More results… still tired but so much better

[Hashibegone]

Hi everyone. I had my results back from private testing and wonder if anyone could let me know why I’m still so tired? Did the tests as advised on here and stopped my vitamins for two weeks prior to test. Am currently on 100mcg of Levothyroxine and take 1 Omega Balance. 1Multi B extra. I Vitamin B12 (sublingual). 1 Vitamin D3 + K2 every day and 1 Magnesium Malate (high absorption) every other day. Take my Levo at 4am and all my vitamins apart from B12 with my evening meal. Should I be doing anything else or anything different please? I’m vegetarian and mostly dairy free. Thank You in advance for any suggestions….

[SeasideSusie Remembering]

Hashisbegone

I think you've forgotten to post your results

[Hashibegone in reply to SeasideSusie]

Ohhhh noooo! Shall I just add them to this reply? Oh I’m sooo dopey!

[SeasideSusie Remembering in reply to Hashibegone]

Yes, you can add them in a "Reply". Click on the last icon in the row below the message box, the rectangle with mountains and sun.

[Hashibegone in reply to SeasideSusie]

….

[SeasideSusie Remembering in reply to Hashibegone]

Still no results showing.

If you're having trouble adding an image, why not just type the results/ranges into a reply.

[Hashibegone in reply to SeasideSusie]

Photo won’t upload I’ll try one more time

[SeasideSusie Remembering in reply to Hashibegone]

I'm sorry but I've had to remove the image.

Your name and date of birth were showing and this leaves you vulnerable to identity theft.

Also there was a lot of wasted space which made the results too small and blurry to read.

Either try again to upload the image without your personal details showing and zooming in on just the results/ranges so that they're big enough to read.

Or type them in.

[Hashibegone in reply to SeasideSusie]

I’m sorry, thank you for noticing the error….

CRP HS <0.3 (0-5)

Ferritin. 48.9. (13-150)

Folate Serum 15.88. (>3.89)

Vit B12 Active 141.0 (37.5-150)

Vit D 101 (50-200)

TSH. 0.64 (0.27-4.2)

Free T3 4.69 (3.1-6.8)

Free Thyroxine 20.7 (12-22)

Thyroid Peroxide ab 177 (<34)

Thyroglobulin ab 294 (<115)

At last? (Fingers crossed!).

[SeasideSusie Remembering in reply to Hashibegone]

Hashibegone

OK, we got there

stopped my vitamins for two weeks prior to test.

No need for that. You can carry on with all of them up to and including the day before testing as this then shows the level your supplements are achieving. The only exception is B Complex/Biotin which should be left off for 3-7 days before the test. Also, if taking iron this should be left off for 7 days before the test.

Did you take your last dose of Levo 24 hours before the test (adjusting time the day before as I assume you didn't do the test at 4am?).

If so then results should be accurate.

CRP HS <0.3 (0-5)

This is a good result, as an inflammation marker the lower the result the better.

Ferritin. 48.9. (13-150)

This is low. Low ferritin can cause fatigue.

Ferritin is recommended to be half way through range which would be about 82 with that range, although some experts say the optimal ferritin level for thyroid function is 90-110ug/L.

It's not advisable to self supplement with iron before further testing. You need an iron panel to check levels of serum iron, total iron binding capacity, transferrin saturation percentage and ferritin. If you already have good levels of serum iron and saturation then taking iron tablets will take these too high and lead to toxicity.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

I can see that you are vegetarian so you will need to check out the acceptable iron rich foods in the list.

Folate Serum 15.88. (>3.89)

This is a decent level. Folate is recommended to be at least half way through range and Medichecks range is actually 3.89-19.45 so half way would be around 12 plus.

Vit B12 Active 141.0 (37.5-150)

This is a good level. It might be worth dropping off the separate B12 supplement now to see if the amount of B12 in the B Complex is enough to maintain a decent level. No point in spending money on a separate B12 supplement if you don't need it.

Vit D 101 (50-200)

Just into the level recommended by the Vit D Society and Grassroots Health who both suggest a level of 100-150nmol/L; however, a recent blog post on Grassroots Health recommend a level of at least 125nmol/L. As we are now into summer and many of us can make Vit D naturally from the sun, I'd leave your D3 dose as it is and check level again at the end of October/beginning of November to see whether you need to increase your dose during the winter months.

