I have recently had these private blood tests with Medichecks and wonder if anyone could give their opinion.
I currently take 125 levothyroxine daily, reduced from 150 as requested by my doctor, eight weeks ago. I don't feel too bad but still have some symptoms, constipation, unable to loose weight, tiredness, brittle nails so wanted to know if I had Hashimoto's, which they say is the case.
The Medichecks doctor recommends supplementing with Vitamin D as I am low, which I will do. I also take, iron, vitamin c and selium supplements.
Inflammation
CRP HS 0.7 mg/l (Range: 0 - 5)
Iron Status
Ferritin 114 ug/L
Optimum Ferritin level for females : >27 ug/L
(Range: 13 - 150)
Vitamins
Folate - Serum 6.0 ug/L
If no change in dietary habits,a normal serum
folate makes folate deficiency unlikely.
(Range: > 2.9)
Vitamin B12 - Active X >256.0 pmol/L (Range: 25.1 - 165)
Vitamin D X 26 nmol/L
Interpretation of results:
Deficient <25 nmol/L
Insufficient 25 - 49 nmol/L
Normal Range 50 - 200 nmol/L
Consider reducing dose >200 nmol/L
(Range: 50 - 200)
Thyroid Hormones
TSH X 0.23 mIU/L (Range: 0.27 - 4.2)
Free T3 4.5 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 20.1 pmol/l (Range: 12 - 22)
Autoimmunity
Thyroglobulin Antibodies X 320.0 IU/mL
Method used for Anti-Tg: Roche Modular
(Range: 0 - 115)
Thyroid Peroxidase Antibodies X 539.0 IU/mL
(Range: 0 - 34)
Hopefully I have put everything on, but sorry if I've missed things off.
Any advice would be greatly appreciated.
Thank you
Written by
Kay1566
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This is an inflammation marker and yours is nice and low so this is a good result.
Ferritin 114 ug/L (Range: 13 - 150)
This is a good result. You say you are taking iron tablets. Are these prescribed and is your GP monitoring you with a regular iron panel test?
If not and you are self supplementing with iron tablets I would suggest that you do an iron blood test with Medichecks (they have a 20% discount code at the top of the page today only):
This is because taking iron tablets raises serum iron as well as ferritin. If serum iron gets too high it's toxic, too much iron is as bad as too little. You need to know how high your serum iron is and whether or not you should continue with the iron tablets.
Folate - Serum 6.0 ug/L (Range: > 2.9)
The range is actually 2.9-14.5 and Folate is recommended to be at least half way through range, so at least 9+ with that range. Eating folate rich food may help raise your level.
Vitamin B12 - Active X >256.0 pmol/L (Range: 25.1 - 165)
This is high over range. Do you supplement with B12 or a B Complex at all? If you don't supplement at all I would discuss this result with your GP who might want to investigate the cause of it being so high.
Vitamin D X 26 nmol/L Deficient <25 nmol/L
As you can see your result is just 1 point off being deficient with their range. Some health authorities class deficiency as <25, others <30.
Whichever yours is I would discuss this with your GP and ask to be treated for Vit D deficiency according to NICE treatment summary for Vit D deficiency: cks.nice.org.uk/vitamin-d-d...
(click on Management > Scenario:Management)
"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 25 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.
* Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
If your GP refuses then I would buy your own supplement and follow that protocol yourself.
Once the loading doses have been completed you will need a reduced amount so you should make sure that you are retested after you have finished the loading doses so that you know how much you should then take going forward. Most doctors, if they continue prescribing, only give 800iu daily which isn't enough. If GP wont retest then do this privately (link below) and post your new result at the time for members to suggest a new dose to bring your level up to what's recommended by the Vit D Society and Grassroots Health - which is 100-150nmol/L - and 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:
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.
Suggestions for D3 supplement - Doctor's Best D3 softgels which are a good quality, budget friendly, clean supplement with no excipients whatsoever. Some people like BetterYou Oral Spray but it does have a lot of excipients.
For Vit 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.
* Nothing to eat or drink except water before the test
* Last dose of Levo 24 hours before test
If this is how you did your test then your results can be interpreted as follows:
TSH X 0.23 mIU/L (Range: 0.27 - 4.2)
Free T3 4.5 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 20.1 pmol/l (Range: 12 - 22)
Your 125mcg Levo is giving you a good level of FT4 at 81% through it's range. However, your FT3 is only 37.84% through it's range and this shows you are not converting T4 to T3 very well.
Optimal nutrient levels are necessary for good conversion to take place so improving Vit D might help.
Selenium is also said to help conversion.
It could be that you are just a poor converter and need the addition of some T3 to your Levo. It's low T3 that causes symptoms.
Thyroglobulin Antibodies X 320.0 IU/mL (Range: 0 - 115)
Thyroid Peroxidase Antibodies X 539.0 IU/mL (Range: 0 - 34)
Your raised antibodies suggest that you are positive for autoimmune thyroid disease aka Hashimoto's which 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.
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. This could very well be why your Vit D is deficient.
Thank you so much for your help, it makes such a difference to get such good advice from people with knowledge and who understand.Sorry I forgot to say I also supplement with magnesium citrate too.
