What do you think? Feeling a bit better
Inflammation
CRP HS 2.44 (0-5)
Iron Status
Ferritin 41 (13-150
Vitamins
Folate - Serum 5.06 (>3.89)
Vitamin B12 - Active >150 (37.5 - 188)
Vitamin D 81.80 >75 - 200 Optimal)
Thyroid Hormones
TSH 0.01 (0,27 - 4.2)
Free T3 5.61 (3.1 - 6.8)
Free Thyroxine 25.300 (Range 12-22)
Autoimmunity
Thyroglobulin Antibodies 75.400 <115
Thyroid Peroxidase Antibodies 80.20 <34
Observation Date : 20-DEC-2021 8,50 am
Many thanks for offers of advice
How much levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
Was last dose levothyroxine 24 hours before test
What vitamin supplements are you currently taking
High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s
Are you on absolutely strictly gluten free diet
Ferritin is very low
Are you vegetarian or vegan
Have you had full iron panel test for anaemia
Folate low
Vitamin D might be better at least around 100nmol
125 from 100 they gave me Teva for 25 but as it was an effort to get it did not want to cause a fuss but the 100 is always same mercury pharma, yes 26 hours prior to test, I have been taking B12 it ran out a few days ago so I thought I would wait until I got results, they took nearly a week to get results postage was bad. I have better u Vitamin D with K I do sometimes forget, sorry! Not strictly gluten, hardly eat bread but occasional dessert as is my weakness.I eat meat and fish a lot and nuts thought I had fair diet. Not had panel as no chance of seeing doctor, when I get prescription though I do have option to write a note so will try that. What can I do to improve Folate, I eat yogurt regularly.
Thank you for your help
Request GP add note to all future prescriptions
Mercury Pharma (Advanz) or Eltroxin only (Eltroxin is identical and made by Mercury Pharma)
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Low vitamin levels common with autoimmune thyroid disease
Rather than just taking B12 suggest vitamin B complex
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.
This can help keep all B vitamins in balance and improve folate
Difference between folate and folic acid
chriskresser.com/folate-vs-...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)
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
Thyroid disease is as much about optimising vitamins as thyroid hormones
Low ferritin common, but you can’t assume iron is low too
cks.nice.org.uk/topics/anae...
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
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
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.
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Never supplement iron without doing full iron panel test for anaemia first
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Thank you SD so helpful as usual I always read posts but this is personal for me and is important at moment. Much appreciated
Have you had coeliac blood test done while eating high levels of gluten
approx 5% with Hashimoto's are coeliac, but a further 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 ideally you would get coeliac blood test done FIRST just to rule it out
lloydspharmacy.com/products...
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.
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
ncbi.nlm.nih.gov/pubmed/296...
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
ncbi.nlm.nih.gov/pubmed/300...
The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease
nuclmed.gr/wp/wp-content/up...
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
restartmed.com/hashimotos-g...
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.
Lots of gluten free options available these days
Great gluten free breads, puddings etc
Read all labels carefully
I was going to write before results as wondered if it was Teva that causes upset stomach (gastro) or if I was taking too much so no mention that I was overmedicating due to high T4?
ok it was what I suspected but I will make sure I optimise vitamins first and see how it goes such a relief to be able to discuss thank you
Morning, please can you explain how t3 is only 53% as its 5.61 and the range is 3.1 - 6.8 I thought that was quite high just a bit confused cheers
Apologies…..your correct
I must have had wrong range on the calculator
Ft3 is 68% through range
Helpful calculator for working out percentage through range
Thank you SlowDragon so would you still think I need T3 once I get my vitamins sorted, have ordered
So……
Currently high Ft4…possibly too high for you
Ft3 67% through range
Improving low vitamin levels and strictly gluten free diet may help conversion rate ….reducing high Ft4 and making Ft4 and Ft3 more balanced
Some people are fine with Ft4 over range.
Others aren’t
(I couldn’t tolerate Ft4 that high)
Reducing levothyroxine dose would reduce high Ft4, but would also reduce Ft3
If improving low vitamin levels and strictly gluten free diet and always same brand levothyroxine doesn’t reduce Ft4/ increase Ft3 you may need slightly less Levothyroxine and possibly the addition of T3 prescribed alongside levothyroxine
Thank you so outcome much the same really when you say you couldn't tolerate high t4 in what way, it is difficult cause I am not sure how I am supposed to feel as not felt right for such a long time but thought it cant be just old age for me to feel so weak in a lot of ways
I felt really unwell with high Ft4, suddenly had vitiligo all over both arms (this completely vanished on lower dose)
Ft3 didn’t rise with higher Ft4 either
I have heterozygous Dio2 gene variation, and now get T3 prescribed on NHS (after a battle)
feeling grim after levo increase
Recent Blood Results After Increase In Levo
Drop in FT4/FT3 and TSH after levo increase
New results after increase
