Gut /thyroid next steps

[Bacca]

Hi all

Did a blood test recently to monitor response to Levo increase.

Did gene testing to further investigate.

In the meantime had stomach upset & week of diarrhoea.

Doctor did tests - not heard back yet. (hypylori...??)

Private bloods on 125 Levo

TSH 2.19 0.27-4.2 mu/L

FT4 16.8 12-22 pmol/L

FT3 3.7 3.1 - 6.8 pmol/L

Vit D 59nmol/L

Cholesterol 6.5 mnl/L

HDL 1.26 nmol/L

non HDL chol 5.24nmol/L

Trig 1.76 nmol/L

HBA1C 39nmol/L >42

Haemoglobulin 138 g/L >120

Transferritin sats 14% >16%

Ferritin 30 ug/L >15

Active B12 36pmol/L >38

Folate 4 ug/L >3

Am now taking 150 Levo.

Thus far in gene research:

have FUT2 mutation

Di02 = cc = mutation decreased t4 to t3

Di01= cc = more active enzyme decreased T4/increased fT3

Mthfr = no issues (!)

Sorry for long post!

Querying anaemia/pa

but wondering if addressing stomach / FUT2 will resolve issues

have pins needles, periodic burning foot pain

enlarged tongue

Taking Vit D with K2 at the moment

Stopped taking B12 for now as got jittery and wanted to know if it was due to Levo increase

Thank you all, this site has helped so much already xx

[Jaydee1507 Administrator]

Free T4 (fT4) 16.8 pmol/L (12 - 22) 48.0%

Free T3 (fT3) 3.7 pmol/L (3.1 - 6.8) 16.2%

So low free thyroid hormone levels plus a TSH of over 2 means you are due for another Levo increase. Your FT3 is far too low, TSH above 2. Most people when they feel well on Levo only will have a TSH of around or just under 1. You aren't the best converter but you have plenty of room for further Levo increase/s.

What is happening about your low B12 level? I would show this result to your GP and hopefully they will retest but may be a serum B12. Are you vegan or vegetarian?

You might want to get some specific advice over on the PA forum here on HealthUnlocked

Folate is far too low, almost deficient but need to address that after B12 is started if you might be starting injections.

Ferritin of 30 or less is classed as deficient by NICE. Again suggest showing GP these results and they may want to run their own tests.

D3 no result. D3 should be tested twice a year.

So all of your vitamin levels are terrible and to begin to feel better you do need to address them.

Do you have positive thyroid antibodies? Many people who do benefit from a strictly gluten free diet. Some others also need to remove dairy.

Have you been tested for coeliac as that might be a good idea?

Sometimes gut issues are due to low thyroid hormone levels and you may benefit from doing a low FODMAP diet for your gut. monashfodmap.com/ibs-centra...

[Bacca in reply to Jaydee1507]

Hi Jaydee, thanks for replying.

I increased Levo dose to 150 after this test.

The doctor had provided a 150 prescription but i was struggling to increase but on seeing this test result tried again and now on 150 Levo dose.

There is room to up dose but after finding FUT2 mutation am wondering whether to add T3 and poss drop a little T4...🤔

My Vit D is 59 nmol/L, working progress am taking D3& K2 oral spray.

All vits still low.

Yes I have Hashimotos.

I was tested for coeliac but negative result

I have since discovered several HLA gene indicators for potential coeliac

and just discovered FUT2 gene mutation increases chance of coeliac

I have mentioned to doctor poss anaemia but dismissed.

Several private tests have suggested getting MMA test as did MMH on this occasion.

Have just checked back and noted Doc has ordered;

Full blood count

Haemoglobin A1c

Liver function

Bone profile

Thyroid S H (no T4 or T3)

Vit B12 and Folate

Urea & Electrolytes (U&E)

Most recent doc appointments have been over phone.

I haven't gone gluten free yet, want to highlight issues to doc first.

It will be interesting to get result and their thoughts, I don't know if NHS recognises FUT2 gene defect? I will get back with outcome........

I see you have FUT2, are you taking the recommended probiotics or anything to address?

Thank you for your time and precious energy!

🥰

[Jaydee1507 Administrator in reply to Bacca]

I think MMA is a hospital test as needs to be near a lab when done to be processed fast. GP may be able to do Homocysteine, possibly. You should really get advice from the PA group here on HealthUnlocked.

The thing with gene indicators is they are just that, an indicator. That gene may not have been switched on..yet, it may never get switched on. I have done a stool analysis and seemed to have enough beneficial bacteria at that time. The NHS doesn't recognise genes as an aid in diagnosis for these things.

If you've done a negative coeliac test then there's little purpose in delaying going GF. Many who benefit from a GF diet have no blood markers or otherwise to suggest going GF might help, but it does.

Your GP needs to test ferritin. Your diet needs to focus on iron rich foods such as chicken livers, pate, red meat.

I'm pleased to hear you got a Levo increase.

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One point, if you don't have 'intrinsic factor' you can't absorb B12 from food or supplements so have to have the shots. If you are anaemic you need iron tabs,I had awful headaches and it was discover my iron levels were low, so a course of iron solved the problem. Try and see an endocrinologist for a proper blood screen, some labs aren't as thorough for GP tests. Your levels can be affected by other meds you take as well, so it has to be seen 'in the round' as it were! Good luck!