Is it possible to have hypothyroidism even though my TSH is 1,2?
I tick the majority of symptoms for hypothyroidism that you put on the list, except weight gain - I've always been thin and now I have poor apetite.
I'm constantly fatigued, waking up in the mornings is impossible and if I do I have a hard time staying awake (it's very hard for me to make it through morning work shifts and after them I crash and have to nap for hours), I have had depression at different times in my life, I always feel cold, I have heavy periods with blood clots. Overall it feels I have a disease - it does feel like it- yet according to blood tests everything is fine, ferritin is low which I compensate with iron supplementation.
Your advice is much appreciated.
Kind regards
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Yes, it's possible. Do you have any other results i.e. Free T4 and Free T3?
There are various causes of people becoming hypothyroid. One of them is if their pituitary is unable to produce sufficient TSH for their needs, and this causes a condition called Central Hypothyroidism which is fairly rare, but probably not as rare as doctors claim.
(The most common kind of hypothyroidism is Primary Hypothyroidism which you don't have with a TSH of 1.2.)
But, with just a TSH result it is impossible to say anything else for certain. Your pituitary and your thyroid could be absolutely fine. You really need to get TSH, Free T4 and Free T3 measured at the same time from the same blood draw to have a chance of finding out if you have a thyroid problem.
Another possibility for your symptoms is low levels of various nutrients. The ones which commonly affect hypothyroid people are low levels of vitamin B12, folate, vitamin D and low ferritin (iron stores). It is also worth finding out if your serum iron is low.
People can have low, "normal", or high levels of ferritin while also having low, "normal" or high levels of serum iron. Different combinations tell you different things about your health.
Hello, thank you for your reply. Ferritin doesn't go beyond 32, which according to an haemologist, is too low. I always take iron since he adviced me to do it a few times per year (e. g. 3 months in a row - pause - repeat), however despite the iron supplements I feel "low" again.
TSH has a daily circadian rhythm, ( highest middle of the night / very early morning .... falling to lowest around 1-2pm ish.. then slowly rising again over the early evening onwards. There can be as much as 40/50% difference in some people , but other people have a much smaller difference. What time of day was your TSH in Dec ,and what time was this one ?
TSH is also possibly higher for a few days each month due to menstrual cycle , but not a lot of evidence of this . only one paper looking at 2 women .. so this may or may not be the case for everyone . i think it was about day 13-17 ish of cycle ? , (day 1 being 'first day of LMP')
Several other things can lead to slight variations in TSH that will later return to your 'usual' level , so a 'one off ' TSH increase doesn't necessarily mean hypothyroidism is developing.
The other explanation is of course , you TSH is genuinely rising , signalling an emerging hypothyroidism problem... but you would need to see this trend continuing over time before you could confirm that is the reason. These two results by themselves are still effectively 'normal'.
A clue to if you were developing 'autoimmune' hypothyroidism would be to test TPOab (thyroid peroxidase antibodies ) and TGab.
If TPOab is positive , then that proves autoimmune thyroid damage is already happening , and may get worse .
p.s . don't know why, but i didn't get any notification of your '@' tagging me in your reply , just noticed it by chance.. might be worth trying again in case none of the others have noticed your reply .
Thank you Slow Dragon, as soon as I have an update will come back and share anything that stands out. Ferritin was 32 the last time I had a blood test done.
My weight: I don't gain any weight, I'm 55 kg and height 1,64m.
I've read weight gain is one of the common symptoms and that's why I doubt I can be hypothyroid. The rest of the symptoms are a very accurate description of how I feel.
Ferritin doesn't go beyond 32, which according to an haemologist, is too low. I always take iron since he adviced me to do it a few times per year (e. g. 3 months in a row - pause - repeat), however despite the iron supplements I feel "low" again.
You will need to supplement longer to improve to at least 70
Not everyone has weight gain, despite it being a common factor. I was always very slim, and didn't put any weight on at all until I had been hypo for 20 years, and that was mainly due to being on the wrong thyroid replacement for so long. Even then, it was only fluid retention around the middle, (which has gone now) so please don't think you're not hypothyroid because you're thin. Not everyone has a high TSH either. We're all different, something most Dr's seem to fail to recognise! I also suffered very with heavy periods, which were not recognised by my GP as a hypo sign, and treated wrongly. If you feel more alert in the evenings, your cortisol levels are probably higher then, and lower in the mornings. You could do a four point saliva test to check, but I think that's also a common symptom of being hypo. Good luck 🍀
I fear to say anything contradictory to any replies you have received, however....
