Post 2 - my own bloods - advice please :)

[Needleandthread44]

Hi everyone

Posted about my dads bloods for feedback but also curious about my own results.

I had my levels tested through GP a few weeks ago and they were looking good (tsh around 1, t4 I think around 17). I was therefore surprised to see the following when I got my tests done privately through medichecks - I am a bit baffled as to why my TSH has shot up, it hasn't been this high in years. Few possible reasons (??) I ran out of levothyroxine and instead of going a few days over the weekend without it I used some of my dads 100mcg tablets which are a different brand.

Or - I tested positive for covid 2 days after bloods, would this impact on TSH (or possibly explain why my inflammation marker is so high??)

I can see Vitamin D is terribly low. Need to start supplementing asap.

Also, since my last medichecks, my antibodies have changed quite a bit, not sure why this would be? What is the difference between the two different antibodies and what might this be telling me?

Thyroglobulin Antibodies X 119 kIU/L (Range: 0 - 115) - previously 87 in October 22

Thyroid Peroxidase Antibodies X 218.1 kIU/L (Range: 0 - 34) - Previously 244 in October 22

TSH X 4.37 mIU/L (Range: 0.27 - 4.2)

Free T3 4.4 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 16.1 pmol/L (Range: 12 - 22)

Vitamin D X 38 nmol/L (50-250)

Folate - Serum 43.1 nmol/L (Range: 8.83 - 60.8)

Vitamin B12 - Active 108 pmol/L

Iron 10.4 umol/L (Range: 10 - 30)

TIBC 66 umol/L (Range: 45 - 81)

UIBC 55.5 umol/L (Range: 13 - 56)

Transferrin Saturation X 16 % (Range: 25 - 45)

Ferritin 53 ug/L (Range: 30 - 150)

CRP HS X 4.9 mg/L (Range: < 3)

Thanks in advance!

[SlowDragon Administrator]

You’re also anaemic

Have you been tested for H Pylori

Are you on strictly gluten free or dairy free diet

If not get coeliac blood test done before considering cutting gluten out

[Needleandthread44 in reply to SlowDragon]

Hi  SlowDragon

I know very little about iron results (the GPs note from Medichecks said: Despite the slightly low transferrin, your ferritin level is normal indicating healthy iron stores. I recommend reviewing your dietary iron intake to prevent your stores becoming depleted.)

Can you elaborate anymore on anaemia?

I've not been tested for H Pylori. Would there be any symptoms if I did have this?

I've not considered Gluten free or diary free diet before as I have no symptoms and generally feel fine. Would this still be recommended?

[SlowDragon Administrator in reply to Needleandthread44]

When hypothyroid and on levothyroxine, especially with Hashimoto’s Ferritin recommended to be over 70 minimum and at least over 100 ideally

Suggest you read the many posts and replies by humanbean on low iron and ferritin

cks.nice.org.uk/topics/anae...

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

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin 

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

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

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin 

healthunlocked.com/thyroidu...

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 

Medichecks iron panel test 

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Excellent article on iron and thyroid 

cambridge.org/core/journals...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron 

healthline.com/nutrition/he...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

Low Iron implicated in hypothyroidism 

healthunlocked.com/thyroidu...

Ferritin range on Medichecks 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

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. ‘

[SlowDragon Administrator in reply to Needleandthread44]

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. 

 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

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.

[Jaydee1507 Administrator]

It may well be that Covid has affected your results. Not sure I would 100% trust these if your TSH is usually lower. It may have affected CRP too.

These results show:

Free T4 (fT4) 16.1 pmol/L (12 - 22) 41.0%

Free T3 (fT3) 4.4 pmol/L (3.1 - 6.8) 35.1%

Along with high TSH would suggest you require a dose increase but probably best to retest in 6-8 weeks to be sure.

Vit D is deficient. Use this calc to work out how much to take along with K2 to get it to around 100. grassrootshealth.net/projec...

Ferritin needs to be 90-100 for zero symptoms and better use of thyroid hormone. Eating chicken livers a few times a week or pate should help.