Can someone help me interpret these results please? The anti-thyroidperoxidase is so high. Does this mean I have hashimotos?
Ferritin and Vitamin D are on the low side. What level of supplements do people suggest?
Mid 50s female. Currently on 125mcg levothyroxine. Slightly overweight but not massive. High BP (managed through meds) and high cholesterol despite eating healthily and exercising which I feel sure is linked to my thyroid. I need to feel well again as I’m tired a lots of the time.
Done through Blue Horizon. I need to go to GP to discuss but feel I need to present a plan as they’ve not been good up to now.
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AnotherEmma
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CRP nice and low which is where you want it to be as it's an inflammation marker.
Ferritin is low at 40.7 (13-150). Some experts say the optimal level for thyroid function is 90-110ug/L. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
Magnesium - Testing magnesium is unreliable. About 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood. So testing what's in the blood isn't giving an accurate picture of our magnesium status.
A red cell magnesium test is said to be the better indicator of magnesium status, not the standard serum magnesium test. The red cell test is expensive and requires phlebotomy which is why it's not included in these bundles.
Cortisol: 236 (166-507)
I'm not particularly au fair with serum cortisol tests but I think I've seen similar results referred to as being on the low side.
I do this test bundle once a year and my cortisol always comes back over range (I don't take supplements); however, when I do a 24 hour saliva cortisol plus DHEA test my cortisol is always quite low.
TSH: 1.21 (0.27-4.20)
FT4: 21.3 (12-22) = 93% through range
FT3: 3.83 (3.1-6.8) = 19.73% through rangeCan we assume that you followed our advised testing protocol:
* Test no later than 9am
* Nothing to eat or drink except water before the test
* Last dose of Levo 24 hours before the test
* No biotin, B Complex or any other supplement containing biotin for 3-7 days before the terst
If so then the above results show that you have poor conversion.
TPO antibodies: 477 (<34)
TG antibodies: 48 (<115)
Your raised TPO antibodies confirm Hashimoto's.
Vit D: 58nmol/L
You might want to check out a recent post that I wrote about Vit D and supplementing:
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).
So now you look at how much is needed to reach 50ng/ml and you'll see that they suggest 3,700iu per day. Nearest to buy is 4,000iu, and cheapest to buy is 5,000iu and take 6 days a week rather than 7.
Once you've reached the recommended level then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
For Vit K2-MK7 my suggestions are Vitabay, Vegavero or Vitamaze brands which all contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Vitabay and Vegavero are either tablets or capsules.
Vitabay does do an oil based liquid.
Vitamaze is an oil based liquid.
With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops.
They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.
Another "all trans" one worth considering if the others aren't availaable:
Magnesium should be taken 4 hours away from thyroid meds and as it tends to be calming it's best taken in the evening. Vit D should also be taken 4 hours away from thyroid meds. Vit K2-MK7 should be taken 2 hours away from thyroid meds. Don't take D3 and K2 at the same time unless both are oil based supplements, they both are fat soluble vitamins which require their own fat to be absorbed otherwise they will compete for the fat.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
So your B12 level is on the low side, needs to come up to at least 550pg/ml, higher might be better.
Folate: 23.30 (8.83-60.8)
Not too bad. Folate is recommended to be at least half way through range so that would be about 35 plus with that range.
You might want to consider a good quality B Complex which should improve both B12 and folate levels. Brands frequently used here are
Thorne Basic B - can be difficult to find and sometimes expensive
Vitablossom Liposomal B Complex - from hempoutlet.co.uk
Yipmai Liposomal B Complex - same as Vitablossom but rebranded for Amazon
Pink Tribe Liposomal B Complex - from Amazon
When taking B Complex this should be left off for 3-7 days before any blood test as it can give false results.
We need optimal nutrient levels for thyroid hormone to work properly and good conversion, so it would be a good idea to optimise all your nutrients first, work on those for now and retest maybe in 3-4 months. If nutrients are then optimal but conversion is still poor (ie high FT4 and low FT3) then consider possibly adding some T3 to your Levo.
