Help deciphering results

[LlamaLegs79]

Hi, can someone please help understand my results. I was diagnosed as hypothyroid in 2019 but after having such a bad experience with levothyroxine I have buried my head in the sand. I have now decided to go private with one of the doctors suggested by this group, so have checked my levels out with medichecks. I want to be armed with as much info before my appointment. The results are in the attached picture. Many thanks in advance.

[fuchsia-pink]

Please take your levo - you will only get worse without it. If your initial brand didn't suit, "yellow card" it and try a different one - and then stick with that brand if you find one that suits. Talk to the pharmacist and/or get "not X" or the brand you want put on the prescription. All brands are not the same - the fillers are different; some are lactose-free and Teva in particular is a "marmite" brand that a lot of people don't get on with but some others actively prefer.

Hopefully SeasideSusie will pop up in a bit to say how you should address your truly dreadful vit D result x

[LlamaLegs79 in reply to fuchsia-pink]

Thank you for taking the time to reply.

[SeasideSusie Remembering]

LlamaLegs79

Your raised antibodies confirm autoimmune thyroid disease (known to patients as Hashimoto's). Did you know this?

Hashi's is is where the thyroid is attacked and gradually destroyed.

Fluctuations in symptoms and test results are common with Hashi's.

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.

Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.

Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies.

Your Ferritin and Active B12 are good.

Folate is low would be better at least half way through range. Medichecks' range is 3.89-19.45 so you'd be aiming for 12+ with that range. A good B Complex such as Thorne Basic B or Igennus Super B will help raise your folate level, as will eating lots of folate rich foods. When supplementing with B Complex we need to leave it off for 7 days before any blood test (including thyroid tests) because it contains Biotin and when Biotin is used in the testing procedure (which most labs, including Medichecks, do) then it can give false results.

Vit D is way too low, it is in the insufficient category. Your GP may be willing to prescribe, in which case it may only be 800iu or 1600iu so you could consider supplementing yourself.

The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.

To reach the recommended level from your current level, you could supplement with 5,000iu D3 daily.

Retest after 3 months.

Once you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3.

D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.

I like Doctor's Best D3 softgels which are very well absorbed, contain only D3 and extra virgin olive oil to aid absorption, nothing else.

For K2-MK7 I like Vitabay or Vegavero.

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.

As for your thyroid results, are you actually taking any Levo at the moment? If so you are undermedicated. The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper parts of their reference ranges, if that is where you feel well.

So if you are taking Levo then you need an increase in dose, 25mcg now, retest in 6-8 weeks. Possibly further increase after that.

[LlamaLegs79 in reply to SeasideSusie]

Thank you. Just the kind of info I needed. I have done lots of reading but find it a but overwhelming. I did suspect that I had hashi's so am now armed with facts I can start making progress.

I am not taking levothyroxine at the minute because it gave me terrible anxiety when I started it in 2019 and I haven't been brave enough to tackle this issue again since. It made me so poorly regardless of brand. I started on 50mg and then went to 25mg. I am willing to start again under guidance from a GP who is more knowledgeable.......keep your fingers crossed for me.

[SlowDragon Administrator]

Which brand of levothyroxine did you start on

How much was starter dose?

Trying different brand of levothyroxine and start again

you have high antibodies and this confirms Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Obviously vitamin D needs improving

Folate too

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.

[LlamaLegs79 in reply to SlowDragon]

Thank you. I now have the info I need and will go away and start carefully again on levothyroxine with proper guidance. I was on 50mg reduced to 25mg last time, various brands. I had terrible anxiety which I had never experienced before. I was also diagnosed with premature ovarian insufficiency at the same time as hypo so I've made progress with HRT since then. I was 39 at the time. The specialist I have contacted has experience of thyroid and female hormones so hoping they can help. They are from the lost provided by this site.

[SlowDragon Administrator in reply to LlamaLegs79]

Anxiety is an extremely common symptom, particularly with Hashimoto’s

Personally I had to take propranolol (beta blocker) in order to tolerate high enough dose of levothyroxine. I wouldn’t recommend it as first option, but if you can’t tolerate levothyroxine.....needs must

I found, that going absolutely strictly gluten free helped significantly reducing anxiety and getting all vitamins at good levels

[LlamaLegs79 in reply to SlowDragon]

Thank you once again. I didn't know that.

[LlamaLegs79 in reply to SlowDragon]

Is it possible that the levo triggered the anxiety as I hadn't experienced it before?

[SlowDragon Administrator in reply to LlamaLegs79]

It’s more likely that it’s adrenal glands not liking increase in metabolism

It’s because of being hypothyroid, not because of levothyroxine

[LlamaLegs79 in reply to SlowDragon]

Thank you. Does it rectify itself once I get the medication right?

[SlowDragon Administrator in reply to LlamaLegs79]

Yes

[LlamaLegs79 in reply to SlowDragon]

Thank you. I can cope with all other symptoms but the anxiety knocks me off my feet.

[SlowDragon Administrator]

Have you been improving low vitamin D levels

Had coeliac blood test done

No on strictly gluten free diet?

If so you are ready to restart on levothyroxine

Mercury Pharma is perhaps most easily tolerated brand

Or Accord brand - but only has 50mcg and 100mcg tablets

Standard starter dose of levothyroxine is 50mcg

Bloods should be retested 6-8 weeks after each dose increase

Dose increased as fast as tolerated

[LlamaLegs79]

Thank you. I have been supplementing across the board, including vit d. I am not Coeliac, a test I paid for. I then requested my medical file from the hospital, and they'd already done it. 😝 The only thing I haven't done is the gluten free diet. Thank you for all your advice.