I have been having blood tests for several years but a temporary GP at my practice was concerned with my thyroid.
I did a home test with Thriva, first thing in the morning on an empty stomach. I am not on any medication other than antidepressant Sertraline.
I phoned my GP with the results but he seemed unconcerned and wants them done again in a couple of months. He did recommend I take an over the counter B12 supplement.
My symptoms are terrible and interfere with my quality of life. I am so fatigued and drained that I can’t function sometimes. I don’t sleep well, iI choke on my own saliva and Iwake up regularly choking. I have times when my fingers go numb, I feel like my throat and tongue are permanently inflamed and sore.
Could anyone help me make sense of my results please?
Should I be asking my GP for anything more?
I am so tired.
Thanks
Ally x
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Allyfin1
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This is low but will be classed as in the "sufficient" range by the NHS.
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 4,000-5,000iu D3 daily.
Retest after 3 months.
Once you've reached the recommended level then a maintenance dose will be needed 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. This can be done 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.
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.
Ferritin is over range. Assuming that you don't take any iron supplements then raised ferritin can be a sign of infection or inflammation. You have Hashi's (*see below) and this can cause inflammation, this could be the cause of your raised ferritin.
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Active B12 is dire at 31 and your GP should be ashamed of himself for suggesting you just take an over the counter B12 supplement. It's very likely that you may need B12 injections. Further testing for B12 deficiency and Pernicious Anaemia is essential.
Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
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Folate: 25.4 (8.83-60.8)
Folate is recommended to be at least half way through range. Yours isn't too bad but is only 32% through range. Eating folate rich foods might help, but once further testing of B12 has been carried out and B12 injections (or supplements) started, you can then add a good quality, bioavailable B Complex such as Thorne Basic B which will improve folate level and keep all the B vitamins balanced.
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TSH: 4.72 (0.27-4.20)
FT4: 11.5 (12-22)
FT3: 4.4 (3.1-6.8)
TPO antibodies: 230.7 (<34)
Tg antibodies: 157.1 (<115)
You have autoimmune thyroid disease, known to patients as Hashimoto's, which is confirmed by your raised antibody level. Hashi's is the most common cause of hypothyroidism and is where the immune system attacks and gradually destroys the thyroid. Your thyroid now cannot produce enough thyroxine (T4) as shown by your below range FT4 level, and your over range TSH also gives a diagnosis of hypothyroidism.
I really don't see how a GP can be unconcerned by these results, especially your below range FT4. It just goes to prove that most GPs know very little about hypothyroidism.
Hopefully your retest in a couple of months will show results just as poor as these and if so your GP needs to prescribe Levothyroxine, starting at 50mcg daily and retesting after 6 weeks, further testing/increasing every 6-8 weeks until your levels are where they need to be for you to feel well.
Some information about Hashi's:
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 and may well be the cause of your dire Vit B12 level.
Thank you so much for this comprehensive answer, I really appreciate it.
I feel like my GP is just not interested in my symptoms at all and he just said to have more bloods done in 3-4 months time (so end of July from my last results) to include vit b12 tests. I feel so dreadful I am wondering whether to just do some private tests sooner with the hope of getting treated?
I am beyond exhausted, some days I literally cannot function and am having no quality of life. My eyes are sore and itchy, I have stomach issues, I am heavy and still gaining weight, I have such bad post-nasal drip that I have a constantly sore throat. My tongue is sore and feels too big for my mouth, my snoring is awful. I choke on nothing all the time, saliva, or if something even touches the back of my throat when I am eating. I also wake up choking. It is so scary.
I really don’t know what to do as it is so difficult to get an appointment at my GP’s and when I do they do everything over the telephone, you are never seen and examined, and I feel like they think I am just a nuisance.
I am at my wits end. 😮💨 It’s so nice to have someone respond to me who understands. Thank again.
I feel like my GP is just not interested in my symptoms at all and he just said to have more bloods done in 3-4 months time (so end of July from my last results) to include vit b12 tests.
If your GP repeats the test then he really needs to do more than the basic TSH or TSH plus FT4 that most GPs do. You definitely need antibodies testing, generally only TPO antibodies are tested at Primary level but that's OK as long as they are over range then the confirm autoimmune thyroid disease. If antibodies are raised alongside over range TSH then your GP should start you on Levothyroxine, without raised antibodies then he will want to wait until your TSH has reached 10.
It might be an idea to put all your symptoms in writing, include a copy of your results, and ask to be put on a trial of Levo.
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