Medichecks results / advice on supplements (hypothyroid)

[Londonist]

I had some really helpful info and advice on my previous post - thank you. I've now had a Medichecks test and these are the results:

TSH: 1.9 (0.27 - 4.2)

FT3: 4.6 (3.1 - 6.8)

FT4: 23 (12 - 22)

Thyroglobulin antibodies: 311 (0 - 115)

Thyroid peroxidase antibodies: 315 (0 - 34)

Ferritin: 58 (13 - 150)

Folate: 5.2 (2.9 - 14.5)

Active B12: 69 (25.1 - 165)

Vitamin D: 32 (50 - 200)

I am taking 125mcg levothyroxine, and this blood test was at 9am, fasting and 26 hours after last dose.

The Medichecks report notes Vitamin D insufficiency and suggests supplementing with 800 -2000 iu (20-50 mcg) of vitamin D per day for ten weeks - does that sound right? It also recommends a serum methylmalonic acid (MMA) blood test to work out whether there is significant underlying B12 deficiency, and eating more folate-rich foods.

Should I be concerned about the high T4 level? On my last NHS test it about six weeks previously it was 21.5 against the same range, so already at the top of the range and now over. I haven't had antibodies tested before so this shows Hashimoto's, so I guess I should think about a gluten-free trial although it would be a big effort!

Ongoing symptoms are fatigue, dry skin and hair, hair loss, constipation, low mood and generally feeling achey and about 100 years old. Brain fog/confusion has improved since I was first diagnosed last summer though.

Would be very grateful for advice on next steps/recommended supplements etc.

[SlowDragon Administrator]

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Low vitamin levels are extremely common with Hashimoto’s

Do you always get same brand of levothyroxine at each prescription

Currently you have very poor conversion of Ft4 (levothyroxine) to Ft3 (active hormone)

Improving low vitamin levels should help improve conversion

So that’s first step

All vitamins are too low and need improving

Vitamin D at least around 80nmol and around 100nmol maybe better

Folate and ferritin at least half way through range

Active B12 at least over 70

[SlowDragon Administrator]

Yes...it’s always worth trying strictly gluten free...but get coeliac blood test done BEFORE cutting gluten out

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

Low vitamin levels affect Thyroid hormone working

Poor gut function 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.

[SlowDragon Administrator]

Low vitamin D

GP should prescribe 1600iu everyday for 6 months

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing at 2000-3000iu daily may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS postal kit

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Taking too much vitamin D is not a good idea

chriskresser.com/vitamin-d-...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[Londonist]

Thank you SlowDragon and apologies - I completely forgot about this post!

I've started the BetterYou Vitamin D (3,000iu) + K2 mouth spray and also a magnesium body spray. Slightly baffled by the many magnesium options so not sure if what I've gone for is right!

I'm eating more folate and iron-rich foods and I'll also try the B vitamin complex recommended on my other post. Fingers crossed all this helps...

Thanks again for the advice

🙂