I have a few quick questions, having received my bloods back from Thriva this morning. My antibodies (TPA), which were 213 are now down to 42.5 - I assume this is a good thing! Still above the range which is 0-34 but I'm assuming they'll always be high if I have Hashi's? I've given up gluten (since Christmas), any other tips?
My T3 is low I think, it was at the higher end of the range when I was initially diagnosed back in 2016 but now is 3.7 (3.1 - 6.😎 so am I right to assume I'm not converting T4 to T3 effectively?
Are iron and ferritin different? Both have come back within range though while iron seems ok, ferritin is very much in the low end of the figures at 41 (13 - 150) so wondered if I should supplement? Vit D is low but I've started supplementing there.
Finally, what's the difference between the figures for Total Vit B12 and Active Vit B12 please? My total is 431 (300 - 569) and my active is 70 (37.5 - 188). Just want to make sure I'm supplementing correctly. They didn't test for folate which is odd.
My cholesterol was slightly above and has been for a while (it's 6 and should be below 5.2, LDL cholesterol is 3.7 and should be below 3.4 according to these figures). Is this common for Hashi's?
Thank you for any assistance you're able to offer!
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My antibodies (TPA), which were 213 are now down to 42.5 - I assume this is a good thing!
I'm not Hashi's but as antibodies have a job to do I don't suppose it matters much what their level is. If your immune system is still attacking your thyroid then the antibodies are there to mop up the mess. The antibodies aren't the problem, it's the hypothyroidism that is.
My T3 is low I think, it was at the higher end of the range when I was initially diagnosed back in 2016 but now is 3.7 (3.1 - 6.😎 so am I right to assume I'm not converting T4 to T3 effectively?
We'd need to know your FT4 result to be able to answer that question and you haven't posted that one.
Are iron and ferritin different?
Yes. Ferritin is a protein that stores iron, releasing it when your body calls for it. Compare it to a pantry full of bakes beans. You like baked beans on toast and have it every day. You keep a stock of tins of beans in your pantry, you buy 10 at a time and stock up every couple of weeks. After about 10 days your stock of baked beans is getting low so you need to go and buy some more, if you leave it a few days longer you'll run out completely. So as our bodies use iron, we need to replenish our iron store by eating iron rich foods to raise our ferritin level. (That's my non-scientific, very simple explanation, probably not completely accurate but you may get the picture.)
Both have come back within range though while iron seems ok, ferritin is very much in the low end of the figures at 41 (13 - 150) so wondered if I should supplement?
So what is your serum iron level, and transferrin saturation %?
No, you shouldn't supplement unless you know you need to. If your serum iron is already at a good level (optimal is said to be 55-70% with the higher end for males) then supplementing will increase your serum iron and that could lead to toxicity. If your serum iron is good and ferritin low then you need to raise ferritin only and that's probably best achieved by eating iron rich foods such as liver, liver pate, black pudding, etc. If taking iron tablets it's essential to test regularly with a full iron panel.
Vit D is low but I've started supplementing there.
How low? What is the level? How much D3 are you taking and in what form - oil based soft gels, tablets, capsules, oral spray?
Are you also taking D3's important cofactors - magnesium and Vit K2-MK7?
Finally, what's the difference between the figures for Total Vit B12 and Active Vit B12 please? My total is 431 (300 - 569) and my active is 70 (37.5 - 188).
There are 2 types of B12 - inactive (bound to proteins) and active (unbound and available to be taken up by the cells). Total B12 measures the total of both active and inactive. Active B12 test measures just the active B12. Active B12 is said to be the better test, think of it like Total T3 and Free T3 - it's Free T3 that is the important test.
For Total B12, according to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
You haven't given the unit of measurement for your Total B12, it could be pmol/L or ng/L or pg/ml (the latter two are the same).
Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital.
Your B12 is not deficient but is low so you could do with supplementing and it's possible that a good quality, bioavailable B Complex containing methylcobalamin and methylfolate will be enough. Consider Thorne Basic B or Igennus Super B but be aware that the Igennus contains Vit C and this keeps the body from using B12.
If supplementing with an individual B12 you need a B Complex as well to balance all the B vitamins.
For Active B12 I'd aim for 100+, for Total B12 I'd aim for top of the range.
Wow this is so helpful, thank you! I will attempt to post all my results below to answer your questions and if I can't I'll break it down! I'm a member of the Vit D group on FB as I get lots of aches and pains, so yes, supplementing with Vit D, K2, magnesium and boron in the correct proportions (I hope/believe!!!)
I recently ordered the Desert Harvest B complex (without B6) which I heard was good but I really appreciate the recommendations as will get one of the ones you mentioned when I run out I always take Vit C - should I stop that then if it might interfere with the B?
Will have a go now with these results... thanks again for taking so much time to respond, greatly appreciated!
I always take Vit C - should I stop that then if it might interfere with the B?
No need to stop your Vit C, just take it 2 hours away from B12, this is why I mentioned the Vit C being in the Igennus B Complex, there is a chance the B12 in the complex might not be absorbed.
As for your results, for the cholesterol I wouldn't worry too much, once optimally medicated for thyroid this should sort itself out, but it's the triglycerides that are the important number anyway and yours aren't out of range.
Your serum iron is 54% through range and your transferrin saturation % is 31% which is just a tad below the optimal of 35 to 45% (higher end for men). I would say not to take iron tablets but try and raise ferritin with diet. Liver is probably the best food for raising ferritin but no more than 200g per week due to it's high Vit A content, you can eat it all in one meal or spread throughout the week, it doesn't matter. Chicken livers are said to be the mildest, followed by lamb's liver, and you can always make your own pate from chicken liver.
Your FT4 at 18 (12-22) is 60% through range and FT3 is 16.22% through range so conversion is pretty poor. However, the first thing I would do is increase your dose of Levo. The aim of a Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in upper part of their reference ranges. So an increase in Levo should bring your TSH down and increase your FT4. Once it's below 1 see where your FT4 is, aim for 19.5+ with that range, then see where your FT3 lies. You haven't said how much Levo you take but a normal increase would be 25mcg then retest after 6-8 weeks.
Aim for optimal nutrient levels:
Vit D - 100-150nmol/L according to the Vit D Society and Grassroots Health
B12 - top of range for Total and 100+ for Active
Folate - at least half way through range
Ferritin - half way through range although some experts say the optimal ferritin level for thyroid function is between 90-110 ng/ml.
If these are optimal and conversion is still poor then you may benefit from the addition of T3.
Had a look at the Thorne and the Igennus - the Igennus has a much higher level of B12 (not the others, just B12) - I wonder if that's to offset the Vit C they put in?
Thank you SO much! Just for context, my GP actually decreased my Levo (I was taking 100 per day, then he decreased to 100 on 4 days then 100 on 3 days and 75 on the others) as my TSH was below 0.5 and my Free T4 at 21 but my T3 was still only 3.8 hence thinking I might have an issue converting. All that info is SO useful, thank you again.
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I always take Vit C - should I stop that then if it might interfere with the B? 
I'm hoping someone will be able to help with all my results. 
Hyper symptoms with Hypo labs
Results at last!
