Clearly all your vitamin levels are terrible, especially ferritin
What vitamin supplements were you taking before this test
Are you vegetarian or vegan
Pre or post menopause
Have you ever had TSI or Trab antibodies tested for Graves’ disease
You’re not currently taking any levothyroxine?
This looks perhaps like temporary Hashimoto’s flare
Work on improving low vitamin levels and retest again in another 6-8 weeks
High TG antibodies could be Graves’ disease, but could be Hashimoto’s
Previous post you said
I started levothyroxine 25mcgs in November 2022 and stopped in June 2023 - I had never taken it regularly as it caused my stomach to bloat and become very painful. My results in June were TSH 0.82 and T4 18.4 - Back in November 2022 TSH was 4.93 and T4 13.8.
25mcg is too small a dose
Standard starter Levo is 50mcg …..taking too small a dose levothyroxine initially can increase hypo symptoms and make gut function worse. Levothyroxine must be taken everyday……retest at 6-8 weeks…..then ready for next increase in dose
Thak you so much for your reply. I havent taken any vitamins for a very long time - Im vegetarian for have recently started eating chicken again as I suspected my iron levels were low.
I took a few 25mcgs of levo at the beginning of last week but stopped - the doctors comment on my private blood tests results were that my levothyroxine dose may be too high (they dont know what I am prescribed) so not sure what to do about the levothyroxine now. Ive never had TSI or Trab antibodies tested for Graves’ disease.
My GP is no good - my iron levels were low when I last had them tested in 2019 and my heart palpitations and shortness of breath started but GP said they were fine - Im loathed to go to them to have all the blood tests you recommend - is there any private places I could go to to get full blood count etc..? Thanks
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes:
Males 16-60: 30-400 ug/L
Female's: 16-60: 30-150
Both >60: 30-650
The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘
Sorry I didnt see it. I went to a clinic to have my last bloods done as read some posts that said it can be hard to do the finger prick test but clinic is quite far away from me - do you know if many people have issues with it?
Your results suggest early stage Hashimoto’s (autoimmune hypothyroid) rather than Graves’ disease (autoimmune hyperthyroid)
Hashimoto’s frequently starts with transient hyperthyroid results and symptoms……swinging from hypo to hyper temporarily ……before becoming increasingly hypothyroid
If, at next test in another 6-8 weeks Ft4 and Ft3 still high ……(unlikely) …..then look at testing for Graves’ disease antibodies
Ive never had TSI or Trab antibodies tested for Graves’ disease.
Graves Disease antibodies test
Has to be done by private blood draw, not DIY fingerprick test
Apologies for the duplication - could I just clarify with you that this is what I should do?
25mcg is too small a doseStandard starter Levo is 50mcg …..taking too small a dose levothyroxine initially can increase hypo symptoms and make gut function worse. Levothyroxine must be taken everyday……retest at 6-8 weeks…..then ready for next increase in dose
At the moment you aren’t taking any levothyroxine?
Is that correct
Assuming yes…..
Currently
Free T3 X 8.0 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine X 26.8 pmol/L (Range: 12 - 22)
Currently thyroid levels slightly high, probably as result of temporary Hashimoto’s flare. This is when cells in your thyroid breakdown due to autoimmune disease, releasing excess thyroid hormones. After an attack thyroid will be more damaged and more hypothyroid
You shouldn’t take any levothyroxine at moment, but situation can change rapidly
Meanwhile…….essential to be working on improving very low vitamin levels
Retest thyroid again in another 6 weeks
Likely to see Ft4 and Ft3 levels dropped back within range
If/when TSH has risen and Ft4 and Ft3 dropped……then it’s time to start back on levothyroxine at 50mcg every day
My folate result was in a healthy range (no numbers given) and my B12 is normal but towards the low end of the normal range - advised me to get a MMA blood test - Serum Methylmalonic acid - not sure my GP would do this. Im worried that if I keep taking Levothyroxine it could cause hyperthyroidism which Ive had before.
The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3
Hi Jenny876 My GP Is a good doctor and has been every 3 months checking my underactive thyroid because levels are all over the place. Early In august 2nd to be precise he has changed my thyroxine from 125 to 100. Now with the last bloods on 125mg lt's came back pre diabetic but only 1 over. Here are my bloods. Serum free T4 level (XaERr) 24.6 pmol/L [12 - 22] Serum TSH level (XaELV) 0.41 miu/L [0.27 - 4.2] Haemoglobin A1c level 6.0 % [4.0 - 5.9]; Above high reference limit
Non-diabetic Hyperglycaemia (NDH) with high risk of
developing Type 2 DM. Lifestyle changes are advised
I have cut out all naughty foods like cake, biscuits, crisps potatoes etc.... I was doing Low Carb and lost 3 stone In 2021 then we moved In April & i was Just grabbing food for quickness whilst moving knocked myself out of ketosis and slowly gained a stone in weight. Doing Keto again but at 30/35 carbs high protein & trying to keep fats down a bit because of pre-Diabetes. I also from after effects of covid when we moved am now post covid and the same symptoms you get with underactive thyroid & usual allergies.
