Normal bloods: Hi everyone, I have suffered with... - Thyroid UK

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Normal bloods

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Hi everyone, I have suffered with hypothyroidism for about 15 years. 3 years ago I had an ultrasound of my thyroid and was told I had nodules and probably hashimitos. For about 2 years I have had frequent throat clearing and some indigestion. I've recently been to the GP who said it's probably reflux and has put me on 40mg omeprazole and scheduled an endoscopy.

My question is, could it be my thyroid, my nails are splitting, my hair falling out, I can't sleep, my legs are aching, I feel like crying all the time, I'm a little breathless and my throat is sore when swallowing. The GP has done full blood work and everything is normal. Will nodules cause a problem with normal bloods?

Sorry for the long post 🙂

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SlowDragon profile image
SlowDragonAdministrator

How much levothyroxine are you currently taking

What are your most recent thyroid and vitamin results

What vitamin supplements are you currently taking

Acid reflux due to LOW stomach acid is common hypothyroid symptom and suggests you are possibly inadequately treated

PPI is to treat high acid and can make absorption worse and deplete vitamin levels

Any PPI should be taken minimum of 4 hours away from levothyroxine…..and ideally longer

As you have Hashimoto’s are you on absolutely strictly gluten free diet or dairy free diet

If not get coeliac blood test done BEFORE considering trial on strictly gluten free diet

Just testing TSH and Ft4 is completely inadequate

Recommended on here that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

you need TSH, FT4 and FT3 tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

tranted profile image
tranted in reply toSlowDragon

Hi and thanks for your response. I currently take 125mg of levothyroxine 4 days per week and 100mg the other 3.

I also take vitamin D 2000 IU (D3*50pg) and vitamin B12 1000pg

My bloods were taken at 11am. I took my thyroxine at 9am 🤷

I always have a gap of at least 4 hours between thyroxine and omeprazole.

My latest bloods as follows.

TSH 1.27mlU/L (0.3 - 5.00)

Vit B12 907ng/l (200 - 960)

Serum Ferritin 130ng/ml (20 - 350)

Serum Folate 5.9ng/ml (3.00 - 18.00)

Serum Sodium 142mmol/L (133 - 146)

Serum Potassium 4.3mmol/L (3.5-5.5)

Serum Creatinine 83umol/L (45 - 84)

tranted profile image
tranted in reply totranted

I have been tested fir coeliac some years ago as both my brother and daughter are positive. I tested negative.

SlowDragon profile image
SlowDragonAdministrator in reply totranted

So

TSH would be higher if tested just before 9am

No Ft4 or Ft3 test - so completely inadequate test

Last dose levothyroxine should be 24 hours before test

Do you always get same brand levothyroxine at each prescription

Folate is far too low

First step is to start a daily vitamin B complex

(See following reply)

Get FULL thyroid levels tested now

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

cheapest option for just TSH, FT4 and FT3 via DIY finger prick test

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Tips on how to do DIY finger prick test 

healthunlocked.com/thyroidu...

Most members manage DIY test no problem

Alternatively Medichecks or BH offer private blood draw

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk/

SlowDragon profile image
SlowDragonAdministrator in reply totranted

Over 80% of Hashimoto’s patients find strictly gluten free is beneficial

Poor gut function 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 over 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

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.

And approx 60% dairy free helps …..something to consider in another 6-8 months

With Hashimoto’s, ferritin can be falsely high due to inflammation

Ideally would request full iron panel test

Or test privately

Medichecks iron panel test 

medichecks.com/products/iro...

Iron ferritin test …early morning and fasting

SlowDragon profile image
SlowDragonAdministrator in reply totranted

Low folate

Rather than just taking B12 instead suggest you try changing to 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 maintain B12 levels too

Difference between folate and folic acid 

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

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

SlowDragon profile image
SlowDragonAdministrator in reply totranted

No vitamin D test

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

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

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...

SlowDragon profile image
SlowDragonAdministrator

Thousands of posts on here about low stomach acid 

healthunlocked.com/search/p...

But never assume you have low stomach acid 

healthygut.com/4-common-bet...

Web links re low stomach acid and reflux and hypothyroidism 

nutritionjersey.com/high-or...

stopthethyroidmadness.com/s...

thyroidpharmacist.com/artic...

 How to test your stomach acid levels 

healthygut.com/articles/3-t...

meraki-nutrition.co.uk/indi...

huffingtonpost.co.uk/laura-...

lispine.com/blog/10-telling...

Protect your teeth if using ACV with mother 

healthunlocked.com/thyroidu...

Ppi 

Omeprazole will lower vitamin levels even further 

gov.uk/drug-safety-update/p...

webmd.com/heartburn-gerd/ne...

pharmacytimes.com/publicati...

PPI and increased risk T2 diabetes 

gut.bmj.com/content/early/2...

Iron Deficiency and PPI 

medpagetoday.com/resource-c...

futurity.org/anemia-proton-...

onlinelibrary.wiley.com/doi...

sciencedirect.com/science/a...

SlowDragon profile image
SlowDragonAdministrator

The GP has done full blood work and everything is normal.

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

Do you always get same brand levothyroxine at each prescription

Please add the actual results and ranges for

TSH

Ft4

Ft3

Vitamin D

Folate

Ferritin

B12

If ferritin is under 50-60….Also need a Full iron panel test for anaemia

Breathlessness is frequently low iron/ferritin

Aching legs….low vitamin D or under medicated thyroid wise

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