Seaside Susie, thank you so much for all the helpful info you shared on my results. I’ve started some of the supplements recommended. How soon should I go for a retest? Is 3 months too soon?
I haven’t done one yet but I know there’s absolutely no chance my iron levels are high, as they’re always slightly low and I’ve been prescribed iron tablets in the recent past. I don’t eat any red meat, and they’re always on the low side. So I plan to take spatone. I didn’t want to do everything at once.
Doctors don't know, because they're not taught much about nutrients
When one considers that nourishment, good quality nourishment is crucial to health, then not teaching about nutrients is ridiculously stupid. How can we trust a profession that ignores food and its significance to wellness and instead focuses on medicine to “fix” certain preventable illnesses/diseases actually caused by poor nutrition. Beyond idiotic, beyond belief
Cholesterol levels are little to do with diet. Yours is high because your FT3 is so very low.
Cholesterol is made in the liver, and the liver strives to keep levels steady: the more you consume, the less it makes, and vice versa. However, when T3, the active thyroid hormone, is low the body cannot process cholesterol correctly and it tends to build up in the blood. But, high cholesterol really is not a problem. It's a symptom, not a disease.
I want to confirm this. I tried diet and exercise to lower high LDL without success. Since I started on T3 my LDL has come down considerably. And as a bonus my CRP is 0.
Your liver makes cholesterol because your body needs it. Without adequate levels of cholesterol it cannot repair and regnerate the body and cannot make sex hormones. So, low cholesterol is dangerous.
Thank you both very much! Lots to look at here. So you recommend I do all this supplementation myself and retest down the line. I was wondering if I needed a referral to an endocrinologist with that anti-thyroidperoxidase level. You don’t think I should be pushing for anything like that?
raised TPOab ( even if hugely raised eg. in the thousands) are not of any interest to endocrinologists .. so no, you don't need to get a referral for that ( in fact they would decline a referral request if it was made for only that reason)
All the raised antibodies show the endocrinologist /GP is that the reason for the patients hypothyroidism is Autoimmune Thyroid Disease ( often called hashimoto's but actually there are other varieties of autoimmune hypothyroidism that do not have a goitre ~ technically hashimoto's has a goitre) .
Raised TPOab help in confirming diagnosis of hypothyroidism and show that the hypothyroidism is likely to be permanent, not transient , and therefore they can reliably expect hormone replacement treatment to be needed life long ...... but once the resulting hypothyroidism has been diagnosed and hormone replacement started , they have no further interest in the antibodies ... mainly because they have no treatment that will affect/ or improve the autoimmune cause of the hypothyroidism .. they can only treat the resulting hypothyroidism , not the autoimmune disease that caused it .
Well yes ,it is depressing that they are not more interested in finding the cause of autoimmune thyroid disease, or of tracking it progress so they learn more about how to treat it effectively ..... but it doesn't mean you won't be able to feel better than you do now .
once you have improved some of those other things mentioned in replies above ,... if you stil don't feel ok , and if you still have relatively high end T4 levels and relatively low T3 levels (poor conversion) , then you could certainly ask GP for a referral to endocrinologist for a trial of T3 added to levo (.. referral based on remaining hypothyroid symptoms / relatively low T3 levels / inability to try a further levo dose increase to improve symptoms due to T4 being already quite high).
But since getting a trial of T3 from NHS endo is such a long process and is highly dependant on where you live as to whether it would be allowed anyway ... then it is better to try and sort the other things first....... if you can feel well using just levo, it's a lot less hassle going forward (and it's never a waste of time sorting 'everything else' first ~ if you did turn out to need T3 and get it prescribed , either by NHS or privately , it will be able to work better if your vits are better).
Don't worry about the antibodies. They are not doing you any harm, and once they're over-range, their level is irrelevant. Lowering them will not get rid of the Hashi's, you will always have that. Antibodies have a job to do, best to just let them get on with it.
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