I have recently undertaken blood test, with the attached results.
i have Autoimmune Thyroiditis (Primary Hypothyroidism) and Primary Hyperparathyroidism.
Autumn 2022 I felt things were going back to how they were in the early days - headaches, weight gain despite exercise and controlled diet (also experimented with gluten free etc), nails easily chipping, hair loss...
Had several conversations with my GP who basically said there is no reason to change any dosage and that he simply wasn't going to raise it. I asked for bloods to be repeated because my TSH had jumped from 0.52 in Sep 2022 to 3.27 in Nov 2022. ft4 and ft3 were not tested at that time.
I found in my pile of medical paperwork an old blood test form where a previous endo had asked for ft3/ft4 amongst other tests so I took that to the hospital and bloods were taken. The results are attached. I have also plotted all the tests that i have had over the years since i was first diagnosed. Some of the bloods tests look similar but i have copied the titles as per the information on my patient knows best app - sorry if the mean the same thing. I just didn't want to assume.
I've never paid too much attention to what brand I had been given in the past and maybe this is what caused the jump from 0.52 to 3.27. Now I am paying attention and had a few old empty boxes which were largely the Accord brand. And still taking Accord. May be i need to change ? i'm not sure what to do.
I was scheduled to have a meeting with my endo this month but was notified in October that it had been pushed forward to April. I emailed my endo twice but received no reply.
I was desperate to get things under control and increased my dosage in Nov from 100mcg to 125mcg - initially taking 112.5mcg for a week and then 150mcg on one day and 100mcg the next day to achieve a 125mcg daily intake.
I had a strip of the Accord Levo and used that to supplement the increase - they only come in 100mcg tablets because that is officially what I should be taking, so have been using a tablet splitter which i purchased off Amazon. It's not precise but I guess its better than crushing the tablet.
The problem is, I'm not sure if I am feeling better or not. I am experiencing aches / pain in legs but they are not swollen. I've had this once before a few months ago and it lasted a couple of days. Now, its almost every day. Even if I am lying down or my feet are up i feel as though the aches and pain are going to make my legs give way. It is difficult to muster up the will power to get up and carry on with day to day things. Its as if the legs are going to stop working. I have never experienced this before and can't be certain if this is as a result of increasing the dose from 100 to 125.
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With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
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 and continue separate B12
Thank you SlowDragon. I stopped all supplements a week prior to the blood test as you mentioned. Is there a way I could upload the document so that the results are viewable?
I do not know if i have a t3 issue ? or should i stick to the 125mcg or bring that down to 100mcg?
because of my increased calcium in blood i have been asked +to take 800iu Vit D, which i take using the Spray.
I am vegetarian but do not eat fish - eggs and dairy are in - and have recently started Liposomal B complex from vitablossom. is this ok?
I also have started taking one tablet of Super Strength Magnesium Supplements 1620mg - 180 Magnesium Citrate Capsules - (500mg Elemental Vegan Magnesium) at night because I struggle to sleep.
Are you already on gluten free or dairy free diet?
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Getting all four vitamins at optimal levels essential
Poor gut function with Hashimoto’s 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.
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
Hashimoto’s and leaky gut often occur together
Both dairy and gluten are inflammatory foods
A 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 may 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.
Thankyou once SlowDragon. I have ordered the B12 drops.I found the B12 links on deficiency extremely helpful and can see similarities with a number of symptoms.
I will test again in 2 to 3 months. Hopefully, fingers crossed, the picture will look a lot better.
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
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
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
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. ‘
From birth till 35 years old I was a non-vegetarian following which i became vegetarian (about 20 years ago) I do eat still products containing egg but thats as far as it goes.
Although I fast intermittently during the week (a couple of days usually where no milk or gluten, no sugar or salt either- typically drink water, black coffee and light liquids unsweetened). On my non fast days, which i will vary from week to week so they do not fall on the same days each week, I do take dairy and gluten products.
I will do the iron panel test first as you suggested and post the results.
The GP prescribed ferrous fumerate for two months and I completed that course a few weeks ago.
Suggest you read the many, many posts and replies by humanbean on iron/ferritin
It’s likely to take 9-12 months to improve low iron/ferritin to a GOOD level……..and just as importantly an ongoing maintenance dose to KEEP ferritin at a good level
Many, many Hashimoto’s patients need to work hard continuously to maintain good iron and ferritin levels. That’s likely not possible on vegetarian diet without iron supplements
Levothyroxine can not work properly unless all for vitamins are OPTIMAL……
Fasting on such regular basis likely significantly reducing your conversion rate of Ft4 to Ft3
Low Ft3 results in low vitamin levels
Low vitamin levels results in poor conversion rate of Ft4 to Ft3 ….resulting in low Ft3
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