You describe the exact symptoms early in my experience with Hashimoto's / Thyroiditis.
All of the blood tests in the world did nothing for me - "borderline" Dr.s said....until about 10 years later when tests finally caught up with the numbers that "proved" I had autoimmune disease. If I knew then what I know now, I would not have suffered debilitating / heavy periods, blood clotting, etc. (Not to mention frequent bouts of mild depression alternating with anxiety, etc.) I would have found my own source of the T3 (bovine - which is today much more readily available) and begun to do my own "low and slow" incremental dosing experiments. TEN YEARS of suffering!
Yes, you can still have thyroiditis even with a low TSH. There are many here at HealthUnlocked and thousands elsewhere who err (if we must) on the side of treating the person and not relying too heavily on the numbers - I lean strongly in that direction. The blood test numbers are not the last word, and again, in my case almost useless - if feeling well is the goal. Not to advise abandoning Good medical care (when you can find it), no but along with that, listen to your own body, and educate, educate, educate yourself on the disease that goes by many names, Hashimoto's, Autoimmune Thyroiditis, etc. And if you can't get a thyroid hormone supplement from the medical world, seek out your own. Don't suffer. (Why wait for the disease to worsen to a level that satisfies a many times "casting about" medical system?)
Just yesterday (3-5-2022) on National Public Radio here in the US, I heard yet another Dr. who herself suffers from Hashimotos and had been to every specialist under the sun, from Neurologist to Dermatologist and everything in between...she herself finally found a diagnosis, (Autoimmune Thyroiditis) after more than 5 years. She said out loud something that we all know...."This is still quite the unknown disease, a modern disease, and we don't know what the cause is, nor why it has increased so suddenly, mostly in women..." ("We" as in main stream medicine). They don't know...the ones with the blood tests, DON'T KNOW, even now in 2022.
There are those who have suffered with the disease, who swear that they have found relief through various diet protocols. I wanted to believe them - and somehow I still listened to those that said - gotta have the medicine / replacement hormone. ("Diets can't cure Hashimotos!") And yet they can - they really can.
When the medicine stopped working for me - after 30 years of doing fairly well on Armour, Naturthroid, porcine sourced medicines from the pharmaceutical world... I had no choice but to really try some of the diet protocols. On about the 3rd protocol / different approach, I found the one that worked for me. Reducing iodine, of all the most simple things, was the key. (Primary: Iodized salt eliminated, but anything from the sea, diary, alcohol, and yes commercial bread greatly reduced). Almost every food has iodine. We can't and shouldn't "eliminate" all iodine, it is a necessary nutrient for the thyroid! And yet, the modern diet has added / hidden iodine in ways we often cannot see on a label. (Many have often warned Hashimotos patients not to take iodine supplementation for very good reason!) The Dr. mentioned above talked about how some "early" research is beginning to uncover evidence that the "cause of the disease is somehow a part of the modern environment / modern foods, and diet." (think processed) Now, I am a believer that corrective diet protocols really can and do heal Hashimotos. (If you look carefully you will see that they all are, many times, very similar) I have not taken more than trace amounts of bovine hormone for the past 18 months, and I feel better than I did taking hormone replacement. (Treat the person, not the numbers!) I am Healthy and feel great with almost no medicine. I have a Dr. that is helping me, and she is not insisting on blood tests - and it is not her diet protocol.
Trust yourself. Listen to your body. (Especially when it screams in pain!) Experiment with the diet protocols, and low (Repeat, low) and slowing increasing / incremental dosing of bovine T3, which is weaker than porcine. Educate yourself here, and there, and everywhere - there is so much more knowledge among the "natural" health proponents than there was even 5 years ago. (and they are decades ahead of main stream medicine) There are those out there who "give away" their diet protocol as a way to also "sell" their particular proprietary supplements, so be aware, and be careful, but don't be too afraid to try, and again please don't wait until some test confirms you are suffering. When I finally found the right diet protocol, it only took a 30 day strict observance / experiment to know I had found what triggered Hashimotos for me - and how to remove it, and finally, after 3 decades, how to take control of my own health decisions, and begin to heal.
She went to a Dr Specializing in Women’s Health. (Another woman Dr). She too was worried about being “labeled” - she knew all too well how notes in the file can tank any hopes for help.I too was offered antidepressants for my Hashimoto’s it’s a horrible feeling. All I know is to keep looking for a Doctor who listens. May you find one a lot sooner than most of us. And please visit Dr. Allen Christiansen‘s website and learn about what you can do to reduce iodine. It’s a simple 30 day experiment that absolutely can do no harm and may do a lot of good.
