I recently had an advance thyroid test done through Medichecks. Im posting my results below to see if anyone has any thoughts. Am seeing my endo next week so want to gather some info before then. Im particularly concerned by the high antibody levels and wondering what this might mean for my treatment. Any input very welcome!
I am currently taking 100mg thyroxine per day and 10mg T3.
Im posting my results and the normality range they have given in brackets.
Ferritin - 23 ug/l (13-150)
Folate serum - 15.1 ug/l (2.9-15.68)
Active B12 - 52 pmol/l (25.1-165)
TSH - 0.06 mlU/l (0.27-4.2)
Free T3 - 4.6 pmol/l (3.1-6.8)
Free Thyroxine - 14.6 pmol/l (12-22)
Thyroglobulin Antibodies - 162 IU/ml (0-115)
Peroxidase Antibodies 97.7IU/ml (0-34)
Thanks!!
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Whereislola21
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The test was done at 9am before eating or drinking anything and last dose of both t3 and t4 was 24 hours before.
I don’t split the dose of t3 currently - would you recommend this?
I have never had coeliac test done and I do eat gluten though I do think I have a mild intolerance as I get quite bad bloating.
I am actually 6 months post-partum and taking a post-natal multivitamin, though I did stop taking this for 10 days prior to the blood test. I am also breastfeeding.
Yes, I missed off vit D by accident - it’s 70.
Yes, I am vegan and have been for about 5 years. Through my pregnancy I took b12 and iron as well as a prenatal multivitamin as I was low in both, though I was advised by gp soon after giving birth to stop as my levels looked normal at the time. Not sure what they were.
Thorne Basic B is an option that contain folate, but is large capsule. You can tip powder out if can’t swallow capsule
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins)
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
This is the multivitamin I am taking. I take three per day all just after my main meals. I am wondering if you would mind taking a look and letting me know if this serves the needs you mention above? Does it contain all of the B vitamins? Should I also be taking Ferritin?
Well, that multi is pretty awful, like they all are.
Some explanations as to why:
1. It contains iron, so absorption of all the vitamins will be completely, or partially blocked. Iron should be taken 2 hours away from everything (four hours away from thyroid hormone) except vit C.
2. It contains calcium:
a) doubtful you actually need to take calcium. Calcium deficiency is rather rare, even in vegans. And excess calcium is a very bad thing.
b) calcium supplements are very badly absorbed and tend to build up in the arteries and soft tissues. They have added K2, which should help absorption, but hard to know how much of that you will actually absorb due to the iron.
c) on the other hand, taking iron and calcium together is not advisable because they bind together (elementary school chemistry!) so, no way of knowing how much of either you will absorb anyway.
3. It contains vit C. And, whilst vit C is a great nutrient, and necessary to aid absorption of iron, it will also negatively affect any vit B12 that you might manage to absorb.
4. It contains zinc and copper. It's true that these two need to be kept balanced, but in hypos they rarely are. Hypos are usually too high in one and too low in the other. So, before taking either of them you should get them both tested. Excess copper is not a nice thing to have!
5. It contains iodine. Iodine is not a good thing for anybody to take unless they have been tested and know they need it. Even then, their treatment should be over-seen by an experienced medical professional. Taking unnecessary iodine when hypo can cause all sorts of problems, making Hashi's worse - or triggering it if you don't already have it. You will already be getting iodine from your levo (if taking it) - 100 mcg levo contains 65 mcg iodine. Excess iodine is antithyroid.
6. It contains the wrong type of selenium.
7. The quantities are unbalanced - too much of some, not enough of other to make a difference. Multi-vits are not designed for people who have defficiencies.
So, you can see how much you are paying for that you aren't even absorbing. Far better to get tested for everything and just take what you need according to the results. And, taking them at the right times, not all at once.
Wow, I had no idea! Thanks so much for all this information, its invaluable.
I will be buying separate vitamins for future use.
Would you recommend any iron supplement in particular given my iron result? Should I be splitting it up into ferritin and folate or can I get one that combines?
I have been prescribed cyanocobalamin (B12) by my GP.
Would you recommend any iron supplement in particular given my iron result?
No, I don't have any recommendations to give because I don't live in the UK, and I have no idea what is available there.
Should I be splitting it up into ferritin and folate or can I get one that combines?
Ferritin is the protein that stores iron. So, to raise the level, you need to take iron.
Folate is a B vitamin. So, no you cannot take folate and iron together. You will get folate from the B complex you need to take at the same time as your sublingual methylcobalamin (B12) - but make sure it is methyl folate, not folic acid.
I have been prescribed cyanocobalamin (B12) by my GP.
Yes, because it's cheaper than methylcobalamin! But not as well absorbed. How much has he prescribed? Doubt it's enough.
What do you make of the b complex below?
Not good for two reasons:
a) they don't tell you the form of the B12 and folate - methyl or not?
b) the quantities are unbalanced - not enough of some, too much of others.
