Blue Horizon test results

[Maddyisla]

Had a hemithyroidectomy in January, on 75 of levothyroxine, put on 10lbs which I cannot shift, not feeling myself. Could anybody explain my results, I look at them and think they seem ok, but I don’t feel ok. Any advice would be marvellous, sorry not tech so I couldn’t figure out how to follow on from my previous post!

[SlowDragon Administrator]

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

Last dose change minimum of 6-8 weeks after any dose change or brand change in levothyroxine

Results show you are poor conversion of Ft4 to ft3

Ft4 is 77% through range

Ft3 is only 22% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Probably can help improve conversion rate by improving low vitamin levels

Vitamin D is good

B12 ok and folate not brilliant

Ferritin too low

What vitamin supplements are you currently taking?

Low iron and/or low ferritin frequently linked to hair loss

Heavy periods are classic sign of being hypothyroid and will lead to low iron and ferritin ask for full iron panel testing for Anaemia

Look at increasing iron rich foods in diet

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/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

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.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

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

healthunlocked.com/thyroidu...

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

Post discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Why low ferritin needs improving

healthunlocked.com/thyroidu...

[Maddyisla in reply to SlowDragon]

Yes it was done first thing on an empty stomach and no medication, increase in dose was 4 weeks ago. The supplements I take are magnesium citrate at night and vitamin D at lunch.

[SlowDragon Administrator]

What was reason for hemi thyroidectomy?

Presumably you have had ultrasound scan of thyroid?

Your antibodies are low, but 20% of Hashimoto’s patients never have high thyroid antibodies

Have you had coeliac blood test done

Definitely worth trying strictly gluten free diet AFTER coeliac blood test done to rule that out

[Maddyisla in reply to SlowDragon]

2 inconclusive biopsies, so R hemithyroidectomy due to large lump, it wasn’t cancer.

[SlowDragon Administrator in reply to Maddyisla]

So lumpy thyroid can suggest hashimoto’s, despite negative antibodies

[Maddyisla in reply to SlowDragon]

So where do I go from here, what should I do next? Sorry about all the questions

[SlowDragon Administrator in reply to Maddyisla]

Work on improving low vitamin levels

Increasing iron rich foods in diet

Perhaps adding vitamin B complex

Retest thyroid and vitamin levels in 3 months

If Ft3 remains low, see thyroid specialist endocrinologist who will prescribe T3

Email Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3 ...NHS and Private

[e-mail]

When adequately treated, TSH will often be well below 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

[SlowDragon Administrator in reply to Maddyisla]

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial. This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B is another option that contain folate, but is large capsule

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Might also be worth trial on strictly gluten free diet. But get coeliac blood test done BEFORE considering cutting gluten out