids, eg high ldl, doctor wanted me on statins and sent for bloods so lipid etc results also below

Just had following thyroid results, i do not know how to interpret, notable might be low ts3 and 4 but also tsh? and also low ferritin,

TOTAL THYROXINE(T4) 69 nmol/L 59 - 154

THYROID STIMULATING HORMONE 2.06 mIU/L 0.27 - 4.2

FREE THYROXINE 14.9 pmol/l 12.0 - 22.0

FREE T3 3.6 pmol/L 3.1 - 6.8

THYROID ANTIBODIES .

Thyroglobulin Antibody 11.1 IU/mL 0-115

Method used for Anti-Tg: Roche Modular

Thyroid Peroxidase Antibodies <9.0 IU/mL 0 - 34

Method used for Anti-TPO: Roche Modular

Vitamin B12 * 1098 pg/ml 197 - 771

Folate (serum) 14.7 ug/L > 2.9

If no change in dietary habits,a normal serum

folate makes folate deficiency unlikely.

FERRITIN 47 ug/L 30 - 400

C Reactive protein <0.6 mg/L <5.0

25 OH Vitamin D * 248 nmol/L 50 - 200

Interpretation of results:

Deficient <25 nmol/L

Insufficient 25 - 49 nmol/L

Normal Range 50 - 200 nmol/L

Consider reducing dose >200 nmol/L

other results from lipids recently, sorry if this is too much info, , again hard for me to interpret

Total ldl 8.1 mmol/l

Trigs 1mmol

HDL 2.5

LDL 5.1

cholestorol/hdl 3.2

Haemoglobin A1C 5.4% .. 35 mmol

Thyroid stimulating hormone 1.9 miU/L

Free t4 12.3 pmol/L (Low???)

Creatine kinase 185 (I take some every day if that makes a difference?)

Glucose 5.9 mmol/L (but bloods taken soon after eating)

Liver .. Bilirubin 6umol/L

Alkaline phosphatase 67 IU/L

Alanine transaminase 20 IU/L

Albumin 47 g/L

Renal profile

Sodium 137 mmol/L

Potassium 4.5 mmol/L

Creatinine 114 umol/L

Estimated GFR 58.

Lipoprotein (a) <7 nmol?L

Apolipoprpotein A1 1.99 g?l

Apolipoproptein b100 1.38 g?l

[SlowDragon Administrator]

Welcome to the forum

What vitamin supplements are you currently taking?

Your vitamin D is very high

Maybe causing issues

Recommend level vitamin D is 100-150nmol max

Ferritin is rather low

Are you 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.

B12 very high

Are you supplementing?

Might be better taking vitamin B complex

Have you had testosterone levels tested?

Yes Ft4 and Ft3 low

TSH is not reacting to low results

Perhaps retest in 2-3 months after working on improving low vitamin levels

[lauriegraham in reply to SlowDragon]

Hi Slow dragonthanks so much.

I dont take b12 much as a supplement but do take adaptoptogenic mushrooms and i gather they can increase b12, and d?

I have not had testosterone checked but assume i should? Can cortisol/stress impact?

i eat red meat and liver etc and have tried to up protein so that is not an issue, and also a lot of 100% chocolate (perhaps too much?)

Also can phytates and polyphenols inhibit iron absorption as i can mainline berries and nuts?

Can turmeric have an effect too? (gets rid of metals)

thanks again. greatly appreciated

[SlowDragon Administrator in reply to lauriegraham]

So are you not supplementing any vitamin D?

Perhaps cut back on mushrooms!

Very low carb diet adversely affects Ft3 levels of patients on levothyroxine......but wether it might affect someone not on levothyroxine......unknown

[jimh111]

THYROID STIMULATING HORMONE 2.06 mIU/L 0.27 - 4.2

FREE THYROXINE 14.9 pmol/l 12.0 - 22.0

FREE T3 3.6 pmol/L 3.1 - 6.8

These numbers taken as a whole suggest hypothyroidism. Usually as fT4 falls TSH rises considerably and fT3 is maintained around mid-interval untill fT4 falls quite low. In your case both fT3 and fT4 are falling but TSH is not responding. This indicates the pituitary is not responding normally, a mild form of 'central hypothyroidism' or subnormal TSH secretion.

Unfortunately, most doctors don't recognise this condition, they look at each hormone separately rather than the overall picture. Try to get a doctor to prescribe levothyroxine, more than 25 mcg. I suspect you will need some liothyronine in the longer term but it is very difficult to get this prescribed.

This sort of pituitary problem can be caused by head trauma, a period of thyrotoxicosis, severe illness, very strict dieting or depression. It is not an autoimmune condtion, your thyroid is probably healthy but is not being stimulated enough. The problem is your TSH is too low given your combined low normal fT3 and fT4.

[lauriegraham in reply to jimh111]

Thanks hugely. makes sense. I dont recognise those causes of pituitary problems. Can stress affect pituitary given links to eg cortisol?

[SlowDragon Administrator in reply to lauriegraham]

Could do

Might want to test DHEA and cortisol

regeneruslabs.com/products/...

cdn.shopify.com/s/files/1/0...

[lauriegraham in reply to SlowDragon]

thanks i will get one done . is this credible as a link with stress and thyroid? nikicleuet.com/blog-1/2019/...

[SlowDragon Administrator in reply to lauriegraham]

Yes, in general I would agree with that summary

[lauriegraham in reply to SlowDragon]

hi. I am going to follow your advice and get cortisol, dhea, is there anything else you advise? someone mentioned testosterone?Blue Horizons do a full adrenal blood test but i assume i need a saliva cortisol swab?

thanks

[SlowDragon Administrator in reply to lauriegraham]

testing cortisol via saliva is good option as shows if the diurnal rhythm is disrupted

Important to include DHEA test as well

Regenerus (and Genova?) cortisol testing includes DHEA

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

[lauriegraham in reply to SlowDragon]

Thanks greatly appreciated

[jimh111 in reply to lauriegraham]

Possibly, but I suspect stress will make you feel better in the sense you become more alert. More likely is that hypothyroidism reduces clearance of stress hormones and lowers intracellular magnesium. These actions will make you more susceptible to stess. I think hypothyroidism is more likely to lead to stress rather than vice versa.

[lauriegraham in reply to jimh111]

thanks so much jimh111. any advice gratefully received, i have been taking a mixed magnesium supplement, magenhance, and another