Blood results and dilemmas

[selenipap]

Hi everybody,

I was diagnosed with a 1.5 cm thyroid tumor (non-cancerous for now) and Hashimoto hypothyroidism 2 years ago (accompanied with low D3, low B12, low iron, high antibodies). I was put on 100mg Euthyrox (levothyroxine). I also started supplementing with B13, D3, iron, and many more supplements. During these 2 years gradually, I put on 17 kg, which I couldn’t lose no matter what I did (keto, intermittent fasting, eating every 3 hours, etc). My last blood test while still on 100mg Euthyrox were in range [TSH 1.5 (0.27-4.20), FT4 15.39 (12-22)].

With my weight being my main concern, I decided to switch to ndt (Thyroid-S). Where I live (Cyprus) ndt is totally unknown, so I had to start self-medicating. Since August I went gradually up to taking 2 grains. For the first time in the last two years, I managed to lose some weight (3 kg). I also feel more “myself” on ndt -no more hot flushes, sweating etc. Besides that, I started losing hair again and lately I feel hypo -low energy, depressed, sleepy. Below are the results from my first blood test while on 2 grains of ndt:

TSH 0.08 mlU/L (0.27-4.20)

FT4 13.24 pmol/L (12-22)

FT3 5.11 pmol/l (3.95-6.80)

Anti-TPO 118.60 IU/mL (0-34)

Anti-TG 60.21 IU/mL (0-115)

B12 742.1 pgr/ml (200-950)

D3 35.78 ng/mL (Bone health >30)

Ferritin 41.3 ng/mL (15-250)

After these results, I’m confused on how to proceed. My options are:

1)Upper ndt by 0.5 or 1 grain

2)Add T3 (which I never tried), maybe 0.15 to 0.25 mg (maybe will further help my weight loss?)

3)Go back to Euthyrox (which I don’t really want!)

Please help me with your opinion!

Thank you all!

Eleni

[greygoose]

If I were you I would increase NDT by 1/4 grain - 1/2 grain is too much in one go. Your FT4 is very low, and that might be a problem for you.

Your ferritin is very low. Have you done an iron panel? You also need to raise vit D. Nutrients need to be optimal for NDT to work properly.

[selenipap in reply to greygoose]

Thank you for your answer! I've done iron panel 2 times during this year and both times everything comes back normal except ferritin, which, according to my gp, it's fine and I don't need to take iron! Anyway, me I was taking iron until recently by my own.

The same goes for vitamin D. I stopped it only during summer, because of the intense sunlight exposure in the Mediterranean region.

Following your advice, I'll upper my ndt by 1/4 and wait for my next blood test.

Thank you!

Eleni

[greygoose in reply to selenipap]

Be very wary of that word 'normal', it doesn't mean very much where blood tests are concerned. It just means 'in-range'. But, for the most part, the ranges are far too wide, so it's where the result falls within the range that is important. What was the serum iron result and range?

You are hypo, therefore, even sunlight exposure in the Mediterranean region is unlikely to be enough to keep your vit D level optimal. We've had people on here from Crete and Australia, and other very hot countries, that have low vit D. The odds are that you will always need to supplement vit D, even in the summer.

[selenipap in reply to greygoose]

In my previous blood test, that included full iron panel my iron was 127 μg/dL (50-150), haemoglobin 14.6 (12-16), hematocrits 45% (37-47), but ferritin was 66 (15-250). Usually, this is the pattern with my blood test, and I think that's why my gp hesitates to prescribe for me iron.

Thank you for highlighting the vit D -sun exposure relation. I was hoping summer sunlight would had helped, but obviously it didn't, so I have to start supplementing again...

[greygoose in reply to selenipap]

Well, for once, I agree with a doctor! lol Your serum iron is good, so taking iron might take it too high. One has to consider that before supplementing.

[SlowDragon Administrator]

Hair loss likely linked to low ferritin

Look at increasing iron rich foods in diet

Get full iron panel test for anaemia

What’s your diet like

Are you vegetarian or vegan?

Are you already on strictly gluten free diet

If not, get coeliac blood test done BEFORE cutting gluten out

[selenipap in reply to SlowDragon]

I usually eat plant based diet. I eat maybe once a week chicken (not my favourite ☺️). Previous blood test repetitively didn't show anaemia.

Regarding, gluten free diet... it's the only diet unfortunately I never had the strength to follow, although in general I don't eat foods that are rich in gluten (pasta, bread, etc).

I"ll check if coeliac blood test is available here and I'll take it. The only test I'm aware of is the general immunoglobulin G (IgG) test for food allergies, which includes gluten. You think it would be helpful? Is there a more specific test?

Thank you,

E.

[SlowDragon Administrator in reply to selenipap]

Well on plant based diet low iron/ferritin/B12 all far more likely

As you supplement B12 do you also take a good quality daily Vitamin B complex…one with folate in

Remember to stop taking any supplements that contain biotin a week before all blood tests as biotin can falsely affect test results

Ferritin needs improving, but never take iron supplements unless full iron panel test shows low iron

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

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

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

[selenipap in reply to SlowDragon]

Dear SlowDragon, thank you for this thorough analysis on ferritin. The truth is that I never thought of it as a big problem, as I always had issues with low iron/ferritin (I used to be vegetarian for many years) and most probably I learnt to live with it.

Maybe now I should pay more attention and find a dr that can see things in a more holistic way, as my gp thinks that everything is normal...

[SlowDragon Administrator in reply to selenipap]

All thyroid hormones need GOOD vitamin levels for thyroid hormones to work well

Ferritin at least half way through range ideally as minimum…..as your iron is good you can only increase by diet (not supplements)