Help needed with interpretation of blood tests please!

[Jasper12345]

I was diagnosed with Hashimotos 7 years ago and have been taking 100m levothyroxine since then. I feel fatigued all the time and continue to gain weight. After multiple requests my GP has finally requested a T3 test - but says results are borderline but no action needed. Any advice would be much appreciated! My results are: TSH 0.16 (0.27-4.2); Free T4 21.0 (12.0-22.0); Triiodothyronine (T3?)4.8 (3.1-6.8).

Thanks!

[greygoose]

Borderline what? You're a poor converter and your FT3 is too low. That's why you still have symptoms. He needs to refer you to an endo so that you can request T3.

[Jasper12345 in reply to greygoose]

Thank you! I finally feel like there may be some hope on the horizon : )

[greygoose in reply to Jasper12345]

You're welcome.

[SlowDragon Administrator]

Welcome to the forum

Was test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

If yes, which brand

Are you male or female

Approx age

Next step get GP to test vitamin D, folate, ferritin and B12

If not already on strictly gluten free diet you also need coeliac blood test done

What vitamin supplements are you currently taking

Getting vitamins tested and optimal will frequently improve conversion of Ft4 to Ft3

Similarly frequently necessary to be on strictly gluten free and/or dairy free diet

[Jasper12345 in reply to SlowDragon]

Hi, the test was done at 11.30am - but last dose of levothyroxine 28 hours before. They did change my brand of levothyroxine a month ago due to supply difficulties. I am a 58 yr old female. Ferretin is 169 (13.0 - 150.0); I am not currently gluten free. I am prescribed vit D. Any help/advice very welcome : )

[SlowDragon Administrator in reply to Jasper12345]

Get GP to test folate and B12 ….or test privately

How much vitamin D are you currently taking

Is it tablets or mouth spray

Tablets should be minimum 4 hours away from levothyroxine

Test vitamin D twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

Another member recommended this one recently

Vitamin D with k2

amazon.co.uk/Strength-Subli...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

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

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Great article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Gluten

So get coeliac blood test done via GP BEFORE trialing strictly gluten free diet

Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but a further 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

First step is always to get all four vitamins tested and at GOOD levels

Next step….look at food intolerances

Splitting dose levothyroxine and/or gluten free diet may significantly improve conversion

See my reply right at bottom of thread

healthunlocked.com/thyroidu...

[Jasper12345]

Thanks, my levothyroxine is now Eltroxin and Vit D has been changed from InVita to Colecalciferol (both tablets rather than spray) - 800u per day.