Blood test results

[27ah]

Here are my recent bloods. I have currently bad constipation with lots of abdominal inflammation. I would welcome help in interpreting these. I am on 125mcg thyroxine and 20mcg T3. I am worried that the poor motility is a thyroid issue (which then aggravates my diverticular disease causing the abdominal swelling etc). I cannot tolerate any more T3. Considering increasing the thyroxine? Not sure what the autoimmunity bit means. I know I need to sort my vit D. Can this contribute to the gut issues? Many thanks in advance

[SeasideSusie Remembering]

27ah

Did you take last doses of Levo and T3 before the test as we always advise, ie. last dose of Levo 24 hours before and last dose of T3 8-12 hours before (splitting T3 and adjusting times the day before if necessary)?

If so then FT4 is 43% through range and FT3 is 59.46% through range. There is plenty of room to increase Levo.

Not sure what the autoimmunity bit means.

Your raised TPO antibodies confirm that the cause of your hypothyroidism is autoimmune which is where the immune system attacks and gradually destroys the thyroid resulting in hypothyroidism. Autoimmune thyroid disease is known to patients as Hashimoto's. The Hashi's isn't treated, it's the hypothyroidism that's treated.

Do you know what dose of Vit D you should be taking and the important cofactors needed?

[27ah in reply to SeasideSusie]

I took thyroxine about 24 hrs before and last dose of T3 about 14 hrs before the test.

The advice with the test was to take 4000iu of vit d for 10 weeks and then 400iu to maintain. Not sure what you mean by cofactors.

[SeasideSusie Remembering in reply to 27ah]

27ah

OK, so your last doses are pretty much on point so your results are accurate and as mentioned there is room to increase Levo.

The advice with the test was to take 4000iu of vit d for 10 weeks

4,000iu D3 daily x 7 days = 28,000 x 10 lweeks = 280,000iu which is the loading dose.

and then 400iu to maintain.

No, that is just a child's dose. To know what you need as your ongoing dose you need to have Vit D retested after the loading doses have been finished. I expect your GP will be unwilling to do this, if so you need to do it yourself.

Although your GP wont know, The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L. So you need to know your new level after the loading doses upon which to base your new dose in order to achieve the dose recommended above.

If GP wont retest then this NHS lab offers a dried bloodspot fingerprick test to the general public for £29:

vitamindtest.org.uk/

Come back with new result and I can help you with your ongoing dose.

Not sure what you mean by cofactors.

Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.

D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.

For Vit K2-MK7 I like Vitabay or Vegavero brands which contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid. These brands are sometimes available on Amazon or Ebay, if out of stock it's possible to order direct from their German websites or look for other brands that mention that are the "All Trans" form.

Magnesium helps D3 to work. We need magnesium so that the body utilises D3, it's required to convert Vit D into it's active form, and large doses of D3 can induce depletion of magnesium. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

[27ah in reply to SeasideSusie]

Hello SeasideSusieYou very kindly offered to help me with a maintenance dose of vit D

I redid my bloods after 3 months of taking 4000iu spray (in side mouth) and here are my results. Not much higher. Would you be able to advise my next steps?

Blood test results

[SeasideSusie Remembering in reply to 27ah]

Hi again

31.50 to 54nmol/L - it's going in the right direction but perhaps not as quickly as you'd hoped 😊

In your position I'd consider two things:

1) Continue with your current spray at the same dose and it should (hopefully) continue to rise. You could always take extra, maybe double up on the weekend perhaps.

Are you taking magnesium? This helps the body convert D3 into it's usable form. If you haven't been using it then start now, that should hopefully help.

or

2) Change to a different form of D3. I know that the spray is absorbed through the mucus membranes in the mouth, but it doesn't suit everyone. It might be worth trying, say, an oil based softgel. I managed to raise my severely deficient level of 15nmol/L to 202nmol/L in 2.5 months by using Drs Best D3 softgels. Again the cofactors described above are needed with any form of D3.

Just to show how different we all are in what we need, my maintenance dose to keep my level around 150nmol/L is 5,000iu daily winter and summer (I can't sit out in the sun so need to keep my supplement dose up in the summer). I've always used Drs Best softgels, never used anything else, they're a good clean supplement and easy on the purse.

[27ah in reply to SeasideSusie]

Thank you for your reply. I am taking magnesium citrate. But not k2. Increasing at the weekend is a good idea. The spray has almost run out. I have some tablets left from before. Will finish those and I suppose retest in another 3 months. I appreciate your help

[27ah]

Thank you for this. I will retest after 10 weeks. That will cover the thyroid tests too. I was already considering magnesium citrate to help with the gut issues. The article to choose which magnesium product is best is very useful.

[SlowDragon Administrator]

Likely you need at least 2000iu-4000iu vitamin D daily even as maintenance dose …..possibly higher in winter

Have you had coeliac blood test done

Are you currently on absolutely strictly gluten free diet already

If not ….likely to see benefits and it’s ALWAYS worth trying

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 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 get coeliac blood test done FIRST just to rule it out

Ideally test via GP

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.

[27ah]

My endo tested for celiac and it was negative. I'm not on gluten free. My brain fog has cleared with the thyroid hormones. In fact most symptoms have improved but the most troublesome thing I have at the moment is problems with the gut. Thinking about increasing thyroxine by 25mcg to see if it helps. The info about Hashimoto's and the low acid and difficulty absorbing nutrients is really interesting.

[SlowDragon Administrator in reply to 27ah]

Strongly recommend trying gluten free diet even though you tested negative for coeliac

Only 5% of Hashimoto’s patients are coeliac, but a further 80% find strictly gluten free diet helps or is essential you don’t need any obvious gut symptoms to still see significant improvement

But definitely trying gluten free …..if you have any gut issues

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.