Advice on blood results and supplementation

[Stratocaster58]

Hi Everyone, I wonder if anyone out there can take a look at my blood results over the last year or so and comment on any issues?

I am currently taking 175mg of Levothyroxine which has been stable for the last few years (first diagnosed as hypo in 2003 and haven’t felt 100% since!). unfortunately, I haven’t really had a great deal of symptom relief, so recently I’ve been adding supplements and having private blood tests done to see if I can get to the bottom of the issue. Initially I felt that B12, Vitamin D, and Folate were low, so I added supplements. Vitamin D has responded well, but I haven’t seen a massive increase in Folate and B12.

Also, do my Iron figures look OK? Ferritin looks OK (low?), but Transferrin saturation is high - does this make any sense.

My TSH seems to jump around quite a bit, and I have noticed that my free T4 is above the normal range, free T3 is in the normal range (but not sure if ratio indicates an issue?)

Any advice and pointers would be greatly appreciated. I’ve attached a screenshot of my blood results. I’ve been taking a B complex supplement and Vitamin D plus cofactors for 6-12 months and have introduced Ubiquinol and Selenium in the last month. I also take kyolic garlic (which includes nattokinase) to help keep my blood pressure normal.

[SlowDragon Administrator]

Only test that includes Ft4 and Ft3 is last test

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

Ft4 slightly over range

FT3: 4.3 pmol/l (Range 3.1 - 6.8)

Ft3 only 32.43% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

Most people when adequately treated will have Ft3 at least 50-60% through range minimum

Exactly what vitamin supplements are you currently taking

Have you had thyroid antibodies tested

Do you know cause of your hypothyroidism?

[SlowDragon Administrator]

Just read in your bio…..your vegetarian

So likely to need to work continuously on improving low B12 and folate

Ferritin is quite low for a bloke

[Stratocaster58 in reply to SlowDragon]

Thanks SlowDragon, I really appreciate your reply.

I remember when I was diagnosed that no antibodies were detected, it was a case of ‘I think your thyroid is becoming sluggish, and as your Mum is hypothyroid we probably need to treat you. I question this now, but having now taken levothyroxine for years it’s probably a bit academic.

I don’t understand why my ferritin is quite low in the range but my transferrin saturation is high and just out of range. Have you seen this before?

Thanks for the link to the range calculator, very useful. I do wonder if there is a conversion issue as the ratio T4 to T3 seems off.

All my blood tests are taken in a fasted state around 8am and I don’t take my Levo until after the test.

I’ve added a screenshot of my supplements- is there anything else I should maybe look at?

Screen shot of my supplements.

[SlowDragon Administrator in reply to Stratocaster58]

There are two thyroid antibodies linked with autoimmune thyroid disease

TPO and TG antibodies

NHS only tests TG antibodies if TPO are high

So if your TPO antibodies were low they won’t test TG antibodies

Significant minority of Hashimoto’s patients only have high TG antibodies

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

If your Mum has thyroid disease it’s likely autoimmune and it runs in families

Strictly gluten free diet and/or dairy free diet often helps or is essential

Getting coeliac blood test done BEFORE considering trial on strictly gluten free diet

[SlowDragon Administrator in reply to Stratocaster58]

Did you stop vitamin B complex a week before test

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and separate B12

As vegetarian you might need separate B12 as well as vitamin B complex

Low B12 symptoms

b12deficiency.info/signs-an...

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.

B12 drops

healthunlocked.com/thyroidu...

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

How other member saw how effective improving low B vitamins has been

healthunlocked.com/thyroidu...

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

[SlowDragon Administrator in reply to Stratocaster58]

Iron and ferritin are complex

Suggest you Google high transferrin and low ferritin

Eg

drwholeness.com/blog/what-d...

Do you always get same brand levothyroxine at each prescription

You could try splitting your dose levothyroxine….taking half waking and half at bedtime

Some people find this gives better conversion of Ft4 to Ft3

and slight increase in TSH

So suggest you try

Gluten free

Dairy free

Get both thyroid antibodies tested.

If both antibodies are negative get ultrasound scan of thyroid

But if Ft3 remains low …..will need small dose T3 prescribed alongside levothyroxine

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

[e-mail]

[Stratocaster58 in reply to SlowDragon]

Many thanks, certainly a lot to look at there 👍

I do tend to always get the same brand of thyroxine, sometimes it’s been tricky with the 25’s but I have a good pharmacist now who orders them in for me.

I’ll try splitting the dose as you suggest, that’s certainly worth a shot, and I guess would more closely mimic how the thyroid gland itself would work!

I’ll also have a dig in to the iron results as you suggest , I need to understand what they are telling me, currently I can’t get my head around the high saturation vs ferritin level.

Lastly thanks for the tip on seeing a good thyroid specialist / endo - I could really do with talking this through with someone and building a plan.

All the best.