I don’t really know about vitamins except your ferritin looks like mine, so I agree on that one I agree that the antibodies look like hashis, or to be technical, it’s not hashis unless you have a goitre (enlarged thyroid) but autoimmune thyroiditis. Which is me. But I say hashis as it keeps things simple!
How are you feeling in general? The TSH looks a little at odds with fT4, so TSH suggests an increase and fT4 looks good, so I am not wise enough to make the call with any conviction. Others will likely know better and my instinct is that the decision should be guided by how symptomatic you are and how well you do or do not feel. Also, TSH lags behind a dose increase by about 8 weeks, so I guess it might go down a little depending on where you are in terms of testing?
Sounds like yes to an increase then! Hopefully someone will help with vitamins just editing to say that - for once - if the GP only tests TSH, then that’s good for you as you get to try an increase to see if it helps!! Ha!
Firstly I would say forget Dr Child's optimal levels for a few reasons:
a) He's talking about a different B12 test, you've done Active B12, he's talking about serum Total B12 test.
b) Thyroid test ranges vary from lab to lab and country to country, he is in the US and the ranges will be different and the unit of measurement for his Total T4 test is different from ours and Total T4 tests aren't much use anyway.
Secondly, Thriva have a very confusing way of displaying their reference ranges when you look at the graphics and their "optimal" ranges are pretty much nonsense. For the "normal" range you have to look at the whole of the green bar - both light and dark green. Ignore their recommendation of "optimal".
To understand Thriva's ranges, download the pdf from the link you will find when you log into your account, the results sheet will look like this:
Dr. Child's recommended range 700-900 pg/ml optimal
1) N/a - I don't know how to convert the measurements but seems ok?
This is a good result for Active B12. You don't need to convert the measurement because Dr Child's is a different test. The Active B12 is the better test.
2) Ferritin 54 ug/L (13-150)
2) I need to get this up - carry on taking iron tablets and eating meat, nuts, pumpkin seeds, dark chocolate and leafy greens.
This is on the low side. Ferritin is recommended to be half way through range. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
If your iron tablets are prescribed then hopefully your GP is monitoring your iron panel (serum iron and saturation %), if not prescribed then you shouldn't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
3) Folate 38.8 nmol/L (8.83-60.8)
3) Could do with getting this up - carry on eating a range of whole foods instead of processed foods.
Folate is recommended to be at least half way through range so that would be 35+ with that range so yours is OK.
4) Vitamin D 122 nmol /L
4) Seems really good to me
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L so yours is OK.
5) FT3 4.7 pmol/L (3.1-6.8)
5) Seems ok, and will probably come down a bit when TSH does?
When TSH is high the "Frees" will generally be low. When TSH is low "Frees" tend to be in the upper part of their ranges. This is 43.24% through range and you'd probably feel better if it was in the upper part of it's range.
6) TSH 5.58 mlU/L (0.27-4.2)
6) TSH out of range and increase of levo should help
This is obviously over range. A high TSH normally suggests undermedication and the need for an increase in your Levo. However, your FT4 doesn't suggest the need for an increase. It's unusual to have a high TSH and a high FT4.
* How much Levo do you take?
* When did you take your last dose of Levo before the test? Last dose should be 24 hours before test.
* Did you do the test no later than 9am?
* Did you have nothing to eat or drink except water before the test?
* Did you take Biotin or a B Complex in the week before the test?
7) ad 8) Means I have hashis?
Yes, they are both elevated and confirm the cause of your hypothyroidism is autoimmune.
9) T4 176 nmol/L
9) Not sure how to convert the measurements but seems high? Again should come down with TSH?
Don't bother converting measurement. This is a Total T4 test and it's not a useful test, it's the FT4 test that tells us what we need to know.
10) FT4 20.2 pmol/L (12-22)
10) Again could probably do with coming down which it hopefully will with increase in levo and lowering of TSH.
Taking more Levo will increase FT4 level not lower it.
The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their reference ranges if that is where you feel well.
Ah good to know! Ok so:1. Disregard Dr. Childs ranges.
2. Use the link to Thriva to get ranges. Ignore their optimal and include in range.
3. Stop taking iron if you haven't had it tested, which I haven't. I'll ask my GP but I'm doubt they'll say yes as they wont test the others hence going to Thriva. As such I may have to get one from Thriva that's fine. I've probably just gone ham because of the hair loss.
4. My TSH has always been the problem. I've always been in range for T4 (first measurement of T3 so can't comment on that). Apparently this means I'm subclinical and the only reason they treat me is because my symptoms are so severe. And I can contest that why my TSH is below 1 I feel wonderful and when its elevated I am fatigued, suffer joint and muscle pain, get brain fog. Its awful. When my TSH was 13 I could hardly get out of bed to pee. At 6 I can do my day but I'm tired and I struggle to focus on learning anything for my exams. Whereas when I'm in range I can power through.
5. When TSH goes down T4 and T3 go up (ah yes I suppose because we're trying to get production of these back up)
6. I was diagnosed with autoimmune thyroid disease in June 2020. I have been in optimal range once and then in NHS range twice so there have been elongated period of being on the same dose but then if I eat gluten everything goes horribly wrong and my glands swell up and it feels like everything is under attack and I'm really feel like I have a fever, during this time i dont seem to absorb the Levo (seems in line with celiac but unfortunately I cut out gluten before they could do any tests and would be too painful to reintroduce for tests). GP increases levo and I was worried that this would mean I'd end up having too much once my gut healed but it doesn't seem to work like that, I wonder if more of my thyroid gets killed off and so I continuously need the replacement. Either way I'm on 125mcg Levo now having started on 50mcg.
7. Last dose of levothyroxine was 24 hours before test.
8. Test was done fasted before 9am
9. Biotin not taken in week before this test. Was taken week before NHS test of TSH and T4 but only once by mistake and result was same as Thriva so dont think it messed it up.
10. So I should be looking to get an iron panel test done soon to make sure me going ham with the supplements hasn't taken me higher than a healthy range. Other than that its just Ferritin and TSH I need to sort out. Ferritin by finding a way to eat liver without hating life, and TSH will be fine when this increase in Levo kicks in. NHS wont test my ferritin. TSH will be tested in 6 weeks along with T4 because I only had the increase of levothyroxine this week from 100mcg to 125mcg. When do you think I should get the ferritin done again? And the other tests? If we're happy with those can I leave it a bit longer? I have to go private for these as my GP wont do them so financially the longer I can leave it the better.
6. ........... I wonder if more of my thyroid gets killed off and so I continuously need the replacement.
Hashi's is where the immune system attacks and gradually destroys the thyroid, so yes more of your thyroid gets killed off with each attack. You have autoimmune hypothyroidism, thyroid hormone replacement is for life and your dose of Levo may need adjusting from time to time.
**
My nutrients are now optimal (except for ferritin which I struggle with) and I do a full thyroid/vitamin panel once a year with one of the private labs.
Vit D - I was severely deficient and since I've reached the recommended level I have to supplement all year round so test twice a year as recommended.
Iron panel - because I know my iron is fine and it's just ferritin I struggle with, and I am still trying to optimise my ferritin level, I am doing an iron panel when I think it's necessary, maybe once or twice a year (besides ferritin being included in my annual full check).
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I agree that the antibodies look like hashis, or to be technical, it’s not hashis unless you have a goitre (enlarged thyroid) but autoimmune thyroiditis. Which is me. But I say hashis as it keeps things simple! 
Thyroid Test Results - Thriva
Can you help with new thyroid blood test results, please 
Thriva results- can anybody assess please
Results in from medichecks. I'd love some input on them please.
Help with test results
