I'm 61, stones overweight despite under 1000 calories maintenance for years. Have 90% of hypothyroid symptoms, but doctors insist on relying on the 'normal' TSH result I get, so no treatment.
Finally decided to have private blood test with Thriva. Seeing doctor again this week, with these results.
Coeliac test was negative, but gluten does irritate/bloat. Diagnosed with underperforming pituitary 40 years ago, in New Zealand. Doctors here don't think that's relevant (yet produces TSH?) . Don't want to complicate this though over pituitary, just thought I'd mention it. Grateful for any thoughts. Very many thanks.
TSH - 3.4 (0.27-4.2, with 1.0-2.5 optimum)
FT4 - 10.7 (12-22, with 12-17 optimum)
FT3 - 3.5 (3.1-6.8, with 3.1-5.0 optimum))
TPOAb - 326 (0-34)
T4 - 72 (66-181)
TgAB- 206.5 (0-115)
Vit.D - 53 (50-200)
Ferritin- 62 (15-150, with 44-150 optimum))
Folate - 25.2 (8.83-60.8, with 30.0-6.8 optimum)
B12 - 69 (37.5-188)
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Featherdown
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Coeliac test negative means you are not fully allergic to gluten. However you may still have a gluten intolerance - you will know how you feel if you eat bread etc to judge this.The results need ranges added - numbers in brackets after your result. this helps us interpret them.
Wow! thank you so much! I've TRIED to get doctors to go down this route for years, so hope the private test results will convince them! I've since added the ranges by editing original post.
I already take a doctor-prescribed vit.D supplement with calcium, as doctor said I could be at start of osteoporosis two years ago. I'll point out the vit.D low measurement.
Doctor insists there's nothing 'low' about my vitamin D, and said it should go up with all this sunshine at the moment (I'm still wearing trousers and cardigans though!) - but thankfully she did appreciate what the blood test results were saying about my thyroid, so has started me on 25mg levothyroxine, which she says at my age is safest to start with (61), but says she is expecting to increase this over coming months. Thank you very much for all your good advice.
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.
The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.
So your TSH is higher than a euthyroid person (who normally wouldn't have a TSH over 2) - but not high enough to usually get treatment in the UK - they will generally want your TSH over-range, possibly as high as 10
BUT you have below range free T4 and high antibodies - and this combination should be enough to persuade a GP to trial you with levo. It's possible to have a type of hypothyroidism where your pituitary "mis-functions" so TSH is "normal" but your other results are low, so although central hypothyroidism is rare, I'd be mentioning this to the GP
Meanwhile, key nutrients all need a boost -so hopefully the nutrient queen, SeasideSusie will pop up in a bit
Thank you very much - when my doctor looked at the blood test results she agreed I did not fit the usual hypothyroid profile, that relies on TSH measurement - so she's sending the results to the endocrinology department for their advice on how to measure my progress, as she has prescribed me with levothyroxine - at last!!! 25mg's to start. I did mention the pituitary aspect, and she just kind of nodded. I think she's happy to treat it as Hashimoto's, and if the tablets work, there's no need to investigate further.
It's best to take your levo on an empty stomach, just with water - one hour before or two hours after other drink or food, so you absorb it properly. Doesn't matter if you take it first hing, last thing or split the dose.
You should have another blood test after 6 - 8 weeks. Please make sure it's as early in the morning as you can get - no later than 9.30 - as TSH is highest then - with a 24 hour gap from your previous dose of levo (then take the next dose straight afterwards)
Thankfully the doctor did agree to my starting levothyroxine - 25 mgs, and because she agreed my TSH level was not a workable measure of how my thyroid is performing, she's passing the blood test results on to the endocrinology department to consider and let her know - be good if they ask to see me? Might ask for referral when she sees me again after blood test in 6-8 weeks she said. I'm in Shropshire. Very many thanks.
Sorry, only just got round to looking at which branch the levo. is - guess what, I've been put on Teva! So far I have had some tummy discomfort and some nausea? was hoping it would settle down with time, just my body getting used to it?
