After many years trusting doctors when they’ve told me my blood test result is within the normal range despite me having symptoms I have had my own tests done. Unfortunately I need some help in making sense of them. I’d be so grateful for any advice you can offer
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To enable us to interpret your results accurately, can you tell us please, do you have a diagnosis of hypothyroidism and are you on any thyroid meds? If so what dose and when did you take the last dose before the test?
This is low. The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.
If you want to improve your curent level then to reach the recommended level from your current level, you could supplement with 3,500-4,000iu D3 daily.
Retest in 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.
This seems to be a good level, ferritin is recommended to be half way through range although some experts say the optimal level for thyroid function is 90-110.
However, ferritin can be raised due to inflammation or infection and appear to be higher than normal.
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Active B12: 64 (37.5-188)
This is on the low side. 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: 17.1 (8.83-60.8)
This is low. Folate is recommended to be at least half way through it's range.
Once B12 has been further tested and B12 injections or supplements started, then you could add a good quality B Complex such as Thorne Basic B. Avoid a B Complex with added Vit C as this keeps the body from using the B12 it contains, B12 should be taken 2 hours away from Vit C.
When taking a B Complex we should stop this for 7 days before any blood test as it contains Biotin and when the testing procedure uses Biotin (which most labs do) then it gives false results.
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TSH: 0.11 (0.27-4.20)
FT3: 5.1 (3.1-6.8)
FT4: 17.4 (12-22)
The aim of a Hypo patient on Levo only, generally, is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well. Your FT4 is 54% through it's range and your FT3 is also 54% through it's range so they are nicely balanced which shows good conversion of T4 to T3. If you do feel symptomatic there is plenty of room to increase your dose and get your FT4 and FT3 higher in range.
Most doctors adjust dose by TSH and freak out when they see it below range. TSH is useful for diagnosing hypothyroidism but once on thyroid hormone replacement it isn't that useful, it's the FT4 and, more importantly FT3, that tell us what we need to know. TSH isn't a thyroid hormone, it's a pituitary hormone, it's the FT4 and FT3 that are the thyroid hormones. Unfortunately most doctors don't know this and think that TSH is the only result that is important.
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Thyroid antibodies
Both are raised confirming autommun thyroid disease, known to patients as Hashimoto's. Did you know this? Hashi's is where the immune system attacks and gradually destroys the thyroid, it is the most common cause of hypothyroidism.
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 this is probably why your levels are low.
I am a bit suspicious about your Ferritin level, especially as the others are low. Hashi's causes inflammation and this could be the reason your ferritin seems so good, it may not be and you may have a good ferritin level normally, but it is a possibility.
If not already on strictly gluten free diet request GP do coeliac blood test, or buy one online before trialing strictly gluten free diet
Meanwhile working on improving low vitamin levels
How much vitamin D are you currently taking
high antibodies 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 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.
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