Lab Results Advise

[Shaf3938]

I just got my latest round of thyroid bloods done... 8:30a and this was after taking my .150mcg of Levo 24 hours prior... I was wondering how these look from everyone here with experience... I had RAI btw almost 2 years ago:

TRAB: 6.28 (Range: <=2.00 IU/L)

Thyroid Peroxidase Antibodies: 49 (Range: <9 IU/mL)

Thyroglobin Antibodies: 138 (Range: < or = 1 IU/mL)

Thyroglobin: 0.5 (Range: Intact Thyroid 2.8-40.9 ng/mL)

(Range: Anthyrotic <0.1)

Vitamin D,25-OH: 49 (Range: Deficiency <20 ng/mL)

(Range: Insufficency 20 - 29 ng/mL)

(Range: Optimal > or = 30 ng/mL)

*Note* I feel like this optimal range is so wide.....

T4 Free: 1.3 (Range: 0.8-1.8 ng/dL)

TSH: 0.50 (Range: 0.40-4.50 mIU/L)

T3 Free: 3.1 (Range: 2.3-4.2 pg/mL)

Vitamin B12: 407 (Range: 200-1100 pg/mL

Folate, Serum: 16.2 (Range: Normal > 5.4 ng/mL)

Now there are some days I still feel like the energy was sucked out of me if I do to much it seems and some days still have a brain fog... I am on Levo only right now so T4 mono therapy and MFG is Amneal... I was wondering if vitamin B12 and vitamin D should be higher and I should be focusing on supplementing there?

Thanks!

[SlowDragon Administrator]

FT4: 1.3 pmol/l (Range 0.8 - 1.8) 50.00%

FT3: 3.1 pmol/l (Range 2.3 - 4.2) 42.11%

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

Many people on levothyroxine will need Ft4 at least 60-70% through range to get Ft3 at least over 50% through range

Have you had coeliac blood test done yet

If not already on strictly gluten free diet, get coeliac blood test BEFORE considering trial on strictly gluten free diet

Can;take many months to see brain fog lift

Have you had iron and ferritin levels tested?

[Shaf3938 in reply to SlowDragon]

So from them ranges I could use an improvement in both of those? What about my Vitamin D and B12 is there room for improvement in those as well??

I’ve never had a coeliac blood test done!

[SlowDragon Administrator in reply to Shaf3938]

What vitamin supplements are you currently taking

Just vitamin D?

Or a daily vitamin B complex?

Get coeliac blood test done, assuming test is negative then trial strictly gluten free diet…..you might be astonished

If coeliac test is positive you will need endoscopy before going gluten free

[Shaf3938 in reply to SlowDragon]

Right now I only take turmeric, a joint support, Omega-3 and Magnesium Glycinate chelate supplement! Thought about adding 200mg Selenium?

[SlowDragon Administrator in reply to Shaf3938]

Personally I would test selenium levels first

[Shaf3938 in reply to SlowDragon]

Yeah I used to take a multi-vitamin but stopped! I guess we shouldn’t be taking anything unless we know we need it

[SlowDragon Administrator in reply to Shaf3938]

Multivitamins never recommended on here

At best a waste of money, but inappropriate supplements can make symptoms worse

[Shaf3938 in reply to SlowDragon]

I might start taking some Vitamin D and do you think it's worth taking a B-Complex? or just B-12?

[SlowDragon Administrator in reply to Shaf3938]

Vitamin B complex, rather than just B12

Vitamin D is good at over 40ng/mL

[Shaf3938 in reply to SlowDragon]

So my Vitamin D is considered good? also I am going to look into a B-Complex... I wish doctors would tell us more about this dang disease...

[pennyannie]

Hey there again :

We tend to feel at our best when theT4 is in the top quadrant of the range as this should in theory result in a higher T3 and it is where your T3 sits in the range that gives you your wellness.

Too low a level of T3 for you and you'll have symptoms of hypothyroidism just as too high a level of T3 for you and you may well experience symptoms of over medication and a little " hyper " whatever " hyper " your original symptoms were.

Your higher cholesterol level is another symptom of undermedication in those on thyroid hormone replacement.

No thyroid hormone works well until ferritin, folate, B12 and vitamin D are all up and maintained at optimal levels - and as mentioned to you previously RAI is known to trash vitamins and minerals and can be a very slow burn.

