Wondering if anyone could help my decipher my results again? For context, I am 41 and trying to conceive.
These are follow up tests to the ones I had in September (which I will attach in a separate post). I took the advice from this forum following those results and have been supplementing with VitD (+K2) and Vit B12, both in liquid form. I am also supplementing with Selenium, B vitamins (incl folate but not biotin), zinc, and inositol.
For the past 2 1/2 months I have been gluten, soy and dairy free. I am still having some gut discomfort so have recently introduced some digestive enzymes, betaine + pepsin and probiotics. I am currently taking 75mcg of levothyroxine.
The TSH level surprised me because I had a TSH blood test in early October (there was a problem with the doctor's TSH test so they repeated it), which was after I'd increased the levo from 50 to 75mcg, and the TSH was much lower - 2.4 - so I was expecting it to be lower again, and I know it needs to be to help me get pregnant. But this may be explained by the fact that only this recent test was done early morning. All tests were done after not taking levo for 24+ hours.
In terms of how I'm feeling I have very few of the classic symptoms. I don't feel overly tired or fatigued (but I also think I may have had low iron for a long time so not really sure what's normal). No brain fog The only thing really is cold hands and feet and slight hair loss. This doesn't seem to have changed since being diagnosed with Hashis and starting on the levo in February this year.
I presume I should ask my doctor to increase my levo dose (although for them it's in range so I may have an argument here). And to start supplementing with iron. Any advice on iron supplements (there are so many kinds out there!), particularly for someone with absorption issues (I have increased the iron in my diet but it doesn't seem to have had an effect) would be very much appreciated. I'd also particularly like to know if my T3/T4 are ok or changed - I find that hard to make sense of. Is there anything else I could/should be doing? I presume I should keep going with the B12 and D+k2 as those results look much better now.
Thanks so much, and apologies for the length of this post!
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And to start supplementing with iron. Any advice on iron supplements (there are so many kinds out there!), particularly for someone with absorption issues (I have increased the iron in my diet but it doesn't seem to have had an effect) would be very much appreciated.
It's not a good idea to self supplement with iron.
Your ferritin at 22.2ug/L is, according to NICE guidelines, indicative of iron deficiency - see
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Your serum iron at 12.9 (5.8-34.5) is just 24.74% through range whereas according to rt3-adrenals.org/Iron_test_... the optimal level is 55% - 70% through range (higher end for males).
Your saturation at 22.8% (20-50) is very low and again, according to the above link, optimal is 35-45% (higher end for males).
It would be best for your GP top prescribe a suitable iron supplement for you and you will need regular monitoring with an iron panel whilst supplementing.
TSH: 3.76 (0.27-4.20)
FT4: 15.9 (12-22)
FT3: 5 (3.1-6.8)
I'd also particularly like to know if my T3/T4 are ok or changed
The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges. Your TSH is far too high for successful conception and pregnancy and your FT4 (which the baby needs from you until it can start making it's own) is a mere 39% through range. Your results show that you need an increase in your dose of Levo, 25mcg now, retest in 6-8 weeks, further increase(s) may be needed.
have been supplementing with VitD (+K2) and Vit B12, both in liquid form. I am also supplementing with Selenium, B vitamins (incl folate but not biotin),
I presume I should keep going with the B12 and D+k2 as those results look much better now.
You don't need B12, it's now higher than their equipment can measure and it's just a waste of money to keep supplementing with it. Your B Complex should contain enough B12 to now maintain your level.
Is there a reason you've chosen a B Complex without biotin? As biotin is one of the B vitamins and we should try and keep all B vitamins balanced, it's probably a good idea to include it. We just have to make sure we leave anything containing biotin off for 3-7 days before any blood test.
I would carry on with the D3/K2 as you're only just into the recommended range of 100-150nmol/L that is suggested by the Vit D Council, Vit D Society and Grassroots Heath. A recent blog post on Grassroots Health recommends a level of at least 125nmol/L. Are you also taking magnesium, that's another important cofactor of D3, it helps the body convert D3 into it's usable form.
You definitely need dose increase in levothyroxine and iron/ferritin levels need improvement
Are you vegetarian or vegan?
Heavy periods?
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
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
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
We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes:
Males 16-60: 30-400 ug/L
Female's: 16-60: 30-150
Both >60: 30-650
The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘
Yes I forgot I'm also supplementing with Magnesium. There isn't biotin in my B vitamins supplement because it's one marketed for male and female fertility and doesn't include it. I will look into that though, thanks. And thanks for the info on B12 - I didn't know that and will stop taking it now.
In relation to the iron, I'm not vegetarian and have upped how much red meat I'm eating (but hate the taste of liver). My periods are kinda heavy but lighter, and less painful, since starting on the levo. So I don't really know why my iron is low. I will of course show the results to my GP but I'm sure she'll just prescribe ferrous sulphate again which I did not get on with. Has anyone here any other recommendations?
Also, can you tell from the T3/T4 results if I'm a good or bad converter?
Try Ferrous Gluconate. It tends to be better on the stomach. Take it every other day, not every day to maximize absorption. You should have a much better ferritin level after 3 months. You can take it with a meal which would help it dissolve better. There is only a 4 inch segment of the small intestine where iron is absorbed. It will load up with iron and it takes a couple of days for the iron to pass through to the bloodstream. This is why taking it every other day is optimal. If you take it every day, the iron will just bypass the area of absorption.
This is what I recommended to jgelliss and her ferritin went from something as low as 12 to 150. Now she is only taking it twice per week to keep the level constant. She thought she was a poor absorber but in fact she was a champion.
It seems I will have a battle to increase my levo dose as the doctor is saying my TSH and T4 are within range, even for trying to conceive. Could anyone provide evidence to show them that TSH needs to be lower to conceive? I've tried to find it on previous posts but it's not appearing and the link Slow Dragon supplied that I thought would have it is broken. (GP update on the Red Whale site).
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