If I'm getting these symptoms with the 25mg Teva, is it hopeful that I should be able to find another brand with no such side effects? If so, do I have to do the whole month on Teva first, till it's time for order some more? And do I need to go through the doctor to change to try a different brand? Sorry, just don't know the protocol. With many thanks.
If you can bear it, perhaps wait until new prescription
Especially as GP perhaps looking for any excuse to stop levothyroxine
Then at next prescription speak to pharmacy to ensure you get either Mercury Pharma brand (Advanz) - available as 25mcg, 50mcg and 100mcg….. or Accord (Almus via Boots or Northstar via Lloyds) but Accord don’t make 25mcg tablets, only 50mcg and 100mcg tablets
You might need to try different pharmacies until get brand you need
This has just scraped into the "adequate" category of >50.
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. You will have to buy these yourself.
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 recommended to be half way through range so that would be 83.5 plus with that range. However, some experts say that the optimal ferritin level for thyroid function is between 90-110 ng/ml.
Yours isn't dire but you might want to improve it. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
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Folate - 25.2 (8.83-60.8)
Folate is recommended to be at least half way through range so that would be 35 plus with that range. Eating folate rich foods may help, as can a good quality, bioavailable B Complex containing methylfolate, eg Thorne Basic B.
When taking B Complex this should be left off for 7 days before any blood test as it contains biotin and this can cause false results when biotin is also used in the testing procedure (which most labs do).
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B12 - 69 (37.5-188)
Active B12 below 70 suggests testing for B12 deficiency. However, as you are just one point below that I would check for signs of B12 deficiency here:
If you do have any 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.
If you don't have any then the B12 contained in the B Complex will help raise your level. I prefer my Active B12 to be 100 plus.
Be aware that any B Complex which also contains Vit C keeps the body from using B12, so best to check before purchasing (Thorne Basic B doesn't contain Vit C).
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Diagnosed with underperforming pituitary 40 years ago, in New Zealand. Doctors here don't think that's relevant (yet produces TSH?)
Although your raised antibodies suggest autoimmune thyroid disease, I don't think the pituitary issue should be completely disregarded. Central Hypothyroidism is diagnosed when TSH is normal, low or minimally elevated and FT4 is below range. Your results fit this criteria.
Mentioned this to doctor today - she's referring my blood test results to the endocrinology department, for advice on monitoring how my thyroid is reacting to the levothyroxine - but she didn't make any note of the pituitary aspect, even though I read out what it said on one of the links - fitting the criteria for Central Thyroidism - but oh so thankfully, she has agreed to me starting levothyroxine, 25mg's, starting tomorrow. At least she agreed I have Hashimotos.
She said that my B12 was perfectly normal and not a concern - so might take supplement - maybe the Engevita vegan nutritional yeast flakes.
She was also firm that my vit.D level was perfectly normal and not a concern either. I could tell she would not listen or welcome hearing what you have told me - hit a bit of a brick wall there. Very many thanks for all the information, will certainly consider all you've told me, as I can tell it's 'facts', not just 'possible facts'.
It's a start. I suppose she's started you on 25mcg as you are over 60, the normal starter dose is 50mcg. You should be retested in 6 weeks, a 25mcg increase, then repeat every 6-8 weeks - testing/increasing - until your levels are where they need to be for you to feel well. The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.
Also work on optimising your vitamins, they all need to be optimal for thyroid hormone to work properly. Remember to leave off B Complex for 7 days before any blood tests, thyroid included.
Featherdown Hypos tend to retain water so much of your overweight may not be fat. We need calories for efficient conversion of T4 to T3. If we don't take in enough calories we disrupt this process and make our hypo situation worse. on a strict diet you may be doing yoursel more harm than good.
I'm on 40mg furosemide for water retention. That's really interesting about the negative side of minimal eating - I'd heard fasting's good for you, but I can see what you're saying makes good sense. Thank you.
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Could I get your opinion on bloods?
Please...could you give your opinion on my mum and brothers thyroid blood results.
