I just received my latest blood results (below). I should have been tested for Coeliac/Hashimotos - am I correct in thinking there is no Hashimotos result, or is this the Serum IGA figure?
Things I noticed (correct if I'm wrong!):
- There is no T3 result (Dr did request this)...
- Not coeliac?
- Ferritin levels still low (taking regular iron & spatone supplement, though stopped iron tablets & vit B for week before tests)
- T4 now in optimal range although TSH result now below reference range (is that a problem?)
- Physically feeling much better on 100mcg levothyroxine but emotionally still a wreck so was contemplating trying gluten free depending on test results. Physically still not 100% as I had a mini 'crash' last week (fatigue, neck tension, acidic throat, body pain) - I'm thinking this may be symptomatic of Hashimotos?
Got a review with the Dr in 2 weeks, any thoughts appreciated!
TIA 🙂
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junebug7
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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.
Are you just taking vitamin B complex, or a separate B12 as well
With 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.
Brilliant answers SlowDragon thank you, if we were in the pub I would buy you a drink (gluten free beer?) 🍺 I’ll look at all the links in detail.
In response to your questions:
- I’m not veggie but I don’t eat much red meat (causes digestive issues) but to compensate I’ve been taking daily Feroglobin in addition to the spatone so I was very surprised it was so low. I take it with a VitC tablet, but I’m pretty low on fruit generally so maybe it’s an absorption issue. I’ve ordered a private blood test to review T3, so as I can’t take iron supplements before that anyway I’ll ramp up the dietary iron and see if that improves…
- I’ve been taking a Vit B complex and the Feroglobin also contains 10 µg vit B12. I have only started the B complex recently though so hopefully that will improve.
- Yes always Accord at prescription.
Relating to gluten etc….the main reason for the blood tests was to confirm Coeliac/Hashimoto status before I try a gluten free approach. On the results it says:
- IGA TTG (BIOFLASH) Negative – does this mean negative to Coeliac disease?
- SERUM IGA Immunoglobin A level 2.17 g/L [0.3 – 3.0] – is this related to the Hashimotos test or have they missed that off completely?
Low vitamin levels suggests gut issues, malabsorption and possibly leaky gut
Difficulty digesting red meat suggest low stomach acid…..extremely common with hypothyroidism
So you still haven’t had thyroid antibodies tested by GP to confirm autoimmune thyroid disease (hashimoto’s) …..unless was tested at original diagnosis
Do you have access to your test results online?
Assuming it is autoimmune thyroid disease
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
As your coeliac 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.
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.
Yes….to a gluten free beer 🍺
Personally I was utterly astonished to discover I was gluten intolerant
Yes I have online access to previous blood tests and can’t find any reference to Hashimotos tests. At least now I know the private test will give me some answers.
That’s interesting what you say about the food intolerances. I’m also totally intolerant to caffeine, a strong cup of coffee makes me feel physically sick and it took me many years to realise that the hungover feeling I was getting in the morning was due to that. Don’t know if it’s connected but I’m finding this thyroid thing is explaining a huge amount of stuff!
- T4 now in optimal range although TSH result now below reference range (is that a problem?)
No, your T4 is in-range, but the range is not 'optimal'. And your FT4 is quite low in-range, so far from optimal. You might find this article of interest:
The low TSH is not really a problem, but is strange given that low FT4. You do need an increase in dose.
Physically still not 100% as I had a mini 'crash' last week (fatigue, neck tension, acidic throat, body pain) - I'm thinking this may be symptomatic of Hashimotos?
Not symptomatic of Hashi's in particular, but of hypothyroidism in general. You can be hypo without having Hashi's. The peculiarity of Hashi's is the swinging between hypo, false 'hyper', and back again. But symptoms are just general hypo symptoms.
Thanks so much for the response greygoose, much appreciated 🙂
I think I’m getting confused between T4 and FT4!
Am I right thinking the FT4 aim should be 50-60% through the range, i.e. between 14.3 - 15.7? If so the FT4 of 14.7 seems just about on target (though I get what you're saying about variations in ‘optimal’ so maybe should be higher)...
No, I don't think you're getting confused between T4 and FT4. T4 is pretty irrelevant in this case.
There is no one point you should be aiming for. You should aim to become well. Which means that you continue increasing the levo until you do, however much it takes. Blood tests are only a rough guide. I would think most hypos would need their FT4 higher than 60% to feel well, and yours is only 52.94%, which isn't very high. But, the point I was making is that your TSH is very low considering that your FT4 isn't very high. Which is unfortunately because doctors tend to only look at the TSH. They would consider yours to be too low and want to reduce your dose, even though you actually need an increase in dose.
But, even so, it isn't really about the FT4 or the TSH, it's more about the FT3, and - as usualy - they haven't even tested that!
Ah I see. Yes unfortunately the Dr put in a specific request to test T3 (and Hashimotos figures) but they haven't tested it at all - why do they do that, is it because there is some edict up on high that they shouldn't be testing it so they don't have to give out T3 medication?
I understand what you mean about the T4/TSH combo now. Hopefully I can stay on the current dosage and things will improve if I can sort my ferritin/iron out
Well, there's an edict that they don't test FT3 if FT4 and TSH are in-range - so rather surprising that they haven't tested the FT3 given your TSH. But, why they thinks it's not necessary under those circumstances I have no idea. It is possibly because they don't want to prescribe T3, or could be just pure ignorance - or a combination of both.
I hope you can stay on your currant dose because things will definitely get worse if they reduce it.
Thanks for your help greygoose. Thankfully the doctor I've finally got is very helpful so I'm hopeful he'll let me stay on the current dose, especially if I say I'll try the gluten free thing.
A virtual gluten free beer on its way to you too, thanks for you help 🙂
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