I am so annoyed that TSH is supposed to be enough evidence of thyroid function and that a ferritin level of 11 is normal. A nurse did these tests so she probably isn't allowed to test even T4. I am advising her to self medicate with iron supplement and vitamin D but I am worried that I am missing something and hoping that your sharp eyes will notice. The low TSH level in particular.
She has Hashimotos which was discovered during surgery for Hyper-Parathyroidism. Her results have always been within normal range but she has symptoms such as exhaustion, inabllity to lose baby weight, PMS monthly. Her TPO antibodies were very high after her last pregnancy which is not unusual, but after coming down they have risen again. Baby is now 2 yrs 6 months old.Is she having a Hashi's flare? That is something I don't know about.
I am struggling to type as I need a shoulder op, so if I don't reply immediately it will be because I am struggling but all opinions are very welcome.
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Impossible to know full thyroid status when testing just TSH. She needs a full test - TSH, FT4 and FT3. If GP wont do it then she can get this done with MonitorMyHealth fingerprick test for £26.10 which I would strongly advise. Details and code for that price here:
I am advising her to self medicate with iron supplement
She needs to be careful. In fact with that ferritin level I would suggest that she insists on speaking to the doctor and presenting the evidence that NICE say this confirms iron deficiency - see here:
Serum iron: 55 to 70% of the range, higher end for men - hers is 51.54%
Saturation: optimal is 35 to 45%, higher end for men - hers is 23% assuming same test
Transferrin: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - hers is at the higher end of range
Ferritin: Low level virtually always indicates need for iron supplementation
So although her serum iron is pretty good and saturation a bit low, it probably wouldn't be classed as iron deficiency but her Transferrin and Ferritin results suggest she needs iron supplementation. Because a keen eye needs to be kept on serum iron and saturation levels this this is best overseen by her GP with regular monitoring.
How much D3 have you suggested she takes, and have you mentioned D3's important cofactors - Vit K2-MK7 and magnesium?
My daughter is not taking levothyroxine or any other thyroid meds. She was worried when she became pregnant with her second child and the received wisdom of those treating her was a low dose of thyroxine. This made her feel much worse( probably because it wasn't enough) so she stopped taking it. Fortunately baby was born healthy. She has been reluctant to try it again expecially as doctors don't think she needs it as her test results have always been within range. I haven't spoken to her about what dose of vitamins to take - must do that , but when she last took Vit D she used the Better You spray and stopped because it mad her mouth sore. Thankyou for this very informative reply
when she last took Vit D she used the Better You spray and stopped because it mad her mouth sore.
I've never liked the sprays because of the excipients. She could have a look at Doctor's Best D3 softgels, good clean supplement with no excipienets, just D3 and extra virgin olive oil.
You might want to check out a recent post that I wrote about Vit D and supplementing:
and you can check out the link to how to work out the dose you need to increase your current level to the recommended level. She'd be look at supplementing with 4,000iu D3 during the winter months then retest around end of March and dose may need adjusting for the summer.
Vit K2-MK7 is needed because taking D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from soft tissues and arteries where it can be deposited and cause problems like kidney stones, calcification of arteries, etc.
For Vit K2-MK7 my suggestions are Vitabay, Vegavero or Vitamaze brands which all contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Vitabay and Vegavero are either tablets or capsules.
Vitabay does do an oil based liquid.
Vitamaze is an oil based liquid.
With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.
If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The K2-MK7 is the All-Trans form
Magnesium should be taken 4 hours away from thyroid meds and as it tends to be calming it's best taken in the evening. Vit D should also be taken 4 hours away from thyroid meds. Vit K2-MK7 should be taken 2 hours away from thyroid meds. Don't take D3 and K2 at the same time unless both are oil based supplements, they both are fat soluble vitamins which require their own fat to be absorbed otherwise they will compete for the fat.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
Her TSH is not low. It's 'normal' - euthyroid - so don't worry about that.
Her TPO antibodies were very high after her last pregnancy which is not unusual, but after coming down they have risen again.
Antibodies fluctuate all the time. It doesn't mean anything. It's not a measure of severity of the disease, it's just what antibodies do.
Is she having a Hashi's flare? That is something I don't know about.
No. If she were, her TSH would be suppressed.
I don't like talking about 'Hashi's flare's' because the name is confusing. I prefer to call it a Hashi's 'hyper' swing, because that's exactly what it is. When the thyroid is under attack from the immune system, the dying cells deposite their stock of hormone into the blood, causing the FT4/3 to rise sharply, and the TSH to drop, making the patient temporarily 'hyper'. With time, though, these excess hormones will be used up/excreted, and she will become hypo again.
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
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
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Test results
Thyroid/Extremely tired!
Finally got blood result print out!! 
Obtained my results as advised by the community, after being advised by GP to go for repeat test in 4-6 weeks as borderline thyroid issue...