I now aim for a ferritin at around 100, folate at 20, active B12 500++ and vitamin D 100 :

As a man you have some higher leeway on the ferritin range but aim for at least a good 50% through

P.S. I'm not sure if i shared this link with you but think you need to know :

ncbi.nlm.nih.gov/pubmed/306...

P.P.S. Did you register on the Elaine Moore Graves Disease Foundation website and ask for a specialist endocrinologist within your zip code ?

[SlowDragon Administrator in reply to pennyannie]

Vitamin D around 100nmol (U.K. units ) = 40mg/mL (USA units)

endmemo.com/medical/unitcon...

[pennyannie in reply to SlowDragon]

Thank you ; as always :

[Shaf3938]

pennyannie ,

This is what Elaine replied to me when I posted my test results to her forum!!

05 Mar 2022 03:59 PM Alert

Hi Jeffrey,

Most of us who had RAI continue to have a low TSH if replacement hormone is optimal. My FT4 was 0.8 the other day and my TSH rose to 0.011 although it's usually less than 0.01. I had to up my dose of Armour. In my case immunotherapy drugs caused my hypothyroidism to worsen.

Your TSH, which is falsely low given your high TRAb, suggests you need more replacement hormone. I was very fatigued last week and thought it was from the immunotherapy. As soon as I upped my Armour dose I began feeling way better. and most people after RAI do need both T4 and T3 replacement hormone.

The ranges for vitamin D can be misleading as well. Most experts report that t hose of us with an autoimmune disorder have optimal 25OH vitamin D3 levels when the results are around 80. I keep mine around 70 with D3 supplements. If lower I don't absorb calcium and magnesium and have leg cramps.

A good multivitamin, more D3, and a switch to Armour or NP would likely help you. Best, Elaine

[pennyannie in reply to Shaf3938]

Thank you :

Does the Elaine Moore website offer a list of specialist in your zip code/ area or can you make a post asking for recommendations of endocrinologist / doctor ?

Yes, you may find you need more than T4 - monotherapy.

A fully functioning working thyroid would be supporting you daily with trace elements of T1. T2 and calcitonin plus a measure of T3 at around 10mcg plus a measure of T4 at around 100mcg.

There is Big Pharma T3 - Liothyronine as there is Big Pharma T4 - Levothyroxine :

There is also Natural Desiccated Thyroid which contains all the same known hormones as that of the thyroid gland, namely trace elements of T1. T2 and calcitonin plus a measure of T3 and a measure of T4 in each tablet, referred to as grains.

Armour and NP are both brands of NDT produced and meant to be readily available in the USA - and I switched to Desiccated Thyroid around 4 years ago and feel much better so this may also be something to consider.

NDT was successfully used to treat hypothyroidism for over 100 years and prior to the science of the blood tests, guidelines and ranges all introduced when Big Pharma launched it's own T3 and T4 medications on the back of NDT.

NDT is derived from pig thyroid dried and ground down into tablets referred to as grains and my tablets state that each grain includes a measure of T3 at 9 mcg + 38 mcg T4 :

So a fixed 1/4 ratio T3/T4 which suits very many people and I think especially relevant when you haven't a thyroid to moderate and rebalance these levels throughout the day.

[Shaf3938 in reply to pennyannie]

Thank you for all the information! I didn’t see that on her website! I was grateful she replied back to the forum as she is dealing with cancer treatment now!

My endocrinologist won’t prescribe armour but I am going to talk to my PCP he is more open to the idea of trying the non conventional medicine because he is a DO and sometimes goes more natural path!

What would be the best to start out on Armour if I can get it? Or what would be the best dosage to start synthetic T3 if I can’t get Armour??

[pennyannie in reply to Shaf3938]

It's difficult for me to advise you how you go about obtaining either synthetic T3 and T4 or Armour in the States - though I am led to believe it's easier in the States than the UK - where many of us self medicate, some of us buying the product from USA websites.

You may be better looking for an integrated, or alternative doctor, and this is exactly why I suggested that you go into the Elaine Moore Graves Disease forum and ask the question there and likely receive replies from people within your catchment area.

I don't know what the rules are on Elaine' s forum, but by registering and using the open forum for all Graves sufferers you should be able to ' pick up ' more local knowledge by asking there, to whom do people go to to get help in your area.

Yes I know Elaine is now recovering from cancer and again, that's another issue surrounding long term RAI treatment that no one tells you about - at least that is my experience.