Help with blood test results - I have hashimotos disease my endocrinologist originally discussed giving me a different drug but two years later I’m still battling with weight increase despite all efforts. I eat 1200 calories a day and walk 7 miles a day, strict regime. I take 125mg and 100mg of thyroxine on alternative days. I recently seen the endocrinologist and had full blood tests taken, these are the results. ( I took no Levothyroxine before the blood test )
Free T4 - 14.3pmol/L
TSH - low at 0.03 mIU/U
Vitamin D 66.6nmol/L
My TSH results are always low, I just don’t understand why originally it was suggested I have a different drug as I’m in the exact same position two years later. GP tries to disagree with endocrinologist putting up my Levothyroxine as GP worried about bone loss.
Any help would be appreciated again.... sorry 😐
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Smily52
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Can you tell us exactly what medication you are taking please. If not Levothyroxine then what?
Can you add the reference ranges for your results please, these vary from lab to lab and although we can see your TSH is low we can't interpret your FT4 result as the range for this test varies considerably.
Was FT3 not tested? This is the most important test.
Your Vit D is low. Do you supplement at all?
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L so if you're not supplementing then you'd be looking at taking 3,500-4,000iu D3 daily to bring your level up to the recommended level and once there you'd find your maintenance dose to keep it there.
As Hashi's often causes gut/absorption problems leading to low nutrient levels or deficiencies, it's essential to test the other core nutrients as well - B12, Folate and Ferritin. Were any of these tested?
Hello thank you for your reply. I take Levothyroxine 125mg and 100mg alternative days. I don’t currently take any vitamin do supplements but I will get some. They endo did test b12 and ferratin and a serum gel biochemistry. The letter to me only shows the results I mentioned but I will email the secretary to get the complete blood test results sent to me. Liver and renal function normal.
What was the different medication the endo mentioned then?
Until we see the reference range for FT4 we won't be able to say whether you are on enough Levo. However, as you are struggling to lose weight it's possible you have low FT3, and we need to see FT4 and FT3 results/ranges from the same blood draw to see of you are converting T4 to T3 well enough. Low T3 causes symptoms and difficulty losing weight.
If you are going to supplement with D3 then there are also important cofactors needed - magnesium and Vit K2-mk7.
D3 aids absorption of calcium from food and K2-mk7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissue where it can be deposited and cause problems. Magnesium helps the body convert D3 into it's usable form.
I don’t know what she was going to suggest, she said it was a new drug but GP wouldn’t like it because if expense. Then I received a letter in the post telling me she would like me to remain on levo. I do still have consultations with her I just thought she was trying to stabilise the meds. I think she was maybe going to give me T3 but nothing has come of it. I will get the supplements you recommend and try them. Thank you
T3 isn't new and they don't like prescribing it because it's expensive. However, if you have poor conversion and an endo agrees you may be able to get a trial. It's so important to test FT3 along with TSH and FT4 but most doctors don't understand this.
Retest Vit D 3 months after starting to supplement - easy fingerprick blood spot test can be done with an NHS lab which offers it to the general public for £29 if GP wont test:
Once you've reached the recommended level then you'll need to find your maintenance dose to keep it there, this may be 2000iu, maybe more, maybe less, it's trial and error and we should retest twice a year to check level and adjust dose of necessary.
Don't start all supplements at once, start with D3, give it 2 weeks and if no adverse reaction then add one of the others, give it 2 weeks and if no adverse reaction add the next one. That way if you do have a reaction you will know what caused it.
Thank you the endo has sent me a form to get blood redone in sept so I will start supplements as you suggest, then get bloods in sept and ask end at the next app about trialling T3
Just testing TSH and Ft4 is completely inadequate and without the ranges (figures in brackets after each result) meaningless
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, especially as you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Have you had coeliac blood test done?
Are you on strictly gluten free diet
Ask GP to test vitamin B12, folate and ferritin levels
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?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Before considering adding T3 we need all four vitamins at GOOD LEVELS
so next step is to get folate, ferritin and B12 tested
With Hashimoto’s gluten intolerance is extremely common
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
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.
When adequately treated, TSH will often be well under one. Most important results are ALWAYS Ft3 followed by Ft4. When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)
Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works
Come back with new post once you folate, ferritin and B12 results
Many, many people need addition of T3 alongside levothyroxine, but vitamin levels must be optimal FIRST
Strictly gluten free diet frequently helps significantly or is absolutely essential
I asked the hospital to send me the full blood test results. Please see below do you recommend higher vit D required and what about TSH? Thanks in advance .
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
Assuming yes
Results show you are under medicated
Ft4 is only 30% through range
Ft3 at 32% through range
Helpful calculator for working out percentage through range
Thank you SlowDragon for such in depth information. I’ve been reading Isabella Wentz book, very good. And in weeks noticed massive improvement from cutting out gluten, sugar and coffee.
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Help with blood test results
Help with blood test results
Help with blood test results?
Help with blood test results
Help with blood test results
