Requesting assistance with thyroid panel lab results.

[RoadToRecovery]

Hello, today I received my thyroid panel blood tests results and would appreciate assistance in reading the results and planning my next move, thank you.

[RoadToRecovery]

Thyroid Panel Lab Results.

Thyroid Panel Lab Results.

[Nanaedake in reply to RoadToRecovery]

Have you been diagnosed with a thyroid condition and are you taking thyroid medication? Why did you have these tests? Have you got symptoms and if so, what are they? Can you give a bit more information please?

[RoadToRecovery in reply to Nanaedake]

The brief version of it would be that I have not been diagnosed with a thyroid condition and not on medication,

my GP / doctor saw that I had elevated TPO antibodies, referred me reluctantly to an endo, was told I would only recieve a 6 month regular check up period (wait and watch approach, no thanks) but did receive a thyroid scan which showed no abnormalities.

They took no further action, so I took it into my own hands to do my research which led me down the path of requesting my own labs.

Looking into functional medicine as my next option.

Symptoms I have experienced are;

- Underweight, difficulty gaining weight.

- Heart palpatations.

- Thinning hair.

- Tinnitus related issues.

- Random joint pains.

- Muscle spasms.

- Cold intolerance

- A form of Hypohidrosis.

- Chronic Hives / Urticaria.

- Fatigue.

- Bouts of depression and anxiety.

Those are the ones I can think of currently.

[SlowDragon Administrator in reply to RoadToRecovery]

Difficulty maintaining weight is strong ground to get coeliac blood test done via GP

Hives and Hashimoto’s

thyroidpharmacist.com/artic...

Joint pain may improve as vitamin D increases

Also gluten or wheat often causes joint pain

[RoadToRecovery in reply to SlowDragon]

Apologies, I didn't see this, appreciate you brining this information to my attention.

Yes, I really need to get onto that Vit D optimisation don't I.

The hives have been a nightmare, although I must have done something right, because it has toned down in severity over the months, but is still a lingering issue.

I would like a concrete answer on this Gluten / Celiac situation / possibility.

[SeasideSusie Remembering in reply to RoadToRecovery]

RoadToRecovery

The first thing to say is that your cortisol level is very, very low, it's at the very bottom of it's range as you did your sample at 9am. I'll ask Hidden to comment on that.

Your thyroid antibodies are raised confirming autoimmune thyroid disease, aka Hashimoto's, which is where the immune system attacks and gradually destroys the thyroid.

Are you on thyroid hormone replacement?

The reverse T3 test is, unfortunately, not worth the time and money doing it. If it comes back raised it can't tell you why it's raised and there are many, many reasons for high rT3 and only one of them is to do with the thyroid which is when there is an excess of unconverted T4. Measuring FT4 and FT3 tells us that anyway.

Ferritin is fine but your vitamins are low. Are you taking any supplements at all?

[RoadToRecovery in reply to SeasideSusie]

I have not even been able to get officially diagnosed with a thyroid problem, so no medication.

(Incompitent or lacking knowledge endo/doctors)

The only supplement I currently take is Vitamin D3 1000 U.I, one a day.

Are the anti bodies, vitamins and cortisol my major concerns as of now then?

[SeasideSusie Remembering in reply to RoadToRecovery]

RoadToRecovery

Vit D: 41nmol/L - taking 1,000iu D3 daily.

This is in the "insufficient" category and low Vit D can cause muscle and joint pains.

Your GP may possibly prescribe a low dose of D3 due to you being in the insufficient category but to be honest you may be better off addressing this yourself.

The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.

To reach the recommended level from your current level, you could supplement with 5,000iu D3 daily.

Retest after 3 months.

Once you've reached the recommended level 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:

vitamindtest.org.uk/

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.

For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.

For Vit K2-MK7 I like Vitabay or Vegavero brands which contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.

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.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

**

B12: 416pmol/L = 564pg/ml

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."

If that was my result I'd be looking to improve my level and get it up to nearer 900-1000pg/ml (664-738pmol/L).

Folate: 13.8 (8.83-60.8)

Folate is recommended to be at least half way through range, so that would be around 35+ with that range.

My suggestion would be to supplement with a good quality, bioavailable B Complex containing methylfolate and methylcobalamin such as Thorne Basic B and this should raise both folate and B12 levels.

When supplementing with B Complex we need to leave this off for 7 days before any blood test because it contains Biotin and when Biotin is used in the testing procedure (which most labs do) then it gives false results.

**

Are the anti bodies, vitamins and cortisol my major concerns as of now then?

You can't do anything about the antibodies. Their job is to mop up the mess after the immune system attacks the thyroid. The Hashi's isn't treated, it's the resulting hypothyroidism that is treated, but you wont get a prescription for Levo until your TSH goes over range along with a raised antibody result.

