I hope you can help me as I'm struggling. I haven't been feeling good for a long time - brainfog, poor memory, aches, fatigue, bloating, broken sleep, ringing in ears, pins n needles in fingers and toes, eyesight not so good.. currently on 125 eutirox and 10 liquid t3 liotir (im in Italy)
I'm confused where to start improving things as my symptoms could be due to hypothyroid, low B12 (ive not taken any b vits / biotin for about a year though i eat eggs, some dairy, nutritional yeast etc) low ferritin (i have a history of low ferritin - i try to eat liver pate but obviously not enough) or low copper! (I had to supplement low copper in the past - then that resolved and zinc was low, now zinc is ok and copper going low again!)
My latest tests are:
TSH 2.25 (0.55-4.78)
FT3 3.68 (2.30-4.20)
FT4 *0.53 (0.89-1.76)
VITAMIN B12 203 (200-910)
OMOCISTEINA 10.1 (3.7-13.9)
FERRITIN 13 (10-291)
IRON 94 (50-170)
TRANSFERRIN 270 (250-380)
TIBC 340 (250-350)
HAEMOGLOBIN 148 (120-160)
COPPER 25 (20-60)
ZINC 1002 (800-1600)
VITAMIN D 25 OH 112 !!! Atleast this is ok! Thank God for small mercies! I am supplementing with liposomel D3
I understand Ft4 lowers if you take T3, but im only taking a small dose and Ft4 is below range whilst ft3 is 72% through range and TSH too high? Do I need to increase levo?
I am thinking I should do more tests on B12 deficiency as I am right at the lower limit (hence why I havent started any supplements incase they interfere with tests)
Do I need iron supplements or is it nutritional deficiency?
I feel very confused and the brainfog isnt helping. My doc here isnt very sympathetic so I need to be clear before I go to him. I got the tests done privately.
Many thanks
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Sandytango
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When did you last take your Levo & T3 before the test?
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)? Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.
Are you taking your Levo consistently on an empty stomach an hour before food, caffeine containing drinks & meds?
Do you always get the same brand Levo/T3?
B12 - you need to see your doctor and get investigations for pernicious anaemia.
No folate result.
Ferritin - you need to persevere with iron rich foods, perhaps drink some orange juice when you eat them. Chicken livers a few times a week, pate, red meat.
Copper & zinc - for the reasons you have found in that you take one and the other lowers, we don't recommend supplementing them as they do need to balance.
Please note that it is common for people to have contradictory iron results.
I'm going to assume you are female.
.
Haemoglobin - Yours is at a good level so you aren't anaemic. This is good. But iron deficiency can occur with or without anaemia, and if it turns out someone is iron deficient it should be treated.
Serum iron
• 55 to 70% of the range
• lower end for women
Your iron is only 37% through the range, suggesting that you need more iron.
TIBC (total iron binding capacity) or Transferrin
• Low in range indicates lack of capacity for additional iron
• High in range indicates body's need for supplemental iron
Your transferrin is low in range at 15% through the range suggesting a lack of capacity for more iron.
Your TIBC is well above mid-range at 69% suggesting that you need more iron.
Ferritin - Your result is awful, and you definitely need more iron. I'm guessing that you don't live in the UK. The NICE guidelines on iron deficiency anaemia, which can be found here :
For people with thyroid disease there are various suggestions for what the ferritin level should be. I'm going to pretend that your ferritin range was 30 - 291 because ranges shouldn't include results that are already deficient.
1) Mid-range i.e. optimal - 160.
2) 50% - 70% of the way through the range i.e. 160 - 213.
3) 90 - 110. This is based on the assumption that the range is 13 - 150, so I am never happy suggesting this.
Based on the above I think you should be aiming for a result of 160. But if you ever approach that and feel well then you should stop trying to increase your ferritin where you feel well.
In the UK iron supplements can be bought without prescription either in pharmacies or online. This reply to another member was based on that :
VITAMIN B12 203 (200-910) - This is right at the bottom of the range and will be causing many of your symptoms. I think you should get tested for Pernicious Anaemia (PA) as soon as possible.
You haven't given a folate result, and you need to get it tested. Don't start taking folate until you've had PA tested and you've had at least some treatment for your B12.
See this link for reasons why, although sadly the whole paper is behind a paywall :
Title : Interaction between excess folate and low vitamin B12 status
Thanks so much - its much clearer now. I forgot to test the folate but will do together with the pernicious anemia tests - am I right in thinking I need the parietal cell antibodies test as priority? I know there are other tests - active B12 serum MMA and Intrinsic Factor antibodies? I am in Italy and think I can buy shots if needed but would have to learn how to self inject. I've had a lot of problems getting a good doctor where I am ...
When someone is producing low levels of thyroid hormones (i.e. both T3 and T4) then the body will prioritise the production of T3 rather than saving T4 in storage.
I think this is what is happening with you. Your body is turning every scrap of T4 it can find into T3. You should definitely increase your T4 intake.
Ok - I am also going to restest thyroid to be sure when I test the folate and for pernicious anemia, as this result seems very odd, though your explanation maybe right! Its all a bit of a mess. So appreciate this group and your knowledge
Zinc and Copper have a "seesaw" relationship for everybody. This means that as copper goes up, zinc will go down. As zinc goes up, copper goes down.
People who have thyroid disease often end up with high copper and low zinc. You are only the second person I have come across on the forum who had low copper and high zinc before supplementing (if I've understood your timeline correctly).
You could try and find the right dose of zinc and copper that gets you to, say, mid-range for both and then stop supplementing to see if your levels stabilise on their own. If not, then supplement at a low level for the one that goes down to try and maintain a balance.
Remember that just because the bottle of supplements says to take "1 a day" doesn't mean you have to do that. You might find that supplementing 2 or 3 or 4 days a week is all you need.
Thanks. Yes, last year my copper was below range in a packed red cell blood test, but supplementing did bring it back up. Then when it normalized zinc went down!
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