Feedback on private Blood tests please, before my Endo appt..

[JUUJOO]

I posted earlier this month asking for advice before I see my Endo at the end of November. I've not been feeling too great and my Endo put me on Hrt as my levels were all in range and he thinks my symptoms are perimenopausal rather than thyroid. (graves/Rai Oct 21) I feel it's a mixture of both. Hrt has helped ever so slightly, but not as I would of hoped and feel I will be discharged at my follow up. I still feel tired, no energy, very low. My hair is falling out again and I now keep getting constipated aswell. My brain is still a mess, navigating work and family life is difficult, my kids are noticing memory issues. Basically ever since having Rai a year ago, I've been a shadow of my normal self. I normally take 100 levothyroxine at night, but took it instead at different timings as per the advice given in my last post. I currently take vit D3, magnesium, omega 3 and selenium with vit A/C.

I would love some advice, so I'm armed with info before my next appt.

[SlowDragon Administrator]

Your extremely under medicated to have such high TSH

Ft3 is far too low

Approx how much do you weigh in kilo

Is HRT a patch or tablet

HRT you swallow frequently results in needing dose increase in levothyroxine

ESSENTIAL to test vitamin D, folate, B12 and full iron panel test for anaemia including ferritin

When were vitamin levels last tested

Have you had coeliac blood test done

Have you tried or are you on strictly gluten free diet or dairy free diet

[JUUJOO in reply to SlowDragon]

Thanks. Im 63kg, weight is stable . Hrt is combined everel sequi patches. Just added vitamins below. Never tested for coeliac, or tried any diets.

[samaja in reply to JUUJOO]

Are you having regular reviews of your HRT? And are the patches working for you? It's a very tricky situation with HRT and thyroid becuase you might need both and the symptoms can be the same for both but both treatments need to be right to give you the benefit rather than hinder one another.

[JUUJOO in reply to samaja]

Yes I've been in regular contact Re the Hrt as I struggled initially taking the patches & utrogestan. (terrible side effects) I then tried pessaries which were still not suitable. I've been on the sequi patches 2 months and I feel much more settled hormonally although I don't yet feel much improvement from taking it. I just feel worse now, but definitely worse thyroid wise. I have a Hrt appt next week and am waiting for my Endo to call.

[JUUJOO]

autoimmunity bloods

autoimmunity bloods

[JUUJOO in reply to JUUJOO]

vitamins bloods

vitamins

[JUUJOO in reply to JUUJOO]

inflamation / ferritin

inflamation/ferritin

[SlowDragon Administrator in reply to JUUJOO]

Ferritin is terrible

Still having periods?

Are you vegetarian or vegan?

You need full iron panel test for anaemia as next step

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Also See page 7 on here 

rcn.org.uk/-/media/royal-co...

Look at increasing iron rich foods in diet 

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

An article that explains why Low ferritin and low thyroid levels are often linked 

preventmiscarriage.com/iron...

 

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin 

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin 

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron 

Medichecks iron panel test 

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Excellent article on iron and thyroid 

cambridge.org/core/journals...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

[JUUJOO in reply to SlowDragon]

Thanks, still having periods, historically heavy. I am not veggie, but don't eat a great deal of meat.

Is a full iron panel included in a full blood count or is that a different test? I may have had iron tested a few months back. Will check my records.

[SlowDragon Administrator in reply to JUUJOO]

What’s required for Full iron panel here

medichecks.com/products/iro...

[SlowDragon Administrator in reply to JUUJOO]

Folate and B12 could be better

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

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

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

[JUUJOO in reply to SlowDragon]

Thanks, I've ordered some so will add those in during the morning.

[SlowDragon Administrator in reply to JUUJOO]

How much vitamin D are you currently taking

Do you increase dose vitamin D in winter?

Look at increasing vitamin D results to at least over 80nmol and around 100nmol maybe better

Are you also taking vitamin k2 ?

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[JUUJOO in reply to SlowDragon]

I have been taking 3000 units, vit d3 soft gel caps for about 8 months, but I don't always take daily, probably 4 times a week.

Ive read about k2/mk7 but don't take any. Will read up on this thanks.

[SlowDragon Administrator in reply to JUUJOO]

suggest you make sure you take vitamin D every day

Retest vitamin D in January (lowest point of year)

[JUUJOO in reply to SlowDragon]

Thankyou, appreciate all your advice.

[SlowDragon Administrator]

FT4: 18 pmol/l (Range 12 - 22)

Ft4 is 60.00% through range

FT3: 3.3 pmol/l (Range 3.1 - 6.8)

Ft3 is only 5.41% Through range

helpful calculator for working out percentage through range

thyroid.dopiaza.org/

Before considering adding T3 all four vitamins need to be tested and at GOOD levels

Likely to need addition of T3 prescribed alongside levothyroxine

Typical dose of T3 is 10mcg or 15mcg per day as 5mcg doses

Initially starting on just 5mcg and adding 2nd 5mcg dose mid afternoon …….. 6-8 days after adding 1st dose

Hold at that dose and retest in 6-8 weeks

[Regenallotment]

goodness you must feel dreadful poor thing.

I was put on HRT for 3 years until I was having 2 periods a month and continuous night sweats.

Different GP via phone consult sent me for blood tests, rang me to stop HRT immediately. Started thyroid meds (TSH was 4.8) and then got advice here as they would have left me on 25mcg and dreadful vitamin levels. Slowly improving, I’m just up to 100mcg with a way to go. I’ve done everything SlowDragon suggested and it is paying off. Good luck with your appointment, ask for a trial for sure. Remember you might feel worse before you feel better. Stick with it 🦋💚🦋

[JUUJOO in reply to Regenallotment]

Thanks, I've actually felt a lot worse!! But it's just very draining... I'm trying to learn what I can from here, such a knowledgeable group. I now need to try and explain all of this to my husband... Its hard enough for me to get my head around!

[SlowDragon Administrator in reply to JUUJOO]

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

[Regenallotment in reply to JUUJOO]

I hear you, I regularly have to remind my husband what it’s like to live with this. “It hurts to just be” was a phrase that helped him get his head around it. I can get a bit obsessed and then upset when he plays things down, a bit like the doctors saying ’normal’ that part is tough but I guess my obsession with my condition is quite boring after a while 😬

[arTistapple in reply to Regenallotment]

I stole that description and gave it to my husband. I hope you do not mind. I think it made some impact on him. He tries hard but I envy him the fact that he does not have to experience it first hand.

[Regenallotment in reply to arTistapple]

so glad it was helpful, sending you my best 🦋💚🦋