TSH. 0.64 (0.27-4.2)

Free T3 4.69 (3.1-6.8) = 42.97% through range

Free Thyroxine 20.7 (12-22) = 87% through range

These results show poor conversion of T4 to T3, you need high in range FT4 to produce FT3 less than half way through range.

Improving iron level can possibly help with conversion. Also supplementing with selenium might help - 100-200mcg daily of selenium L-Selenomethionine or yeast bound selenium (avoid selenite or selenate forms). Some people prefer to test selenium level before supplementing although 100mcg is said to be a safe amount to take without testing.

Once all nutrients are at optimal levels if conversion is still poor then consider adding T3 to Levo.

Thyroid Peroxide ab 177 (<34)

Thyroglobulin ab 294 (<115)

Confirms your Hashi's.

[Hashibegone in reply to SeasideSusie]

Hi… sorry for the delay in replying, I’ve been up to my eyes in grandkids the last few days…Thank you for another brilliant reply. I’ll take heed again of the things you suggest. I’m getting there but there was just so much to take in and learn at the beginning of this journey.

First thing I’ll do is the iron panel. I have been wondering if I need an iron supplement for a bit. But knew there was something about just taking iron because ferritin was low. Just couldn’t remember what it was 🙄

I was quite surprised that my vit D wasn’t higher actually, glad it’s ok though and I will stay as I am for now. I spend most of my time outside in the summer and have just had a fortnight in Greece with wall to wall sunshine every day so that’s why I expected it to be high.

As for your advice re my iron levels… I really hope it’s that which is the problem because if it helps with the T4/T3 situation I’ll be so happy because I absolutely dread the thought of losing another battle with the GP and then having to source T3 myself and going it alone so to speak….I’d have no idea where to start with sourcing a safe supply of Liowhatsitsname 🤦‍♀️ Or what to do about mixing Levo with it etc. Anyway I’ll cross that bridge if I have to eh……

Thanks again for all of your help, you’re an absolute star!

[eiddew in reply to Hashibegone]

Hi Hashibegone

Sorry, missed your D3 in last post.

I would be running a marathon if my ferritin, FT3 & FT4 are at your levels.

The worst items on your list are your auto-thyroid antibodies. They are indicators of leaky gut (Intestinal permeability), and food "sensitivities".

I second a few others here to do some food subtraction experiments.

Do check out these two links, if you are not yet familiar with Dr. Izabella Wentz

thyroidpharmacist.com/artic...

healthunlocked.com/redirect...

Your D3 can be much better, to calm your autoimmunity. Yes, we have sunshine at the moment, but we don't go out walking in our bikinis. 30 000 iu ~ 20-30 min of summer sun with maximal skin exposure, it's not toxic.

On "optimal dose" of D3

judsonsomerville.com/

Jacking up D3 is one of the first things of Rachel Hill's successful Hashi's remission journey

theinvisiblehypothyroidism....

HTH, take care

[Hashibegone in reply to eiddew]

Thanks for your reply. Yes I might put myself forward for the next marathon I’ll see 😁 if I get my ferritin levels optimal. If you’re not feeling brilliant it might be worth looking back at my previous posts and the brilliant links various people shared with me regarding optimal levels of everything and conversion of T4 to T 3… my T4 is marvellous now especially as it was 13 I think when I was finally diagnosed with an actual problem (Hashimoto’s) and not depression which seems to be the go to diagnosis of many gp’s nowadays…however as Seaside Suzie has pointed out my T3 is not coinciding with my good level of T4. The tiredness is probably the only symptom that really bothers me now, I accept that I’ll never be the ‘me’ I was before hashis but with the help of Seaside Suzie, Slow Dragon and other great guys on here my life is worth living again.

[eiddew in reply to Hashibegone]

Hi Hashibegone

It's good to see you are energetic enough to take time to respond to every one.

A bit of clarification on the "biochemistry" here.

Iron is directly involved in thyroid hormone "production" / "biogenesis", not "conversion". There are two enzymes, TPO (thyroid Peroxidase) and DUOX2, in the thyroid gland, which help to put iodine on TG (thyroglobulin). Part of the iodinated TG gets cleaved off inside the thyroid cell, and release predominantly T4 into the blood stream.

TPO and DUOX2 bind, and require, heme-iron for their activities.