Hello dtate2016 , I post a comment publicly here so everyone can join and comment 🙂.
As far as I´ve read, iodine is necessary for the thyroid, specially for the conversion of T4 into T3. The necessary daily iodine intake ranges between 100 and 200 micrograms. As I haven´t got a diagnose yet for hypothiroidism as underlying reason for my symptoms (depressed mood, sensitivity to cold, lack of energy, puffy morning face, etc) I think best is to keep taking it on a normal basis. Here where I live we cook with sea salt, rich in iodine.
As for my diet (trying to think of a reason for my symptoms) I quit eating dairy products more than 10 years ago. I only consume oat milk. This leads me to think of a calcium deficiency (?).
As far as I´ve read so far, iodine is necessary for the thyroid, specially for the conversion of T4 into T3.
Please, can you add some explanation to that? I cannot see why iodine is necessary for conversion of T4 into T3 - a process which actually releases one atom of iodine for each molecule of T4 that is converted.
"Its (the thryoid´s) main function is to concentrate iodine and sintetize, store and segregate thryoid hormones. For the synthesis part it needs, beside iodine, the aminoacid thyrosine.
Iodine, which is essential for the thyroid function, gets into the body through water and food (the necessary daily intake of iodine ranges from 100-200 micrograms) and its execrated through urine and stools."
Thyroid problems. Explanation and treatment options in Spanish. Source: www.elsevier.es
This means the (healthy ) thyroid uses iodine to make T4 and T3 . ,, but iodine does not help convert T4 into T3 ... this action is done by deiodinases inside cells over the body which remove of one of T4's 4 iodine atoms to get T3 which is 3 iodine atoms. Once you are getting T4 ready made in Levothyroxine , your thyroid need less iodine because it is making less T4.
Agreed, tattybogle. Try as I might, I cannot get the words above to mean that iodine is necessary to convert T4 into T3. Nor from the similar words I got by using Google Translate on the site quoted.
Iodine is a necessary nutrient (which I've posted every time). In all reality, it is not possible to "eliminate" iodine, as you have noted - it's in almost every food, and some salts. No, but the encouragement to those who may be hypo / have hashimoto's (from my experience only) is to balance the iodine / be careful about overloading on iodine. This advise has been long suggested for those of us who know for sure that we have hashimoto's / autoimmune thyroiditis. Many here have long warned that iodine (supplementation most especially) is dangerous for those of us with Hashimotos. For emphasis: iodine in "excess" can make thyroid problems worse.
I am not a Dr., and I would not advise anyone to try an iodine "reduction" diet without a Dr. monitoring.
This is fairly new research and here in the US, many of us are finding great healing (which I always believed was impossible) - I am living proof that it is not impossible. (Isabelle Wentz endorsed the book advocating iodine reducing diets). I do believe that through my own ignorance I was consuming way more iodine than is recommended. I was diagnosed by a Dr., more than 30 years ago with Hashimotos, and have suffered with T4 mono therapy / NDT therapy for decades - to a greater or lesser degree. I suffer no more. I take 98% less medicine. The greatest change that has brought this about in my own experience is the reduction of iodine through the removal of iodized salt. Here in the US, governmental influence brought about adding iodine to table salt in the 40's and 50's. It may have been necessary at that time. Since the early 80's and the inclusion of more and more processed foods served every day on the dinner table, iodine intake has skyrocketed, along with increasing cases of hashimotos. I have the added (Dr. administered DNA test) handicap, if you will, of poor elimination of toxins. (The MFTHR genetic polymorphism) Iodine overload is especially toxic for people with these genetic variables / poor diet.
Iodine is necessary for many metabolic functions. I'm not quite so sure it's necessary for T4 - T3 conversion. In fact, a very learned and respected Dr. told me that T4 didn't work well for me because I had a very "low conversion rate". (The same Dr. that found the MFTHR gene) This was at least 10 years ago, when I was still taking Levo / NDT and not doing well - consuming loads of iodine. If iodine was necessary for the conversion of T4 to T3, why did the conversion not occur in my case? (rhetorical question)
My experience says otherwise, and yet....we are all still learning. None of us have the corner on any one size fits all cure. I do know that iodine reduction / balancing works well for some of us. I do know that a 30 day experiment of avoiding (do not read "eliminate") iodine rich foods and salt will settle the bet. Feeling better is the very first clue.
