Hello, I am going to post my recent blood test results and would appreciate your thoughts and advice please. My last results approx 4 months ago were:
TSH
4.69 mU/L [0.35 - 5.5]
FREE T4
17.4 pmol/L [10.5 - 21.0]
Please note change to free T4 reference range.
FREE T3
3.9 pmol/L [3.5 - 6.5]
This was on 100mcg. I then upped to 100 -125mcg on alternate days. After my recent results and discussion with Dr I have upped to 125mcg daily. This was just over a week ago. I have been on holiday and unable to seek advice before now! I took Thyroxine in the morning the day before the test and fasted for about 10 hours. My Dr says the results confirm Hashimoto's. He also said not to worry about a low lymphocyte count, this is common and often fluctuates. I'm not sure why this was tested in the first place. Both my TSH and T4 seem to have gone down and my T3 stayed the same. Please advise! The main reason for wanting to get my dose right is to lose a very stubborn stone (or 2) in weight and to hopefully improve tiredness, occasional brain fog and stiffness. I don't think my symptoms are that bad though compared to what I read on here. I am on Teva too. I don't think this is having any adverse reactions but could see if I can change brand when I am due a new prescription. I am interested to know if I should also be taking supplements. I currently take Selenium with Zinc and Vit D+K2 spray. I was taking Magnesium with B vits but haven't replaced when ran out. My B12 was tested this time around. My Ferritin from before was 50.8 ug/L [10.0 - 291.0] and my Vit D 76.1 nmol/l. I haven't had Folate done but can ask when I get my next test in September/October. I really appreciate any help and advice you can give. Thank you!
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ElephantShoes
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Thank you SlowDragon . The test after increasing to 100mcg/125mcg on alternate days was actually after about 13 weeks as I delayed because of Covid jab. I do intend to get my next test after increasing to 125mcg daily in 6-8 weeks.
My Dr in his email to me said: other results are a negative test for coeliac disease and a negative anti-nuclear antibody, which, if positive would be a marker for rheumatic conditions like lupus.
So, not coeliac. Is gluten free diet recommended? Also, what do you recommend for improving B12 and ferritin? I'm not keen on liver! Thank you for your help.
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
As your coeliac result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits.
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.
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
If 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) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
Suggest you retest ferritin at next test see if it’s going up or down
Look at increasing iron rich foods in diet
Eating iron rich foods eg plenty red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
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
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