Selenium is important for T4 to T3 conversion in many tissues, not just in the thyroid gland. The enzymes, which remove one "iodine" from T4 to make T3, are seleno-proteins. Their active sites are modified with an attached selenium.

I agree with Seaside Suzie. Your FT3 does look like it can go into the optimal range, 5- 7, based on the glorious FT4 you have.

So supplement on selenium, or Brazil nuts with lab-tested quantity of Se on the package. Waitrose Duchy seems to be the best source on my radar. 10g nuts ~ 200 mcg.

waitrose.com/ecom/products/...

Fatigue can also be due to an active immune response happening. Our immune cells consume a lot of energy, they are very active and motile cells. I felt wiped out after my COVID jabs.

The vaccine induces a foreign protein being made in our body, the "antigen". The antigen is the viral spike protein. This elicits an immune response, resulting in the production of antibodies.

This scenario is analogous to an immune response to gluten due to leaky gut condition. Undigested / poorly digest gluten molecules breaching through the thin gut lining, and leaking into the blood stream, become the "antigen". Our immune system takes that as a foreign "invader", and mounts an immune response, generating antibodies.

Our current thinking is that anti-gluten antibodies can cross-react with our own proteins due to "molecular mimicry". Bits of gluten protein may look like bits of TPO, TG or other of our own proteins.

Dairy and egg are two other common "antigens" for auto-immune diseases, not just Hashi. Dietary elimination has helped many patients to improve their symptoms.

Thanks for sharing your experience with Izabella Wentz's books. I can see they can come across as complicated at first sight. Individual "remission" stories on her website are easier to unpack.

thyroidpharmacist.com/?s=re...

take good care

[Hashibegone in reply to eiddew]

Yes I have some days better than others. If I sit for more than 10 minutes I’m asleep or wanting to sleep, be it a good or bad day. I fight it constantly. Thank you for all the information. 😊

[malohant]

Hi

Do you have Hashi's (Autoimmune)? If so have you tried an exclusion diet? I was in a similar place a couple of years ago and got fed up with it so I went on Isabella Wentz's Hashimoto Procotol diet, it took 3 months of gradually excluding foods to a point where I was no longer spiking and crashing and was able to reintroduce some foods. The foods which trigger my fatigue are gluten, nuts, and most seeds and many seed based foods (Wentz gives a long list of potential triggers, once you've eliminated them you can reintroduce one by one and see which affects you).

All of that said, I still have ongoing fatigue, it's just much easier to manage. Some of us just don't react well to levothyroxine, I'm currently on a trial of liothyronine T3 but it hasn't made much difference yet.

Best of luck x

M

[Hashibegone in reply to malohant]

Hi, yes I have Hashis. I feel bad that I have not excluded gluten yet. I have tried and stuck to it for a bit but nowhere near long enough, I will do better! It’s just one of the many many things I’ve been advised to do. I’ve done most of the things suggested and have absolutely got my life back. It was totally pointless being here before I got the help I did from this forum. Soooo, after over a year of getting myself sorted I feel I’m almost at the point of embarking on the gluten free journey for real this time. I bought Isabella Wentz book at the beginning of my journey but I couldn’t make sense of it at that time. I could hardly string a sentence together or concertante for more than around 3 minutes at that point so trying to read any book was impossible, and especially a book like hers with a million pieces of information on each page! 😊 Good luck on your recovery journey and do let us know how it goes with the Lio… how long have you been taking it? Teva Levo affected me badly but I now avoid it like the plague and insist on accord or northstar which I’m fine with…. Kind regards

[malohant in reply to Hashibegone]

Yes I didn't do well on Tevo levo either, I only get Northstar (accord) these days.

I must confess I don't think I read all of the text in Wentz's book either, but there are bits where she breaks down quite simply what you can and can't eat and for how long (well I found it simple enough, but I know brain fog can be a bugger).

There are some great gluten free recipes out there online (and even passable AIP recipes!) but it does take some experimenting with and it helps that I like to cook.

Hope you find some improvement, however it comes.

Best of luck

M x

[eiddew]

Hello Hashibegone

"Take my Levo at 4am"

Are you one of those funky people with genetic predisposition to have a shifted circadian rhythm? They exist, going to bed early, and rising early. 4 am is very early for most "normal people".