I have no idea why my B12 is high, I was told this last year after investigation into high platelets. I have never supplemented B12 at all.
I will try speaking to my doctor about this and the vitamin D3.
Do you think I should say about Hashimoto's and not converting t4 to t3, all my doctors seem to go by is just tsh levels and wont test anything else, hence my private one.
all my doctors seem to go by is just tsh levels and wont test anything else,
Yes, unfortunately this is what they're taught, it has to be a very enlightened doctor to consider the actual thyroid hormones (FT4 and FT3) rather than the pituitary hormone (TSH). Most of us have this problem and it keeps us ill.
Do you think I should say about Hashimoto's and not converting t4 to t3,
You can show him your results and say something along the lines of
"It would appear that the cause of my hypothyroidism is autoimmune"
this is actually the most common cause of hypothyroidism. He may or may not be interested, most of them dismiss antibodies as being unimportant (if they understand what it's all about!), but it's not the Hashi's that's treated it's the resulting hypothyroidism.
As for conversion of T4 to T3, again many doctors are ignorant of this and a GP can't do anything about prescribing T3, that has to come from an endo if you can find one that is open to T3 prescribing if they understand about conversion. Most endos are diabetes specialists and have little to no knowledge about treating hypothyroidism properly.
I don't have raised antibodies so that subject has never come up by my GP is totally TSH obsessed and refuses to discuss FT4 and FT3 level. I haven't even bothered bringing up the subject of my poor conversion, I've not got anywhere with anything in the past and that is not likely to change so I just address this myself like many members here do.
Currently your TSH is low/suppressed and I'm guessing that is all your doctor is looking at and why he reduced your dose by 25 mcg 6 weeks ago as s/he believes you are verging towards hyper or overmedication - maybe show the private blood test so to confirm you are no way near what they " think " :
Sadly in primary care it seems irrespective of why you are hypothyroid only a TSH is run.
The TSH was originally introduced as a diagnostic tool to help diagnose hypothyroidism and was never intended to be used once the patient was taking any form of thyroid hormone replacement. and the least important measure of anything when on thyroid hormone replacement.
Your T4 is now around 80 % through but your T3 is struggling at around 38% through :
Ideally both T3 and T4 need to be balanced and we generally feel better when both thyroid hormones are nearing the top quadrants of their ranges.
If you felt better on 150 mcg T4 this higher dose might have just elevated your T3 that bit higher to alleviate hypothyroid symptoms I would suggest returning to your previous dose.
Hashimoto's is an auto immune disease and it can get confusing as you can experience erratic thyroid levels when your immune system is active. These " hyper swings " inevitably swing back with your thyroid being further damaged and disabled and with you needing to increase your thyroid hormone replacement to compensate accordingly.
The accepted conversion ratio when on T4 - Levothyroxine only is 1 - 3.50 - 4.50 - T3/T4 with most people preferring to be around 4 or under :
So to find your conversion ratio you simply divide your T3 into your T4 and I'm getting 4.50 :
Hopefully once your vitamins and minerals are all optimal this conversion will improve :
Hypothyroidism and hyperthyroidism are the extreme ends of the same T3 stick: too high a level of T3 and you are looking at hyper type symptoms whereas too low a level of T3 and you are looking at hypo type symptoms :
I read of many people following the research and writings of Dr Isabella Wentz who has Hashimoto's and read healing of the gut and checking for food intolerances such as gluten, wheat, dairy and processed foods that can tend to activate an immune system response in some people.
I'm with Graves post RAI thyroid ablation back in 2005 and now I'm self medicating and buying my own full spectrum thyroid hormone replacement as I was refused anything other than T4 - Levothyroxine despite there being other thyroid hormone options widely available in most other countries.
Thank you everyone, I shall speak to my doctor and see how I get on.If I'm still struggling I shall more than likely be back for some more help and advice.
you have high antibodies this confirms cause is 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
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.
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
No I've never taken multi vitamins, only take, iron prescribed by the doctor, vitamin c to help the absorption of that, selenium and magnesium citrate. I have high platelets which my Mum does too, I was referred last year to a consultant as the platelets had been high for ten years apparently, I never knew as no one had told me, but they had been monitoring since I had been diagnosed with my thyroid. They have no idea why the platelets are high but are just keeping an eye on them still, but the consultant mentioned my B12 being high, which again I didn't know, GP never done anything so I will ask again.Thank you for your advice, it is appreciated.
Hi Fiona my B12 came back over range on my last Medichecks test as well. Took it to the GP. Not concerned and said would ‘re-test’ (GP has never tested B12!) in six months. I don’t supplement or drink alcohol. Bit bewildering. Hope they do more for you! x
It's very interesting about the gluten free diet. As a child I was diagnosed with ceolic, was totally gluten free from being weaned to about ten when they decided to reintroduce it back into my diet and I seemed to tolerate it. I have had ceolic tests in the past and they have come back fine, but maybe I need to try the diet again to see if it helps like you suggested, thank you.
I have recently had a reduction in my Thyroxine intake. I put this down to the fact that for the last year or so, I have been drinking & cooking with Fluoride-free water; as I read somewhere that Fluoride interferes with Thyroid function...maybe you should give it a try too? God Bless You!
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