Diagnosed hypothyroid in Feb 2023 & subsequently with Hashimoto’s all results in bio
Just had Monitor my Health results back, I went privately as wanted to check how I was doing after following recommended (on here) supplements for a few months, dose increase to 125 Levothyroxine and on my FT3.
Results are:
TSH 0.59 (0.27 - 4.2)
FT4 18.1 (12-22pmol) so 61% thru range
FT3 3.9 (3.1 - 6.8pmol) so 21.62% thru range
Monitor my Health haven’t given ranges on the following
HB 154g/L
Ferritin 25 ug/L
TSAT 22%
Active B12 100 pmol
Folate 6.1ug/L
I take Thorne basic B, Vit D with K2 spray, fish oil, magnesium and zinc and am gluten free. Followed all the testing protocols and stopped the Thorne supplement 1 week before test.
Any insight/ advice on the results welcome.
Does my conversion rate still look poor? Will continuing to supplement further improve this? Should I be exploring T3? Can I do anything else to improve Ferritin? Is there anything else I should be doing to feel the best I can?
Thanks for reading and any wisdom you can share!
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Slowrunner1208
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If conversion is good then the ft3 percentage should be just slightly lower than the ft4 percentage.21% compared to 61% shows you have poor conversion. I would think about adding t3.
Conversion pretty poor there, especially on that sort of levo dose. Increasing levo much further would likely send your T4 over range. From your previous bloods post a few months back, it looks like your T3 and conversion have actually got worse. Improving vits might help marginally, but likely won't solve it. A trial of T3 is warranted if you're still symptomatic(?), but depends on your situation. If you're going through the NHS, you'd maybe need to wait a while longer on levo only to get an endo referral and convince them to do a trial (others will hopefully jump in to clarify the rules around that). Otherwise, with those bloods, you could fairly easily get T3 prescribed privately.
Ferritin and folate look really low as well. For ferritin, it's usually suggested you get a full iron panel to show actual iron, transferrin saturation, etc., because low ferritin doesn't necessarily mean low iron - have you been able to do that? Medichecks have a good one. For raising ferritin, I've found heme iron very useful (I use Three Arrows Simply Heme) - my ferritin has gone from 25 to 81 in about 4 months, and it's a well-tolerated form of iron. For folate, alongside a methyl b complex, a separate extra folate supplement can be useful to boost that for a few months. I've used Biocare methylfolate sublingual drops, just a half dose together with their sublingual b complex, and that's risen nicely as well. With low ferritin and folate, you may have the MTHFR gene, which means methylated forms B vitamins are preferable (MTHFR affects methylation).
Thanks seveneleven! I may need to explore private T3 route, though not sure how easy that will be. GP goes off TSH only and I often feel like I’m labelled as an older, worried well woman.
Private route is easy if you can afford it. If you ask for the list of private docs on here, that's a good place to start - it's how I found the one I'm using for my prescriptions now. Sounds like your GP is the standard unhelpful and unknowledgeable variety! Still worth asking for an endo referral based on your last two blood tests showing low T3 and therefore poor conversion. Might not get anywhere if they're very ignorant, but at least you can say you tried. Have seen on here that sometimes even if you get the referral, the endo they refer to is poor on thyroid as well and refuses to see the patient, saying they're fine based on bloods in range. Hope you get somewhere though. Good luck!
Before considering booking consultation with endocrinologist you need to get all four vitamins optimal
Vitamin D at least over 80nmol
Ferritin at least over 70
Folate at top of range
Active B12 at least over 70
your results- please add ranges
No vitamin D
Ferritin 25 ug/L
Active B12 100 pmol
Folate 6.1ug/L
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)and separate B12
My latest tests were with MMH and they didn’t add ranges for:
Ferritin 25 ug/L
Active B12 100 pmol
Folate 6.1ug/L
I will contact them to see if I can get the ranges.
Vitamin D was 75nml, it has improved since test in May
I’m waiting for my medichecks iron panel test to arrive so will do that next week.
I eat pumpkin seeds everyday and now make sure I eat red meat twice a week and have a couple of squares of dark chocolate most nights. I’ll look at the lists of other iron rich food and will add in some daily orange juice.
Lots of other really helpful reading to look at too!
Thanks so much, really appreciate the advice before I take next steps re a private appointment. If I can progress without having to find money for that it would be great. 😊
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
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. ‘
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