Updated Test Results: I have now had a full... - Thyroid UK

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Updated Test Results

LizT10 profile image
17 Replies

I have now had a full Thyroid blood test in London. The results are as follows:

T4. 96 (59 - 154)

TSH. 1.01 (0.27 - 4.2)

Free Thyroxine. 18.1 (12.0 - 22.0)

Free T3 4.0. (3.1 - 6.8)

Thyroglobulin Antibody. 172. (0 - 115)

Thyroid Peroxidase Antibodies. 173. (0 - 34)

Vitamin D. 58. (50 - 200)

Vitamin B12. 446. (197 - 771)

Folate (serum). 6.7. (> 2.9)

Ferritin. 104. (13- 150)

C Reactive protein. 3.1 (< 5.0)

I would be very grateful for any comments. Why are the antibody results so far out of kilter and what can I do about them?

I am currently on 112.5 mcg Levothyroxine plus Vitamin D supplement but still have lots of symptoms including indigestion, brain fog, over active bowel, fatigue and generally feel unwell, particularly between breakfast and lunch.

I think I am extremely sensitive to thyroxine. Would I be better off trying Armour? If so, where is best to source it? Look forward to hearing any suggestions/advice of the best way forward...

Many thanks

LizT10

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17 Replies
Jaydee1507 profile image
Jaydee1507Administrator

In what way do you think you are sensitive to Levo?

How did you take this test? What time of day? When was last dose of Levo before test? Recommend 24hrs last dose and fast day of test taking it at 9am.

Your antibodies are raised as you have autoimmune thyroid disease called Hashimoto's. It's possible to have results in the thousands. people with Hashi's often benefit from a gluten free diet, some others need to eliminate dairy. Have you tried this?

Free T4 (fT4) 18.1 pmol/L (12 - 22) 61.0%

Free T3 (fT3) 4 pmol/L (3.1 - 6.8) 24.3%

Your conversion isn't great but you have plenty of room for a 25mcg dose increase. Getting vitamins OPTIMAL will also help conversion and how you feel.

Folate is quite low. Try a good B complex that has active or methyl vitamins. This will keep your B's in balance and also help you B12. This one is good. amazon.co.uk/Yipmai-Liposom...

Ferritin is good but continue to eat red meats etc

Vit D is lowish. Use this calc to work out how much to take to get your numbers to 100. grassrootshealth.net/projec...

Buy a D3 with K2 to help it go to your bones where it is needed.

LizT10 profile image
LizT10 in reply toJaydee1507

Thank you very much for your comments. I had the test at 9.30 am which was 12 hours after my last thyroxine dose. Next time I will make sure it is 24 hrs.

I think I will up my vitamin supplements and increase my thyroxine to 125 mcg and hope that improves things.

LizT10

SlowDragon profile image
SlowDragonAdministrator

was test done early morning, and last dose levothyroxine 24 hours before test

FT4: 18.1 pmol/l (Range 12 - 22)

Ft4 only 61.00% through range

FT3: 4 pmol/l (Range 3.1 - 6.8)

Ft3 only 24.32% through range

Results show you probably have room for dose increase to 125mcg daily

Currently have poor conversion of Ft4 to Ft3

Improving low vitamin levels and increasing dose levothyroxine should help

Most people when adequately treated will have Ft3 at least 50-60% through range

Which brand of levothyroxine are you taking and is it always same brand

Are you cutting 25mcg in half to get 12.5mcg daily

How long have you been on current dose

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

If not had coeliac blood test, get this done, ideally via GP BEFORE considering trial on strictly gluten free diet

Vitamin levels are really not very good

What vitamin supplements are you currently taking

LizT10 profile image
LizT10 in reply toSlowDragon

Many thanks for your reply.

Yes, I cut a 25 mcg pill in half to get to 112.50. I have been on that dose since November. I felt fine for about 8 weeks but since then all the usual symptoms have returned. I will increase to 125 mcg and add some more supplements and hope that helps.

I have had a coeliac test which came back negative so if the increase in thyroxine doesn’t help, I will go gluten free and see if that does the trick.

Thanks for your input - all very helpful.

LizT10

SlowDragon profile image
SlowDragonAdministrator in reply toLizT10

which brand are 100mcg tablets and which brand are 25mcg

LizT10 profile image
LizT10 in reply toSlowDragon

I take two x 50 mcg which are Accord. The 25 mcg pills are made by North Star.

Would it be better to have both the same make?

I expect my doctor's pharmacy go for the cheapest.....

helvella profile image
helvellaAdministrator in reply toLizT10

You will no longer get NorthStar.

That was an own-label supplier primarily for Lloyds pharmacies. Now abandoned.

The 50 and 100 microgram tablets were Accord.

The 25 microgram tablets were Teva.

SlowDragon profile image
SlowDragonAdministrator in reply toLizT10

Recommend you get rid of the Teva (Northstar)

Accord don’t make 25mcg

Get GP to increase number of 50mcg Accord tablets and cut in half to get 25mcg

Use pill cutter or sharp craft scalpel

Get weekly pill dispenser to keep spare half in for next day

Teva brand upsets many, many people

Northstar levothyroxine being phased out this month 

 Many patients do NOT get on well with Teva brand of Levothyroxine. Teva is lactose free.

Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome 

Teva is the only brand that makes 75mcg tablet. 

So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

But for some people (usually if lactose intolerant, Teva is by far the best option)

Aristo (currently 100mcg only) is lactose free and mannitol free. 

March 2023 - Aristo now called Vencamil

healthunlocked.com/thyroidu...

Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets 

 

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

LizT10 profile image
LizT10 in reply toSlowDragon

many thanks for all this info - it is really helpful

SlowDragon profile image
SlowDragonAdministrator

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. 

 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

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.

Similarly few months later consider trying dairy free too. Approx 50-60% Hashimoto’s patients find dairy free beneficial

Hashimoto’s and leaky gut often occur together

LizT10 profile image
LizT10 in reply toSlowDragon

Thank you so much for your comments. I am going to increase my thyroxine dose to 125 mcg and add more vitamin supplements. If that doesn’t improve matters I will go gluten free. My previous coeliac test came back negative.

Many thanks

LizT10

SlowDragon profile image
SlowDragonAdministrator

Vitamin D

How much vitamin D are you currently taking

It’s obviously not high enough dose

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to between 100-125nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7. 

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

Another member recommended this one recently

Vitamin D with k2

amazon.co.uk/Strength-Subli...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease 

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease 

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium 

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Jaydee1507 profile image
Jaydee1507Administrator

By the way, what are you eating for breakfast?

LizT10 profile image
LizT10 in reply toJaydee1507

muesli with little milk and banana followed by a slice of toast with butter and marmalade. I eat a lot but have lost weight recently and am not overweight - BMI is 23 or so.

LizT10 profile image
LizT10 in reply toLizT10

PS. I am v active and never sit down until the evening

Jaydee1507 profile image
Jaydee1507Administrator in reply toLizT10

It's just you said you feel worse after breakfast so perhaps there's an issue with what you are eating? Thats quite a high carb content breakfast with gluten and dairy. Many Hashi people find gluten and issue, next is dairy.

You could try swapping it out for an egg based breakfast and see if that helps.

LizT10 profile image
LizT10 in reply toJaydee1507

thanks - will try that

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