Blood test interpretation, Hypothyroid

[Chippa]

Any comments on recent blood tests both thyroid and vitamins gratefully received. On Levothyroxine 100mcg. Feeling extremely tired, irritable and anxious

[SeasideSusie Remembering]

Chippa

CRP and Ferritin look good.

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Testing magnesium is unreliable. About 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood. So testing what's in the blood isn't giving an accurate picture of our magnesium status.

A red cell magnesium test is the better indicator of magnesium status, not the standard serum magnesium test. The red cell test is expensive and requres phlebotomy which is why it's not included in these bundles.

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TSH: 0.46 (0.27-4.20)

FT4: 17.4 (12-22)

FT3: 4.20 (3.1-6.8)

The aim of a hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper parts of their reference ranges, if that is where you feel well. Your FT4 is 54% through range and your FT3 is 29.73% through range. They aren't particularly well balanced and shows that your conversion of T4 to T3 could be better. However, as your FT4 is only just over half way through range I would suggest that the first thing to do is increase your Levo to get your FT4 level up to about 75% through range then look at the FT3 again. This is assuming that you took your last dose of Levo 24 hours before the test (no longer as this would give a false low FT4 result) and that you didn't take any supplement containing biotin (eg B Complex) for 3-7 days before the test.

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Your raised thyroid antibodies confirm that the cause of your hypothyroidism is autoimmune, known to patients as Hashimoto's. This is where the immune system attacks and gradually destroys the thyroid.

Fluctuations in symptoms and test results are common with Hashi's.

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.

Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.

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Vit D is good, the Vit D Council, Vit D Society and Grassroots Health all recommend a level between 100-150nmol/L.

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B12: 459pmol/L = 621pg/ml

This is a decent level. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

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Folate: 14.9 (8.83-60.8)

This is low. Folate is recommended to be at least half way through it's range. Eating more folate rich foods can help as can taking a good quality bioavailable B Complex. I have used Thorne Basic B for a long time and always been happy.

If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.

When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).

[Chippa in reply to SeasideSusie]

Thank you this is really helpful, looks like I may also need to be investigated for Cushing too!

[SeasideSusie Remembering in reply to Chippa]

Oh sorry Chippa, I did notice that when I first looked but forgot to comment on it (how nice it would be to have a brain that works properly!). Yes, definitely look into that. Either do a 24 hour saliva cortisol plus DHEA test with Regenerus or Genova Diagnostics to check your levels throughout the day to give you a good basis to go forward with your GP, or ask your GP to investigate.

Regenerus: thyroiduk.org/help-and-supp...

Genova: thyroiduk.org/help-and-supp...