Hello dtate2016 , thank your for your comprehensive answer. You say you´re not a doctor but you clearly have the knowledge that many of them should have! I agree it´s very hard to decrease the intake of salt given the amount of additives of today´s food, sodium glutamate is found almost everywhere in processed food.
As for your experience, how were you diagnosed with Hashimoto´s after so many years of battle? Were you tested for thyroid peroxidase plus thyroglobuline if I may ask?
Another thing that i´ve noticed is that by body temperature doesn´t go beyond 36,3º C (97,34 Fahrenheit). I came across an article about late Dr Broda who said that the simplest way to detect an erratic thyroid is to measure the body temp on the second day/third day of the period. If it´s below 36,5º it indicates a possible underactive thyroid. I remember constantly having cold hands and feet 🥶.
Yes, Dr. Broda is an excellent resource. I've read some of her papers, and I have seen her worked referenced in countless other new kids on the block (new thyroid "experts"). The temp thing is reliable, although there could be many other reasons for a low temp. My temp has been 97.1 (F) for years. (when I got Covid it went to 99.0 degrees F.)
Here in the US, an endocrinologist, diagnosed Hashimotos (for me in the 80's) via a urine test. As gross as it may sound, he had me collect urine for a week in a special kit he sent home with patients. At the end of the week it goes back and for whatever it was he tested (I didn't know enough to doubt / question back then) the urine and said, "you have hashimotos disease". Blood tests by other endo's proved inconclusive (he was the second or third endo - the only one who did anything besides blood tests), they all said I was a "borderline" thyroid problem. ("Go home, take this Xanax and try to solve your family problems." - What family problems??!!)
So, the diagnosis came long ago. What good did it do to know that I had hashimotos's when the cure (Levothyroxine) was worse than the disease? It DID NOT WORK for me. (no Dr. believed that) I did not get better, I got worse. Hence, the suffering continued. The good Dr. who sent me to the endo who discovered hashimotos, switched the medicine to NDT, and I bounced around feeling pretty well most of the time. I was young and strong and resilient. I pushed through the bad days, being a full time working mom, volunteer, outdoors lady, gardener, traveling (a very full life!) Still suffering silently. (brain fog mostly)
Now, I know - it was the salt. I had iodized salt on the table, cooking with it, adding more to my plate, etc. Who knew?! I ate my fair share of junk food as well. Looking back, I had more than on "thyroid storm" within seconds of devouring hot dogs - foot long hot dogs, 1 l (loaded with iodized salt) b hot dogs, and on and on. (Wasn't I have fun?!) So scary. I wonder how much iodized salt is in junk food, and most especially the beloved hot dog.
Quite accidentally, I began to eat a better diet that excluded hot dogs, and processed food and did not connect the reason why I began to feel some better. (No more thyroid storms). I had one Dr. tell me that I made up the term "thyroid storms". One could cry if it would do any good.
In 2018 or 2019, when they began to change the formula of various NDT thyroid prescriptions (here in the US), the porcine NDT (Naturthroid, Armour, etc.) Things began to get really bad for me. Now, the crutches of T3 / T4 (NDT) stopped working even a little bit. Back to Levo - back to suffering hugely. I simply had to find the answer on my own. It was a roller coaster. More and more experts who pushed their own brand of vitamins, minerals, other "cures", diets, etc. kept insisting hashimotos could be cured! I even tried donkey milk! (Yes there is a breed of lactating donkey) I tried camel milk. What choice did I have? I think the diets did help a little - but I was not feeling that much better, and again, could not take the T3 / T4 medicines. The search continued....and then...I tried the iodine reduction diet for 30 days. It was miraculous. I talked to my Dr., (who wasn't quite sure if I had lost my mind!) - I showed her the research, gave her a copy of the book by Dr. Allen Christianson, gave her a copy of the DNA test that proved the MFTHR polymorphism, and pleaded with her to help me navigate this approach. She agreed. (she actually did read and study the resources I gave to her). That was over a year ago. Now when I question her about this or that - she just laughs! She says if I feel better, then we have both succeeded.
To sum up my particular problem, as I understand it now...there are two reasons why my thyroid is improving. Reducing iodine has lowered the toxicity of iodine overload, brought on by my body's poor ability to eliminate toxins (MFTHR problem). And of course, poor elimination of toxins could be brought on by other toxic overloads, other than iodine, and most probably is. The thyroid is the canary in the coal mine. Still, iodine reduction / removing the toxic iodine buildup was the single most apparent reason for improved thyroid function. So much the more reason to eat clean (no dairy, no processed foods, no alcohol, no sugar!) Realistically, one doesn't really eliminate all of those foods, but drastically reduces them. Again, I was not a believer that diet protocols could "heal" thyroiditis / hashimotos. I am now.
