Hope you are all well. I had a full thyroid panel in April 2021. My thyroid peroxidase antibody level came back as >1000 IU/ml.
The rest of results were with range.
T3,t4 and TSH.
I was referred to a thyroid specialist who i had a telephone consultation with and diagnosed with hypothyroidism. He said he will write to GP and ask them to monitor TSH levels.
The GP has been doing a TSH test only and not a full panel.
My fatigue and weight gain have been really high. I also have Lupus and stage 4 endometriosis. In a medical menopause for 2 years awaiting hysterectomy.
Please see below results of TSH over a year. I have finally convinced my GP to do a full panel as they previously refused. Waiting for results.
See attached. What other questions should I be asking?
Thank you kindly.
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Awwy
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It's unlikely your GP will do a full panel as all labs now refuse to do an FT3 test and not many even an FT4, hence we all buy tests from private labs.
Results being within the range are not good enough and we need OPTIMAL results whcih usually means upper part of the reference range.
Other things to look at would be key vitamin levels. As hypo people we don't absorb vitamins well so need to keep on top of ferritin, folate, B12 and D3. Levels need to be supplemented until 70% of the reference range.
Many people feel well when their TSH is under 1, but not everyone.
Are you vegetarian/vegan? Just wondering why your B12 was so low.
OPTIMAL ferritin for your thyroid hormone to work properly is around 90-100 so you have a way to go with that. Low ferritin alone will make you feel unwell with symptoms at levels under 75. Its recommended to eat food sources of iron such as chicken livers or pate, difficult if vegetarian.
Cheapest for private testing is monitor my health with a finger prick test. I use Medichecks as need a blood draw but more expensive.
You could push for a dose increase. I'm sure others will come along with all the right quotes to show your GP. If one refuses, try another at the same practice.
HiNo im not vegan. I eat chicken. Eat a lot of raw spinach. Take vit c supplements.
Not a fan of red meat I eat occasionally. My cholesterol is very high. Which im surprised at as I have given up most dairy products and all joys of life 😅. (Biscuits cakes etc...)
Was diagnosed with something called fredrickson type iia hyperlipoproteinemia. GP said not my fault it genetic and predisposes me to higher cholesterol.
It would pay you to eat red meat more often or you will be permanently iron deficient and suffering. That and eating chicken liver pate a few times a week would really help you feel better.
High cholesterol is also a feature of undermedicated hypothyroidism so getting your levels a bit better would help that too.
Was diagnosed with something called fredrickson type iia hyperlipoproteinemia. GP said not my fault it genetic and predisposes me to higher cholesterol.
Far more likely that your high cholesterol is directly linked to your hypothyroidism
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
High thyroid antibodies confirms autoimmune thyroid disease
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s. But here in U.K. medics generally only call it hypothyroidism and would look blank if you said “Hashimoto’s “
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
My last test result of B12 was 168 ng/l.
My last test for D was 59.5 nmol/L.
My serum ferritin is currently at 29 ug/L.
I did have an iron transfusion last year as it was extremely low.
Are you vegetarian or vegan?
With such extremely low B12 levels you need testing for Pernicious Anaemia before starting on B12 injections or daily B12 supplements
Acid reflux is extremely common HYPOTHYROID symptom and will improve once you get started on levothyroxine/improve terrible vitamin levels/likely to need to be gluten free as well
Medics incorrectly tend to assume it’s high acid….
Low stomach acid can be a common hypothyroid issue
I never knew this at all! I have just done a 24 hour ambulatory impedance and pH test. Ordered by the gastroenterologist. Waiting results. I also have a very dry throat sore throat. I never linked the 2.
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.
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. ‘
I am in a medical menopause. On 10 weekly injections of zoladex with add back HRT Tibilone. I am waiting for a hysterectomy. Been 2 years. GP just said everything with the numbers they expect. Prior to this my periods were extremely heavy. I have had 3 iron transfusions. Last one was over a year ago.
Looks like I have got a lot of reading to do. Thank you so much for the resources. I can take these and have a proper conversation. My folate level i finally found had to back several pages.
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.
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
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.
I tried gluten free diet for 6 months. Didnt notice any difference. I changed my milk to almond again didnt notice much difference. Think I need to re-look at my whole diet after reading some of these articles. My weight had done this. The dip you see is when I went down to 800 calories a day. I currently eat no more than 1500 but my weight is still climbing. 🤨😪
once your serum B12 is over 500 (or Active B12 level has reached 70), reduce the separate B12 ……and just carry on with the B Complex. You may be able to stop separate B12 or may need to add 2-3 times a week
B12 range in U.K. is too wide
Interesting that in this research B12 below 400 is considered inadequate
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)
Thorne currently difficult to find at reasonable price, should be around £20
If you want to try a different brand in the meantime, one with virtually identical doses of the ingredients, and bioavailable too, then take a look at Vitablossom Liposomal B Complex. Amazon sometimes has it branded Vitablossom but it's also available there branded as Yipmai, it's the same supplement
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 (eg Jarrow methyl folate 400mcg) and continue separate B12
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