Hi everyone. Feeling totally exhausted I opted to go for private blood tests as GP insisting TSH was the only test needed. Results came back as follows:
TSH 0.7 T3 3.2 T4 17
Peroxidase antibodies 489.9
Anti thyroglobulin antibodies 5.2
I spoke to a GP about the scary antibody levels and was told that as I have thyrotoxicosis my antibodies will always be high. Am I looking in the wrong direction linking my tiredness with my thyroid.
vitamin D level was 58
B12 190. Foliage B9 8.7
Also putting on weight for no reason and like many of you fed up with being told it’s all menopause.
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DylanA
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* No biotin, B Complex or any supplement containing biotin for 3-7 days before test
How much Levo do you take?
Do you take any supplements?
Please add reference ranges that came with your results, these vary from lab to lab so we need them to be able to interpret your results.
Is your B12 Active B12 or Total B12. Big difference. With Active B12 that result would show you are over range, with Total B12 it would show you are likely to be B12 deficient.
Folate, again could be very low of reasonable depending on range.
Peroxidase antibodies: 0 - 5.61 result 489.9 IU/mL. !
Antithroglobulin antibodies: 0 - 4.11 Result 5.2 IU/mL
Should I be worried about my antibody levels or is that just telling me what I already know. Ie hypothyroidism.
The elevated antibody levels confirm that the cause of your hypothyroidism is autoimmune, ie Hashimoto's, which is the most common cause of hypothyroidism.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. Some of yours are low.
Vitamin B12. 138-652. Result 190 pmol/L = 257pg/ml
B12 is particularly low. This is the Total B12 test and according to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Some people with B12 in the 300s have been found to need B12 injections.
Do you have any signs of B12 deficiency – check here:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results and if you have B12 deficiency is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.
If you don't then you could supplement with a B12 sublingual along with a good quality B Complex until your level reaches over 500, once at that level you can drop the B12 sublingual and just continue with the B Complex.
Suggestions for B12 supplements which include two forms of bioactive B12 - methylcobalamin and adenosylcobalamin which you might want to check out:
Note that the Nature Provides supplement contains a much higher dose than the Cytoplan one.
Folate vitamin B9: 7-46.4 result 8.7 nmol/L
This is very low, not deficiency but extremely low, only just within range. Eating folate rich foods may help, also supplementing with a good quality, bioavailable B Complex.
I have used Thorne Basic B for a long time and always been happy.
If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.
When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
As mentioned above, do not start a B Complex until further testing of B12 has been carried out (if necessary) and B12 injections or supplements started.
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).
So now you look at how much is needed to reach 50ng/ml and you'll see that they suggest 3,700iu per day. The nearest you can buy is 4,000iu. You could take 4,000iu daily (28,000iu per week) but it's often cheaper to buy 5,000iu and take 6 days per week (30,000iu).
Retest after 3 months.
Once you've reached the recommended level then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
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.
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.
Was Ferritin tested? Low ferritin and/or low iron bring their own symptoms, one of which is fatigue, and a good ferritin level is needed for conversion of T4 to T3.
TSH: 0.35 - 4.94 Result 0.7 ulU/mL
Free T3: 2.4 - 6. Result 3.2 pmol/L= 22% through range
Free T4: 9-19. Result 17 pmol/L = 80% through range
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, if that is where you feel well.
Your FT4 and FT3 results show poor conversion of T4 to T3. This could be due to your low nutrient levels, we need optimal levels for thyroid hormone to work properly and good conversion to take place.
Optimising your nutrients is your first priority, once these are optimal if your conversion is still poor it would be worth considering adding some T3 to your Levo.
I will be interested in how the GP responds as many don't seem to have been taught about how best to diagnose/treat those patients who have a dysfunctional thyroid gland.
I will let you know! I have been thinking hard about how to structure the conversation in a way that doesn’t make me sound like I am self diagnosing or claiming to know more than them!
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
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
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.
How other member saw how effective improving low B vitamins has been
thank you so much for all your advice and info. A lot to take in. I will definitely be investigating the pernicious anaemia question as my mum suffers from it and could be familiar
Ensure you request a blood test for Pernicious Anaemia.
My mother had this condition (I also have it) but after a few years with a 3 monthly injection her GP told her that 'blood is fine and you don't need any more injections'.
Both my sister and I thought that was 'good'.
Little did we know what was ahead as Mum developed stomach cancer due to the withdrawal of B12 injections.
It’s extremely common to develop Food intolerances
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
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 test positive for coeliac, but a further 80% find strictly gluten free diet helps or is essential due to 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 and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
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
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
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.
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Frustrated and exhausted not depressed
Exhaustion may not be thyroid related!
still feeling exhausted
New results - but still exhausted