Deep restorative sleep is the most important "foundation" of health, underpinning "nutrition" & "exercise". Lack of it can muck up our immune system. Your TPO Ab and TG Ab are not good.

How has your sleep been? Vitamin D3 can improve sleep. D3 indirectly puts us in the "paralytic" mode for deep sleep. What's the dosage of your 1x D3+K2? Tablet, capsule, or liquid? Have you had D3 tested?

Daylight exposure, exercise, stress reduction / meditation / breath work, etc, all contribute to good sleep.

Hope your energy level still allows you to go outside (now the weather is mostly nice), and walk a bit, however slowly, EVERY DAY. I do that religiously.

I will post a plug to an "Inflammation" online summit in a separate post. I expect good info from there, to be added to Dr. Izabella Wentz and Dr. Westin Childs.

take good care, you have a learning spirit, you will get better and feel better

[Beads in reply to eiddew]

I take my levo at 4:30am. There’s an alarm on the iPad next to the bed, it goes bing bing bing, I wake up, fumble my pills out of the pot, glug glug glug water, back asleep until the real alarm. I get up (sometimes very slowly) and can have coffee and some brekkie straight away.

[eiddew in reply to Beads]

Hi Beads

I'm curious. Have you always been taking your meds at 4:30am? Is that a recommendation by your GP, or something you worked long to optimize at some point?

Below is a synopsis from one of Dr. Izabella Wentz's page

thyroidpharmacist.com/artic...

===

Most thyroid medications (with the exception of Tirosint and Tirosint-SOL) should always be taken on an empty stomach, at least 30 minutes before your first meal of the day. (Some people may even need to wait 1-2 hours if they have additional gut issues.)

There are also certain foods to avoid within one hour of taking thyroid medication, including coffee, soy, grapefruit juice, cottonseed meal, walnuts, and dietary fiber.

===

Hope your rationale of breaking up your sleep is not simply to have coffee first thing when you "properly" wake up.

If your sleep is good, you don't need caffeine first thing in the morning, nor in the afternoon. And you can easily postpone your first meal 30 min after waking up.

[Beads in reply to eiddew]

It’s because I sometimes struggle to remove myself from my bed. So there’s not enough time to have breakfast or coffee if I take them when I get up. So I set my alarm for an hour and a half before the real alarm, just so I can eat/drink when I do get up.

I booked the doc yesterday for a blood test (had a ‘lie in’ coz I wasn’t taking my levo) at 8, by the time I got to work at 8:30 the caffeine headache had kicked in (I only have the one caffeinated coffee, first thing) and my stomach was trying to exit its way out through my spine.

[Hashibegone in reply to Beads]

Hi. Yes my sentiments exactly!!! 😁 I don’t even have to set my alarm, I’ve always been able to wake at anytime (roughly) if I just think it before going to sleep. So, I wake at 4 (sort of) take my Levo, which I have to cut out from the rest of the pack (just so I can check, when I get up, that I have definitely woken and taken it!) 😊 because I too am still at least half asleep, then that’s it until I wake naturally and properly around 7-7:30 Coffee as soon as I get up….happy days!! 😁

[SlowDragon Administrator]

Have you had coeliac blood test done

Are you on strictly gluten free diet or tried it?

[Hashibegone in reply to SlowDragon]

Hi Slow Dragon…Thank you for replying to me again. Yes I had a coeliac test at your suggestion and it was negative. And, Nooooo I haven’t seriously tried the gluten free route just yet. My health is now at the point though, where I feel I have the strength to go down that route. I did try it a while ago but found it hard and didn’t really have my heart in it. I will try it soon though. How long would you suggest is the optimal period of time to stay on it before reintroduction of gluten if I feel no better? I have had two low CRP results and so did wonder if they would have been higher if I had a gluten intolerance? Just a thought….(hope/😊)

Thanks again

[SlowDragon Administrator in reply to Hashibegone]

Suggest you work on improving low ferritin first

Very difficult to maintain good iron and ferritin on plant based diet

Looking for ferritin at least around 70 minimum

Some people notice improvement immediately within 3-10 days …..others it’s more slow subtle differences

3-6 Months is a realistic trial

Strictly gluten free. Watch out for cross contamination

[Hashibegone in reply to SlowDragon]

Ok, will do…. thank you ….again 😊