How long have you felt unwell? Have you tried any of the diet protocols? Thinking about the air pollution, water pollution (I understand some water systems include iodine - but I think that is in more of the poorer countries), pesticides in foods, and on and on. The question comes up: What if toxic buildup is a major contributor to all of the autoimmune diseases? If so, only those of us who have a diminished capacity to eliminate toxins would exhibit disease / suffer more.
There is certainly more than one way to combat thyroid disease, as we learn here on HealthUnlocked. It is a task to have to find your own way, find what it is that makes you feel better, and most especially if we can't find a Dr. to help. And yet, it is possible - a long journey sometimes, but possible. Please share what you find - when you find what works for you (and you will!). We all have each other.
Thank you for your comprehensive answer dtate2016 .
I don't really know what's going on with me. Depression comes on and off, this feeling of being constantly tired does as well. I'm desperate to find the answer for me.
I might send you a private message asking you for some advice.
I´ve read an interesting study about ferritin and its link to the bone marrow.
In short it should always be above 50 micrograms per liter. I´ve neved reached such level, in fact my ferritin was incredibly low (5 micrograms/liter) in 2020.
Just out of curiosity what are you taking to improve your iron?
How much pure/elemental iron does each tablet contain?
How many times a day do you take a tablet?
I am curious because supplementing for three months then pausing is just going to allow your iron to drop during the pause, and undo all the benefit you got from iron during the first three months.
Personal anecdote : It took me nearly two years of supplementing at maximum dose just to get my ferritin to mid-range. My serum iron was still low.
Obviously different people absorb iron at different rates, and anaemia is an issue for many members (7 that I know of) of my family on my late mother's side, so I suspect we have a genetic problem.
I went to a private haemologist and he said that, although the iron was fine, one has to take a look at the ferritin, cause it's the stock of iron available on the blood stream. If it's too low, heavy periods are to blame and also low iron intake (by that time I avoided eating red meat for ethical reasons).
He adviced me to take 100mg of an iron supplement named "Ferbisol" here in Spain. He said that anything below that would be like "drinking a glass of water". He told me also to visit a gynaecologist to get prescribed something that made menses less heavy (I never did, I just started taking the iron supplement). In 2 months I started to feel better (before that I was dead tired after only walking up the stairs and I was losing hair profusely).
The visit to this heamologist was the most productive and educative visit ever. GPs don't ask for ferritin on blood tests, 'cause they think key markers are blood iron and heamoglobin, but they aren't, it's ferritin.
I think you're right, one can make a progression after three months taking iron but the break in between will only take me steps back.
Sorry, forgot to say I take one tablet per day, more than that it's not recommended. These tablets are good, the iron gets absorbed directly in the gut.
I´d like to give you an update. In February I got infected with COVID and I overcame it. The months passed by and, although I didn´t feel like that with the infection, I stared to feel weak, to have insomnia and for the last months I started feeling acutely fatigued and to have body aches (both muscles and bones), severe premenstrual syndrome (acute pain and swelling on breasts, swollen belly, weight gain). By now it´s hard for me to get out of the bed and have to take several naps throughout the day, I also work from home and from bed most of the times. The fatige is so debilitating that I´m turning down work for the first time not to stress me out and because I have no energy.
I´ve been to the GP many times, and lately I´ve been to private doctors, a cardiologist for ventricular extrasystoles (premature hearbeats), an allergist for constant skin itching, an internist for the fatigue (with the suspicion of cronic fatigue syndrome) and finally back to my GP, who after pushing and explaining him that i´m not ok despite normal lab results, asked for a serology report, thyroid study and some extras tested in case I had an autoimmune disease.
The results have left me baffled, these are the results that stand out (I´ve put in bold what was marked below and above range on the original reports):
I´d like to receive your views on this, these results are a good reflection on how I feel. The thing that mostly baffles me is the Epstein-Barr virus and the free T4 and T3.
I´d like to mention here the people that have participated so far in my comments so they can read this post: SeasideSusie SlowDragon helvella dtate2016 humanbean tattybogle . I hope to find you well! This aside, everyone is welcome to leave their feedback.
Much appreciated! Your forum is the best thing out on the Internet.
PS: I´d like to give you a donation to support the work you do, If you can send me a link for donations please send it to me.
Small edit: I took "folic acid" for "folate" (my bad), I´ve now corrected it. The one I got tested in was folic acid.
