Help with blood test results

[Donnaca]

Hello,

I would be very grateful for some advice, I put on weight in the pandemic and have been trying to lose it for the past 18 months, my diet and exercise is very good - I follow a gluten free, dairy free diet with lots of veg and protein, I exercise around 3-4 times a week too.

3 months ago I did Low level Laser therapy on my thyroid to try and rejuvenate the tissue - my thyroid on last scan was only 1mm, it was a bit of a trial as I do not have much gland left so not sure if the treatment would help me or not. I do feel better in myself but other patients have had quite dramatic results and do not need medication anymore or it has been reduced.

These are my latest results, Medichecks just said I need to go on a diet and not have a cheat day.

Do they all look healthy? I am on 150mcg of levo a day but I want to try erfa as I met a lady who said her weight dropped off when she starting taking it.

TSH 0.36mU/L (0.27 - 4.2)

Free T3 4.08 (pmol/L 3.1 - 6.8)

Free thyroxine 21.6 (pmol/L12 - 22)

THYROGLOBULIN ANTIBODIES 170 IU/mL < 115 R

THYROID PEROXIDASE ANTIBODIES 190 IU/mL < 34 R

CRP HS 0.39mg/L 0 - 5 R

FERRITIN 38.6 ug/L 13 - 150 R

FOLATE Serum 11.35 ug/L > 3.89 R

B12 Active >150 pmol/L 37.5 - 150 R (I had B12 shots last month)

Vitamin D 66 nmol/L 50 - 200 R

Thanks in advance.

[pennyannie]

Hello Donnaca :

The accepted conversion ratio when on T4 Levothyroxine only - is said to be : 1 / 3.50 - 4. 50 - T3/ T4 - with most people feeling at their best when they come in at around 4 or under :

So to find your conversion ratio you simply divide your T3 into your T4 and I'm getting yours coming in at around 5.30 - so your conversion of the T4 is compromised and not good.

Conversion can be compromised by low levels of ferritin, folate, B12 and vitamin D , inflammation, any physiological stress ( emotional or physical ) depression, dieting and ageing.

So, whilst we can't turn back the clock we can do something about some of this ourselves.

Your ferritin was very low last time you posted, was an iron panel run and an iron infusion suggested ?

I now know I need to maintain my ferritin at around 100 : folate at 20 : active B12 75 + ( I see you have an issue there and have shots ) and vitamin D at around 100 :

No thyroid hormone works well until your core strength vitamins and minerals are maintained at optimal levels.

Yes, in order to rebalance your T3 and T4 the logical next step could be either to introduce some T3 with you T4 or switch to Natural Desiccated Thyroid of which Efra is a brand, which contains all the same known hormones as that of the human gland.

Currently your doctor can only prescribe T4 so you will need a referral to an endocrinologist for either of these other thyroid hormone replacement options.

[Donnaca in reply to pennyannie]

Thank you so much for your reply, I really appreciate it. I have managed to recently find an iron supplement which has increased my ferritin in a couple of weeks so I will keep taking that to get the dose optimal. The GP said my ferritin is within normal range so I can take iron supplements if I want - I am working on it myself now.

I have just found an online private doctor who prescribes NDT - TBH I do not have the fight in me to request it from the NHS, they have always been useless with my thyroid problems.

Thanks again.

[pennyannie in reply to Donnaca]

Yes, I can concur on your NHS experiences - was your very low ferritin investigated 3 years ago and iron tablets prescribed by your doctor ?

[Donnaca in reply to pennyannie]

They gave me some iron tablets to take but they said there was nothing to be concerned about so it wasn't investigated further, I couldn't get them to repeat another test.

[pennyannie in reply to Donnaca]

So you had an endoscopy / colonoscopy and everything was all clear :

Good - iron is complex - and you need to read up around it as it's happened to you again :

I found it took a good year to build up my ferritin from 22 and when I started taking an active role in getting myself better as the iron tablets prescribed me, made everything worse.

An iron bisglycinate ferritin supplement is softer on the body if you can't get on with the basic formula tablets.

[Donnaca in reply to pennyannie]

Yes it clear, they said I had some inflammation from taking laxatives though (the joys of thyroid issues). I am taking iron bisglycinate which also has some folate in, I do feel like it is softer on my body. You are right, I need to be more careful with my iron, I have been eating liver and also taking sun chlorella which helps (it contains no iodine). My ferritin is now going back up properly thankfully.

My hormone test says I am not peri meno yet, I had a private test. I eat meat - I tried the veggie/vegan way but that made me worse.

I will test my iron again in 2 more months. What I have noticed is that my hair-loss is significantly less already in the past few weeks which is amazing.

[SlowDragon Administrator]

Ferritin is verging on deficient and certainly too low

Are you pre or post menopause

Vegetarian or vegan?

cks.nice.org.uk/topics/anae...

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

List of iron rich foods

dailyiron.net

Links about iron and ferritin

An article that explains why Low ferritin and low thyroid levels are often linked

preventmiscarriage.com/iron...

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

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

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron

Medichecks iron panel test

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

How much vitamin D are you currently taking

Aiming for vitamin D at least around 80nmol and around 100nmol maybe better

Improving low vitamin levels is first step

Then as gluten intolerant and dairy intolerance likely to need addition of T3 prescribed alongside levothyroxine (or NDT)

You won’t get NDT - Erfa or Armour on NHS

You might get T3

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3 or NDT

[e-mail]

[Donnaca in reply to SlowDragon]

I stopped taking Vitamin D a few months ago due to feeling overwhelmed by supplements, I have been on a parasite and heavy metal cleanse which is now finished (prescribed by a private doctor). I will begin supplementing on D3 again. I have a spray that is 3000 IU with K2.

Thank you for the articles, I will read through these. I have had miscarriages in the past and now I know why.

[SlowDragon Administrator in reply to Donnaca]

Sadly far too many doctors ignore low iron/ferritin