I wouldn't take that one, if I were you. What you want is Thorne Basic B Complex.
Thank you! I have ordered their b complex and their selenium and have asked the community re iron supplements.
Do you think the b12 in the Thorne b complex would be enough, or do I need to still take the one from GP. Yes, it is the cheaper and less effective version and they've prescribed 50mcg daily.
Only 50 mcg and the wrong form? Not worth taking. Won't do a thing for you. If I were you, with your level, I would get a sublingual methylcobalaming of 1000 mcg daily, plus the B complex, and take that until the pot is empty. Then, continue with just the B complex as a maintenance dose.
I have never had coeliac test done and I do eat gluten though I do think I have a mild intolerance as I get quite bad bloating.
you have high antibodies this is known by medics here in UK as autoimmune thyroid disease. Technically it’s Hashimoto's (with goitre) or Ord’s thyroiditis (no goitre). Both variants are autoimmune and more commonly just 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
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
Before considering trial on gluten free diet get coeliac blood test done FIRST just to rule it out
If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)
If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
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.
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.
The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3
Also test iron and ferritin levels regularly, especially if supplementing iron
Extremely difficult to maintain optimal vitamin levels as Hashimoto’s patient, but doubly so if vegetarian or vegan
Vitamin D at 70 is ok, but not brilliant
Aiming for at least around 80nmol and around 100nmol maybe better
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
You need an iron panel to confirm iron deficiency and a full blood count to see if you have anaemia. You can have iron deficiency with or without anaemia.
Folate serum - 15.1 ug/l (2.9-15.68)
Are you supplementing with methylfolate or a B Complex?
Active B12 - 52 pmol/l (25.1-165)
This is low. 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.
TSH - 0.06 mlU/l (0.27-4.2)
Free T3 - 4.6 pmol/l (3.1-6.8)
Free Thyroxine - 14.6 pmol/l (12-22)
These are fairly typical results for someone on combination thyroid hormone replacement. One expects to see a low, even suppresssed TSH when taking T3. One also expects to see FT4 lower in range than when taking Levo only. Your FT3 is on the low side for someone taking T3, typically it would be in the upper part of it's range.
Your FT4 is 26% through range and your FT3 is 40.54% through range.
Whether these levels are right for you only you can say (they would be too low for me and I am on Levo plus T3).
Where we need FT4 and FT3 when on combination meds is very individual. There is room to increase your meds if you don't feel optimally medicated. Both FT4 and FT3 could do with improving if you feel you need to increase meds. However, only increase one at a time, never both together or you wont know what helps. If you increase Levo this will increase your FT4 and your FT3 depending on how much natural conversion you have. Increasing T3 will increase your FT3 level and may reduce your FT4 level.
Thyroglobulin Antibodies - 162 IU/ml (0-115)
Peroxidase Antibodies 97.7IU/ml (0-34)
Im particularly concerned by the high antibody levels and wondering what this might mean for my treatment.
Raised antibodies confirm autoimmune thyroid disease, known to patients as Hashimoto's. It means nothing in regards to your treatment. Hashi's isn't treated, it's the resulting hypothyroidism that's treated.
Hashi's which is where the immune system attacks the thyroid and gradually destroys it.
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. This may explain your dire ferritin level and low B12.
I am ordering an advanced iron profile test, though my gp said my iron levels were normal based on my last blood test so I think this is something I will have to manage myself by supplementing. I will contact them re the B12 but again they have said quite recently that my results are in normal range and actually took me off a prescribed b12 they were giving me during pregnancy, which was 6 months ago.
Below is the multivitamin I am taking. I take it three times a day after each meal. Does this seem adequate to you? I stopped taking it two weeks before these most recent bloods.
I will discuss with my endo on Thursday the idea of increasing t3 or t4 one at a time. I certainly dont feel adequately medicated so hopefully he has some suggestions there.
Thanks for the info about removing gluten. I am keen to try that and once I have finished all of the gluten containing items I currently have in the house I am going to give it a go.
Your GP is being negligent in following NICE guidelines if he wont consider investigating your iron level, they are quite clear about a level below 30 being iron deficiency. If yourGP doesn't like the fact that it's a private test then he should do his own.
Multivitamins aren't recommended here for a variety of reasons, they tend to contain too little of anything to help low levels and usually use the cheapest, least absorbable and wrong form of active ingredients; however, yours does actually use the right forms. But it does contain things that should be tested for before supplementing and we should only take if found to be deficient, these are calcium and iodine. Were either of these tested? If not then it's not wise to take them.
Iodine solution used to be used to treat hypERthyroidism and can make hypOthyroidism worse.
We always recommend testing key nutrients and supplementing what is necessary at an appropriate dose.
PS - if you want to test iodine then the best test is a non-loading urine test which Genova Diagnostics offer:
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