The cortisol result should prompt further investigation by your GP, Hidden will explain when she's around, I am not au fait with the tests but low cortisol may suggest Addison's Disease.

[RoadToRecovery in reply to SeasideSusie]

I truly appreciate your detailed response, I will get right onto taking notes and absorbing all the information, and putting your advice into action.

I will keep you updated with any questions I am have and changes I may experience, also looking forward to the input of Pauline.

Many thanks, Susie!

[SlowDragon Administrator]

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

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

Low vitamin levels affect Thyroid hormone working

Obviously you need to improve your low vitamin levels as first step

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

healthcheckshop.co.uk/store...?

Assuming coeliac 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.

hypothyroidmom.com/how-to-l...

Eliminate Gluten. Even if you don’t have Hashimoto’s. Even if you have “no adverse reactions”. Eliminate gluten. There are no universal rules except this one.

Why gluten intolerance can upset cortisol levels

kalishinstitute.com/blog/gl...

[SlowDragon Administrator]

You need to show these results to GP

Especially the low cortisol

See endocrinologist again for further testing for adrenal insufficiency or Addison’s

ACTH testing or 24 hour urine test for total cortisol

Common for adrenals to get exhausted trying to compensate for lack of thyroid hormones

You need thyroid and adrenal specialist endocrinologist

Roughly where in the U.K. are you?

Email Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private

[e-mail]

[RoadToRecovery in reply to SlowDragon]

Thank you for providing me witb all that information, really appreciated.

I have read about the potential gluten connection and was actively making an elimination effort, and because of your confirmation and information on it, will continue to make the effort in elimination of gluten from my diet.

I am hoping that the adrenal issue is simply a fatigue brought on by the thyroid condition and not another disease I have to battle along side. (Addison's)

Though the cortisol level is worrying and looking like a bleak outcome.

I am currently based in the Greater Manchester area, I will get right onto contacting the contact / email you have provided.

Many thanks!

[Hidden in reply to RoadToRecovery]

Sorry only just seen this. I agree your cortisol level is very low & urgently needs to be addressed. You need to be seen by an Endo for them to run further tests. Ask our GP to do an early morning cortisol again so they can see themselves the level is low. Even though the reference range given is from 113, the optimal level for cortisol around 9am should be between 350-550nmol/Ls so yours is very low. You need to see an Endo who is conversant with pituitary/adrenal issues as not all of them are. As we aren't allowed to comment on hospital or doctors I will message you with a couple of suggestions. The Ensdo should do a short synacthen test to see how your adrenal glands respond to the artificial ACTH you are injected with. They also need to do anACTH blood test at the start to see if the issue is with your pituitary gland rather than adrenal glands. The pituitary secretes ACTH to stimulate the adrenal glands to produce cortisol. Being diagnosed with either adrenal insufficiency or Addison's is not a bleak outcome if treated properly with replacement steroids. I have secondary adrenal insufficiency caused by removal of a tumour from the pituitary gland so I am now steroid dependent. Addison's or primary can be caused by an auto immune condition or removal of both adrenal glands. Secondary adrenal insufficiency is caused by either long term steroid use or an issues with the pituitary gland.

In the meantime if you start to vomit or have diarrhoea, feel dizzy,have a low BP contact 111 & tell them that you may have adrenal insufficiency or are going into adrenal crisis, it is a medical emergency & needs to be treated quickly with steroids. I'm happy to answer any questions if I can.

[RoadToRecovery in reply to Hidden]

Hey,

Thanks again for all the information and advice you have provided.

Will get right onto taking notes and putting into action in seeing my registered GP or any private options as this needs to be addressed as quickly as possible.

I will make sure to message you directly If I have an specific of urgent questions that may be of relevance, again, thank you for your input along with Susie's.

[SlowDragon Administrator in reply to RoadToRecovery]

Like many undiagnosed/long standing Hashimoto’s patients I had adrenal exhaustion, but once thyroid was (finally) correctly treated, it slowly improved, especially after improving low vitamin levels and like thousands of members I found strictly gluten free diet absolutely essential. More on my profile.

I was tested throughly for Addison’s, Cushings and pheochromacytoma (tumour on adrenals) …..but thyroid was the cause ….and getting thyroid sorted slowly resolved adrenal issues.

[RoadToRecovery in reply to SlowDragon]

Well, let's hope that I am also a case of adrenal exhaustion that can be corrected through thyroid management, and not something more concerning and serious.

I really do need to ger right onto that vitamin & mineral optimisation, as well as the gluten removal / investigation.

Appreciate your input, thank you.