I have the results of my blood test and wanted to get some thoughts from this wise group before I go to doctors to discuss increasing my current miserly dose of 25 levo a day. I had the test at 8.45am before any medication.
SYMPTOMS
I am cold, have pins and needles in my hands feet and lips, reflux, light headed, terrible nails and dry skin and hair, and achy muscles, so I feel confident that my symptoms support the need for a change regardless of the results
TSH 5.38 (0.27-4.2)
FT3 3.51 (3.1-6.8)
FT4 14.2 (12-22)
TGab 408 (should be less than 115)
TPab 9 (should be less than 34)
Ferritin 30.3 (13-150)
Folate 6.25 (3.89 - 19.45)
B12 active 65.2 (37.5-188)
Vit D 100 (50-200)
From reading lots of questions and answers to other posts my thoughts are as follows:
This confirms I have Hashimotos. (I found my test results from 2017 and there were no antibodies so this is new news).
ACTIONS
I need to get my FT4 up which will hopefully put my FT3 up. I will tell the gp about the dosage advice for Levo that relates to my weight.
I also need to get my ferritin and B12 up even though they are in the reference range. I saw previous posts say aim for 90-100 ferritin and at least 100 B12. I am particularly worried about B12 as pernicious anaemia had dire consequences for my mum.
Are these the right conclusions? Am I missing anything?
Do I also need to improve folate?
Medichecks recommended I get an MMA test. My first thought was that they are just cross selling but I wonder whether I should do it anyway because of my mum’s history with B12 issues. Any thoughts?
PS slow dragon advised I check my resting heart rate when I posted about purple lips. I’ve done that and it’s just over 60, so low but ok.
Thanks in advance for any responses.
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Sparklyjenson
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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
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
Hi, I had some iron results just before Christmas due to unexplained acute abdominal pain.serum iron 23.3 (5.8-34.5) - looks ok as more than 50% through range
UIBC 28 (24.2-70.1)
iron binding saturation 45 (15-50%)
haemoglobin 131 (120-150)
haematocrit 0.392 (0.36-0.46)
RBC 4.5 (3.8-4.8)
I was told these are all fine. They didn't test ferritin at the time, but I've now got that through today - Ferritin 30.3 (13-150)
Does that mean it's just ferritin that I need to increase e.g. through eating liver?
Those results don't suggest iron deficiency or anaemia so with just low Ferritin it's best to try and raise this with diet. It's taken a long time but eating about 140g liver per week (you can have up to 200g) has gradually raised my ferritin without rasing my serum iron. Apart from low ferritin the rest of my iron panel has always been good and no anaemia.
Hi, just a quick update that my GP has agreed to increase my Levo to 50 with immediate effect and to test again in 8 weeks.I had more trouble getting her to take any action on the b12 investigations. She said the lab won’t do it if I’m within the reference range even if it’s low and I have b12 deficiency symptoms and it caused my mum to become severely disabled. She said she would test it again at the same time as my thyroid. I’m going to get private tests done. I’m not waiting. I will add a separate post as I have a question about that.
Thanks to everyone on this group for giving me the knowledge and confidence to follow up on these results.
Hashimoto's thyroiditis (HT) is the most common form of autoimmune thyroid disorders characterized by lower production of thyroid hormones and positivity to autoantibodies to thyroglobulin (TgAb) and/or thyroid peroxidase (TPOAb).
……Elevated TgAb levels are associated with symptom burden in HT patients, suggesting a role of thyroid autoimmunity in clinical manifestations of HT. Based on these results, we recommend screening for TgAb antibodies in HT patients with symptom burden
That's interesting. I just assumed if either of the TG antibody types were high that it was automatically hashis. Is there a reason why one would be high and one low? I can't find anything when I google it. Everything I read seems to lump them together saying that they adversely impact the synthesis of T4 and T3.
Majority of Hashimoto’s patients have either high TPO or high TPO and high TG antibodies….but a significant minority of Hashimoto’s only have high TG antibodies
As NHS only tests TG antibodies if TPO antibodies are high and above range, most NHS patients struggle to get tested/diagnosis
You might find your GP doesn’t understand the significance of high TG antibodies
Yes….they both or individually show autoimmune thyroid disease
But NHS seems “behind the times”
Similarly because NHS only ever tests thyroid antibodies once ….they are generally unaware that gluten free diet often slowly reduces high TPO antibodies
Below is BMJ research document (summary only), which confirms that, although MMA is the best test, there is really NO reliable test and it is the symptoms that are important, especially when they are neurological....
UKNEQAS guidelines also point out that neurological symptoms should be treated with injections every other day until no further improvement to prevent further damage.
GP should also take into account family history usually passed down through the maternal line and that research shows 40% of those with thyroid disease go on to develop PA and vice versa. Three in our family have both - two having had gene testing, showing inability to absorb B12.
bmj.com/content/349/bmj.g5226
Note: It is difficult to prove B12 absorption if you have already been supplementing as this will skew the results.
Tracy Witty's B12 website has advice on writing to your doctor, as well as further research papers and advice.
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Blood results
Latest test results
Latest Medichecks Results - low FT3 - Dr will refer me to NHS Endo, should I try? Do I need to up my Levo in the meantime?