You might find one of my recent posts of some interest. (Albeit the topic is EBV vaccines, it does explain why their development could be so important.)
Urgency and necessity of Epstein-Barr virus prophylactic vaccines
Absolutely clearly, you are hypothyroid. But I suspect that your pituitary is not producing as much TSH as might be expected for your FT3 and FT4 levels. Hence, any doctor used to using TSH only might not get anywhere near understanding how bad you are.
Which in some ways gets back to your original starting post. With TSH 1.2, that would often be OK. But not, it appears, for you.
You clearly are low on vitamin D and ferritin. I'd supplement for both. And maybe some B12 - should be OK but some people seem to need rather more in their blood than others.
I was wondering how one can differentiate between Hypothyroidism in its various forms and Non-Thyroidal Illness Syndrome, which is why I tagged you and others.
I'm also not sure if supplementing iron is a good idea in someone who has EBV. It might all end up in ferritin, with iron in the blood being kept really low.
You have vitamin D deficiency. You have two choices (if you lived in the UK - I don't know what your options are in Spain) - either ask your doctor to prescribe high dose supplements for you or buy your own.
When reading about vitamin D on the internet please be aware that two different units of measurement are commonly used in measuring vitamin D levels and it is easy to get confused by them.
When supplementing vitamin D be aware that two different units of measurement are used for this too - some supplements are measured in micrograms (mcg) and others are measured in International Units (iU). You can convert from one to the other with this link :
You mentioned that you had recently had Covid. It has been discovered that having Covid can cause reactivation of EBV in some (?) or all (?) those who have been infected by EBV in the past.
If you want to do more research on this I would suggest that you do a web search for "covid and ebv reactivation". There have been many research papers and articles published on the subject.
Please note these different names for the same problem :
So, you will probably be suffering from lingering Covid symptoms and also EBV symptoms. If you need to nap, take a nap. If you are weak don't try to exercise your way out of it. If you make as few demands on your body as possible then you might recover given sufficient time. But nobody can make any promises.
Your Free T4 and Free T3 are below range. You appear to be suffering from "Non-Thyroidal Illness Syndrome", also known as "Low T3 Syndrome", which is not surprising given your Covid and EBV history this year. You might also see the term "Euthyroid Sick Syndrome" but you aren't euthyroid. It might be useful for you to know the name for researching your problems.
What I'm not sure of is whether it is safe or useful for people in your situation to take T3 or T4. By reducing your thyroid hormones your body is making it impossible for you to exert yourself as a protective measure. That may be a good idea while you are recovering from Covid and EBV. But how long will it go on for and what will prompt your body to start recovering?
Ferritin is a measure of your iron stores. Yours is low. In a "healthy" person with well-treated primary hypothyroidism, the optimal levels of iron are suggested to be roughly mid-range (85 with your range) or 50% - 70% of the way through the range (85 - 115 with your range).
It sounds from that, that supplementing iron must be a really good idea in your case. But whether or not to supplement iron is a complicated question. You're obviously ill. If your body is swimming with undesirable viruses and/or bacteria then taking iron could possibly encourage the growth of those things. All living things, including viruses, bacteria, fungi, and parasites, need iron to multiply and that includes things that we don't want in our bodies. But you need iron too, for creating blood cells and other tissues, so it is a delicate balancing act. Should you take iron while risking undesirable things multiplying?
I think, with respect to iron, you should ask your doctor to do an iron panel.
It usually consists of
Serum iron
TIBC (Total Iron Binding Capacity) or Transferrin
Transferrin Saturation Percentage
Ferritin
CRP or CRP-hs (C-Reactive Protein. hs stands for "high sensitivity" )
Once you have the results of such a batch of tests, get the results and reference ranges. Then start taking iron supplements. I can give you info on the ones available in the UK - ignore the stuff about pregnancy :
In your shoes I would suggest trying to get hold of ferrous gluconate 300mg. Maximum dose is 6 tablets a day, but you could start with one a day, and increase by one per day every week according to tolerance. But I think in your situation that you shouldn't take more than 3 per day. And if you ever take thyroid hormones, iron can block absorption of them, so take thyroid hormones and iron four hours apart.
Once you start taking iron, and because you are ill, I would suggest that you get an iron panel test done every 6 - 8 weeks. Then come back and ask for feedback on the results.
If you start feeling sicker on iron tablets stop taking them immediately.
Optimal for Folate is upper half of the reference range i.e. 11.38 - 20 with your range. Yours is too low and you will need to supplement. Personally I try to keep mine near the top of the range.