Kazzy17, Are you remembering to leave a gap of 24 hours between your last dose of levo and the blood draw? Taking Levo a few hours before the test can show a false high and your GP may reduce your dose as a result.
Fasting and low carb diets can also affect thyroid blood results.
How are your key vitamins looking - ferritin, folate, B12 & D3?
Hi Jaydee no I have never been told since 2003 on Levo to leave 24hrs between last dose and blood draw. This ls my bloods Full blood count. I take D3 but not B12
Serum non high density lipoprotein cholesterol level 2.36 mmol/L
To be honest I am not on a level to understand this all as lt's all medical and I am ln the UK so maybe NHS test are different I don't know ls the honest answer.
The timing between taking Levo and blood test is a patient to patient tip and I doubt any doctor knows about it. That is why patient groups are popular, because we know the details. I'd recommend you use the 24hour timing method in the future.
I can only comment on thyroid and vitamin bloods, not full blood count and cholesterol.
It may well be that you have low vitamin levels which is extremely common in hypo people. You can ask your GP to test your levels for ferritin, folate, B12 & D3 or private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...
There is also a new company offering walk in & mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
Thank you Jaydee so much so before my next thyroid bloods leave 100mg out 24hrs before my test which ls next month. I also will ask lf I can have a ferritin, folate, B12 & D3 blood test. I checked on my test's before moving here last year & the fantastic doctor l wish l could have stayed with her but to far out of catchment. She did a Ferritin folate test back In 2019 which was good. No problem's so I can say l haven't been tested since then.
Come back with new post of your own once you get results
Always get same brand levothyroxine at each prescription
Test folate, B12 and ferritin at least annually
Test vitamin D twice a year
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
List of private testing options and money off codes
I can't do Private but certainly NHS I will take your advice. As far as same brand most times lt's accord & that's what l have now. Occasionally lt ls another brand In the gold box. My last test was early morning for a change but had taken Thyroxin at 4am because of the other meds I take. Now my GP has said I shouldn't be having to wake up with an alarm In the middle of the night. I should take thyroxine an hour before which I do at 11pm and my other meds when going to bed. Also he said to take 30/45 minutes after eating for Thyroxine. Am I getting the right advise.
My last test was early morning for a change but had taken Thyroxin at 4am because of the other meds I take. Now my GP has said I shouldn't be having to wake up with an alarm In the middle of the night. I should take thyroxine an hour before which I do at 11pm and my other meds when going to bed. Also he said to take 30/45 minutes after eating for Thyroxine.
GP is incorrect
Thyroxine must be on empty stomach, then nothing apart from water for at least an hour after
No other medications or vitamin supplements within 2 hours. Some like magnesium, calcium, vitamin D, iron, or any PPI or HRT you swallow at least 4 hours away from levothyroxine
If you normally take levothyroxine in middle of night or early morning, just delay taking until immediately after blood test
Timing of last dose levothyroxine will only affect Ft4 result not TSH
Timings are patient to patient tip …..generally waste of time discussing with a GP
Basically I was doing lt right because I take night meds and morning tabs. So I was taking Thyroxine at 5am or 6am before taking my morning meds at 10am which I am taking blood pressure tablets & Omeprazole I am 71yrs l have an inoperable spine so occoccasionally I take Naproxen (I try to not take them) I prefer going natural special heat patches from china. At night time which ls around 12-1am I take statin 10mg, diazepam 8mg & amitriptyline 20mg. L have been told to not mix these meds with thyroxine. Hence I set an alarm (my poor hubby) for 5am or 6am. . My other question lf l may ls what about eating with levothyroxine and how far apart should food be. I am asking as to be able to not have to wake at this time. I understand that levothyroxine should be on a empty stomach. I take D3 4000iu(100 mcg)
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
As any PPI will lower vitamin levels you need to work especially hard to maintain GOOD vitamin levels
Many many members have managed to get off PPI by improving vitamin levels, getting thyroid levels OPTIMAL (Ft4 and Ft3 at least 60-70% through range) …….and very often gluten free/dairy free
Test B12, folate and ferritin at least annually
Vitamin D
Test twice yearly via NHS private testing service when supplementing
Once again I have been on 10mg of statin for high cholesterol dating back but my level ls good now and l am watching what l eat as my last bloods showed pre-type 2 so l am now carb and calorie watching what l eat keeping my plan etc.
Come back with new post once you get FULL thyroid and vitamin testing done
all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Thank you I feel like a broken record and you have been so helpful. I knew the advise was wrong hence l am on here with you. My next test should be October for thyroid & I am going to ask for the pre-diabetic type 2 to be done again. As l know l have been eating nasty foods for stress really and lost my Sister July 1st. So cake, chocolate etc etc.... that's all stopped now & I am back on the planner diet wise.
On any replacement thyroid hormone, especially levothyroxine we MUST have GOOD vitamin levels for good conversion of Ft4 (levothyroxine) to Ft3 (active hormone)
Frequently on just levothyroxine Ft4 is high but Ft3 too low
I will do as they are doing every 3 months at the moment, but that has also been longer in between 6-9 months. I know lt's cut backs l was also told every blood test costs them £10 at my last practise before we moved here. Not by my lovely GP lt was a nurse at the practice. Thanks so much again
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