Help with results please! : Did blood test with... - Thyroid UK

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Help with results please!

nadchaoli profile image
6 Replies

Did blood test with Medichecks - have attached results and would really appreciate advice.

My TSH has historically been suppressed as it’s the only way I feel well. GP agreed to this after I saw endocrinologist who said it wasn’t a problem. Am wondering if should request dose increase (I’m already on 125mcg daily). I would rather try to tackle vitamins first, though.

Medicheck doc comments included…

“Your vitamin D level remains in low normal range. Vitamin D levels which are not in optimal range can affect your motivation to exercise, and your speed and stamina whilst exercising. If you are not already doing so, please consider taking 400 iu (10mcg) per day to help optimise your levels.

You have normal levels of vitamin B12, but it is towards the low end of the normal range. To work out whether there is significant underlying B12 deficiency I recommend arranging a serum methylmalonic acid (MMA) blood test.”

I’m planning to start D and B12 - are there particular brands you recommend? Folate is also lowish so thinking of also adding that.

They obviously commented on level of thyroid peroxidase antibodies but I understand that it’s associated with having Hashimoto’s so unsure if they can be reduced?

(Blood tests were first thing, was fasting and hadn’t taken levothyroxine yet that day)

Thank you in advance for all your help and advice!

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SlowDragon profile image
SlowDragonAdministrator

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

Ft4 is 61.00% through range

FT3: 4.5 pmol/l (Range 3.1 - 6.8)

Ft3 only 37.84% through range

Do you always get same brand levothyroxine at each prescription

Do you normally take levothyroxine waking or bedtime and always on empty stomach and then nothing apart from water for at least an hour after

Presumably you knew that your hypothyroidism is autoimmune

Have you had coeliac blood test

Are you already on gluten or dairy free diet

What vitamin supplements are you currently taking

Getting vitamin levels optimal will help improve conversion rate of Ft4 to Ft3

Vitamin D, folate and B12 all low

nadchaoli profile image
nadchaoli in reply toSlowDragon

Thank you so much for the prompt and detailed replies! I’ll answer all your Qs but am at work st it may take me a while

Do you always get same brand levothyroxine at each prescription - I do, had prescription amended with brands (Actavis/Accord and Wockhardt only) though pharmacy still often tries to give me “wrong” brand and I have to ask for it to be corrected.

Do you normally take levothyroxine waking or bedtime and always on empty stomach and then nothing apart from water for at least an hour after - I do, usually in early hours when I wake up

Have you had coeliac blood test - no, should I? A friend is coeliac and I get none of the hideous symptoms she suffers from

Are you already on gluten or dairy free diet - no, I love cheese too much! I don’t each much gluten since I started keto for weight loss

What vitamin supplements are you currently taking - I actually stopped taking any about a month ago as wanted to get accurate result from this. It was a multivitamin specifically for menopause. Should I continue this multivitamin or get separate ones for D, folate and B12 - ignore this, just read your next reply!

Yes, I understand re Hashimoto’s - I finally got diagnosis of Hashimoto’s after GP did antibody test after I kept returning to GP with symptoms.

Thank you for your help :)

SlowDragon profile image
SlowDragonAdministrator in reply tonadchaoli

Keto can possibly reduce conversion of Ft4 to Ft3

Gluten and Hashimoto’s

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 

of barely eating any gluten no point testing for coeliac

If 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…..though necessity for endoscopy may have been scrapped due to waiting lists) 

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% find dairy free beneficial

Surprisingly I personally haven’t missed cheese as much as I suspected I would…..in part because results are so good dairy free

Hashimoto’s and leaky gut often occur together

Both dairy and gluten are inflammatory foods

SlowDragon profile image
SlowDragonAdministrator in reply tonadchaoli

Multivitamins never recommended on here

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator

B12

Low B12 symptoms 

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and add a separate vitamin B Complex after a week 

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 

B12 drops 

natureprovides.com/products...

Or

B12 sublingual lozenges 

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

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-£25. iherb.com often have in stock. Or try ebay 

Other options 

healthunlocked.com/thyroidu....

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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

SlowDragon profile image
SlowDragonAdministrator

only add one supplement at a time

Waiting at least 10-14 days to assess any changes before adding another

Vitamin D

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 around 80nmol or 100nmol 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...

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

Perhaps try 1000iu per day initially and retest in 2-3 months

You may need higher dose

Vitamin D and thyroid disease 

grassrootshealth.net/blog/t...

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...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

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