Optimal for B12 varies depending on source.
a) Minimum of 500 ng/mL
b) Upper half of range i.e. 566 - 932.
c) Top of range i.e. 931
d) 1000 ng/mL
Personally I keep my own B12 at around 1000+
Vitamin B12 isn't dangerous if it goes over range.
It is important when both B12 and folate are low for supplementing to start with Vitamin B12 for a few days or a week first then add in folate. The best supplement for most people is methylcobalamin. Some people also take adenosylcobalamin too.
You'll see it contains methylcobalamin, L-5-MTHF aka methylfolate, and Pyridoxal 5'-Phosphate. These are the active forms of B12, folate and B6. The others are standard.
You could take a B Complex first and see if it raises your B12 and folate. If it doesn't raise your levels or does it very slowly you could take the B Complex with additional methylcobalamin and methylfolate. Once your levels of these are optimal you could continue the B Complex alone and drop the others.
Please note that it isn't a good idea to take a high dose of vitamin B6 because it is the only B vitamin that can become toxic at high levels. the 10mg in Thorne Basic B is about right for many of us.
Also note that biotin can corrupt test machines and test results, so any products containing biotin should be stopped for 3 - 7 days before testing. The higher the dose the longer it will need to be stopped for testing.
Decreased production of neutrophils is associated with deficiencies of vitamin B12 and folic acid, aplastic anemia, tumors, drugs, metabolic disease, nutritional deficiency and immune mechanisms.
I am not a doctor and have no medical training whatsoever.
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If I was in your shoes I would suggest that you ask your doctor to test you for parasites. I'm not suggesting that you have any, but it makes sense to eliminate possibilities that could be making your health worse. It is suggested as one possible cause for high eosinophils.
One of the commonest parasites (about 50% of the UK population apparently has them) is threadworms, also called pinworms. In the UK no prescription is required to treat them. We can go to a pharmacy and buy a product called Ovex (mebendazole). I don't know if there are any dangers in someone with your health problems taking them, but it would be worth looking it up and checking first!
Another thing to take seriously is your nutrient levels e.g. the B vitamins already discussed, iron (at least in the short term to see what happens), magnesium - almost everyone on the planet is low in magnesium. If you want more info on recommended magnesium supplements then ask.
Take vitamin D (as already discussed).
You could ask your doctor for electrolyte testing. A list of the main electrolytes are given on this link :
Another thing to consider is zinc and copper testing. In people who are hypothyroid zinc is often low while copper is high - but this isn't guaranteed so it is worth finding out first.
Iodine and selenium testing (don't bother with patch testing for iodine - it is a useless test, and don't bother with loading tests either). The best test for iodine is a urine test.
Oh, I've just remembered... Take high dose vitamin C. It is supposed to be helpful for lots of illnesses and excess is excreted in urine.
Don't start taking everything at once. If you have a bad reaction to something and you've started six different supplements then you won't know which one caused the problem.
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Don't let any doctor diagnose you with Chronic Fatigue Syndrome (CFS) or ME (Myalgic Encephalomyelitis). Reject the diagnosis. This is commonly diagnosed when the doctor gives up and says there is nothing wrong with you. But clearly you have quite a few provable things wrong with you, so the doctor should not diagnose CFS. In the UK and some other countries getting a diagnosis of CFS is a wastebasket diagnosis. Once it is on your records you will be ignored and will be assumed to be making things up and mentally ill. It's all nonsense of course - but doctors love patient blaming.
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I'm still in two minds about whether or not you should take thyroid hormones. I'm hoping diogenes might contribute.
So sorry to hear about the COVID. I too had the dreaded virus, what a cursed disease! It takes a very long time, 60 to 90 days to regain the energy if you are anything like me. I hated the bed rest required to get better.
This same US government reporting agency reports the beneficial effects of Olive Leaf Extract on removing the residual virus: ncbi.nlm.nih.gov/pmc/articl...
There are many other natural nourishing remedies for EBV. You will read that there are no cures. I don’t know about that. I do know that Olive Leaf Extract is great with many viruses - perhaps and including COVID. We do have one caution to consider when we’re thinking about Covid, that is, inducing pro-inflammatory Cytokine storms. So, proceed with caution in using any of these powerful herbal remedies - depending on where you are in your COVID recovery. If you should start to feel worse, discontinue immediately. Personally, I have used Olive Leaf Extract for EBV, (seeking relief from autoimmune thyroiditis), and felt like it did help. It’s great stuff! However, I stayed away from Olive leaf extract in treating COVID as I did fear the Cytokine storms.
What I did instead (for COVID) is stick to the more nourishing ginger teas, using ginger in chicken soup, etc. - I liked the way ginger would give me just a little return on energy. I even created all sorts of ginger and lemon juice “toddies” if you will, sometimes including a little whiskey! (Just a splash). I even chewed on raw ginger. Gradually, gradually, I did get better. It has been almost a year. I would not be afraid to use Olive Leaf Extract now. In fact, in writing to you, I’m thinking I will do just that.
I too had to work during my illness (from home) - rest as often as I could. I am not a napper, but naps and rest seemed to be all one can do.
Hope you get better Laura! Thanks for keeping in touch.
hi. Many very knowledgeable people will come along soon with great advice. But firstly, you have glandular fever and you are hypothyroid. That is clear. But I don’t know if there is a connection that glandular fever could be affecting the FT3/4 results. I’m sure others will know. Glandular Fever is a virus that only rest will help you get well.
Has your GP seen these results? If you are not on Levothyroxine you should be.
Hello Sarah, thank you for your feedback. I don´t know what glandular fever is, I´ve never heard about it. Is is something connected with the Epstein-Barr infection/Vitamin D deficiency? Or rather to the thyroid levels?
I try to sleep a lot, sometimes for hours, but the fatigue, pain (especially lower back and neck) and headaches are always there, they don´t go away.
my daughter had Glandular Fever (Epstein-Barr) as a teenager. Your Dr should be prescribing medication for this. I would think the headache and pain are linked to the virus. Please contact your GP. It can take a long time to recover and rest is the most important thing.
Now I really don’t know if there is a connection with Hypothyroidism. Others here may be able to help with that.
Don’t panic it’s a virus 🦠 it will go but be patient and rest!
I think you may need to be a bit proactive about your TSH/FT3/4. Those results show you need Levothyroxine.
You need to request further testing for glandular fever caused by Epstein Barr virus. The IgG test only tells you you’ve had it in the past the IgM will tell you if it’s current and a pcr test is even better which gp may be able to request. Xx
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.
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.
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
If you want to try a different brand in the meantime, one with virtually identical doses of the ingredients, and bioavailable too, then take a look at Vitablossom Liposomal B Complex. Amazon sometimes has it branded Vitablossom but it's also available there branded as Yipmai, it's the same supplement
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
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12
Hello to every one who has shared their thoughts on my last update on Epstein-Barr virus and Vit D deficiency (something I hadn´t expected!).
I feel flattered by all your answers, they came in so quickly, you´re amazing and very professional. I feel accompanied by you on this, thank you very much 😥.
helvella (my pituitary gland has never been tested, only my TSH by the public health system and free T3/T4 by a private lab),
SlowDragon (thank you for your comprehensive answers, you certainly have a "fountain of knowledge" - funny pseudonym by the way),
humanbean (the info provided by you does help me a lot, I´ll make one Word doc out of your suggestions and links. I´ve bought Mebendazol here in Spain and I´m taking it since yesterday, I´ve read a scientific article on web Elsevier about a case of eosinophilia that was treated with antiparasitic drugs, Mebendazol was among the recommended ones. Thank you for all your valuable tips!!),
SarahJane1471 (thank you, I didn´t know Glandular Fever was a synonym for EBV, it feels awful),
Hay2016 (exactly, the GP explained to me that IgG is a telltale sign for a past infection, on the report there´s a note saying: "infection older than 3 months")
dtate2016 (So nice to hear from you! Sorry if you had gone through COVID as well, you´re fortunate to have no major aftereffects, I´m glad you don´t! This virus has changed the lives on many, mine included. Here in Spain there´re plenty of long-haulers who have set up associations. I´ve also read in forums of people affected by EBV that "Monolaurin" does help fighting viruses and have seen a noticeable improvement in their health condition, have you read about this?)
I want to mention a small edit on my update: I took "folic acid" for "folate" (my bad), I´ve now corrected it. I got tested in folic acid.
I had not heard of that particular product “monolauren”, but I have read and use coconut oil daily. We are presently using it in treating an 82 year old with dementia. It has shown great promise in stalling and even reversing some forms of dementia. (He has not been diagnosed officially with Alzheimer’s). We do see some alert and good days with him.
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Ashwagandha lowers TSH and makes me hypo?
Is there Relationship between TSH, FT3, and FT4? How could I Improve my FT4 and FT3 levels? 
I think I could be going from Graves/hyper to hypo
Thick and Fast. Another paper questioning TSH as a standard test for hypo treatment
