Hyperactive thyroid 😕

[Kari55]

hi, I have posted here a few years ago when my husband was diagnosed with Graves’ disease and get lots of help. This time it’s me and it looks like I might have the same condition 😕 I started feeling heart palpitations that wouldn’t go away so decided to go to the hospital. I have attached the results (no ranged unfortunately). They have also checked for TRAb but I’m waiting for results. I’m a bit puzzled because thyroid conditions don’t run in my family. I’m on propranolol 20mg 3x a day but they didn’t want to give me carbimazole at this stage. Any advice on how I can help myself? I have ditched gluten today and started taking selenium. Should I do anything else?

[PurpleNails Administrator]

Your FT3 is high but your FT4 is in range. The range isn’t showing so can’t see exact %.

TRab is more specific to Graves. I see why dr is waiting to check results.

Propranolol will help with symptoms & can help lower FT4:FT3 conversion so good option. Do not stop it abruptly. I was made very ill with migraines when specialist said I didn’t need any more stop it. GP put me back on it a month later as permanent migraine prevention. I slowly lowered but remain on 30mg.

I had disproportionately high FT3 with hyper nodule & this often develops slowly whereas Graves can show a very high levels suddenly. As you have antibodies it more likely autoimmune is what affecting your thyroid.

Gluten free & selenium good steps. Max dose of selenium of 200mcg for 6 months the reduce to 100mcg.

Have key nutrients tested, folate, ferritin, B12 & vitamin D. Optimal levels are not same as in range.

Neutrophil show as low & that’s a concern if looking to start anti thyroid. & dr will want to see that improved before introducing an antithyroid as a rare side affect causes theses to lower.

[Kari55 in reply to PurpleNails]

Thank you for this informative reply. I should add that my ferritin is very low as I suffer from heavy periods since I had my twins. I supplemented for a while but it wrecked my stomach.

[helvella Administrator in reply to Kari55]

Just because one iron supplement caused stomach issues doesn't mean they all will!

Ferrous sulphate is notorious for causing stomach/gut issues - and it is usually the first that will be prescribed.

Remember, in general, iron supplements are available without prescription so you potentially can try several options.

helvella - Iron Document

This is a summary of what I have read up and found out about iron supplements over the past few years. I am not in any way medically trained. You are strongly encouraged to check every detail before making any decisions for yourself.

helvella.blogspot.com/p/hel...

[Kari55 in reply to helvella]

That’s a great article thank you!

[gset]

hi there, thyroid conditions don’t run in my family but a Pfizer covid jab started my Graves . Covid does the same to me in terms of autoimmune reaction. So I am still getting the jabs as the disease is wors3 for me.

[Kari55 in reply to gset]

Thank you. I had Covid almost 2 years ago, was testing positive for 25 days. Prior to that I had 2x AstraZeneca and 1x Moderna jab. I’m 42 so didn’t get anymore jabs. How quickly after jab you got Graves?

[gset]

I started to get shaky in the weeks after the jab in Jan 22 and then only found out my thyroid had deteriorated in April, then as no medical follow up had happened, I ended up in hospital with A Fib in August 22 when they diagnosed Graves, then had relapse after covid jab in December 23. It seems to be the Pfizer one that affects me. The others didn’t and I have had 8 boosters.

[SlowDragon Administrator]

This looks more like early stage Hashimoto’s

Hashimoto’s frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid

Graves’ disease has to be confirmed by testing TSI or Trab antibodies

You need Vitamin D, folate, ferritin and B12 tested too

Low mean cell HB suggests anaemia

So a full iron panel test might be good idea too

[Kari55 in reply to SlowDragon]

I thought my HB was ok 🤔 I’m having problems with very low ferritin since my periods came back after pregnancy. They are very heavy. Could this be the original cause of my issues with thyroid?

[SlowDragon Administrator in reply to Kari55]

Having low iron/ferritin often results in heavy periods

(Odd …..design error…..ideally should be reverse)

How low is your ferritin

low iron/ferritin can increase risk of developing hypothyroidism

healthunlocked.com/thyroidu...

Being hypo tends to result in heavy periods too

Hashimoto’s frequently starts after hormonal changes, especially pregnancy

[Kari55 in reply to SlowDragon]

Thank you for your reply. My ferritin was 16 (10-200) in June but only 3 in 2022. I guess I need to repeat the test. Also in June, my folate was 11.7 (3-20), B12 229(200-910). My thyroid was tested in 2022 and was normal. TSH was 1.35 (0.35-5) in 2022. I gave birth in z October 2019 and had a blood transfusions due to haemorrhage during c-section. My period came back in November 2020, the low ferritin was picked up in 2022. Thyroid disease doesn’t run in my family.

[SlowDragon Administrator in reply to Kari55]

had a blood transfusions due to haemorrhage during c-section

This could have resulted In Sheehan syndrome

ncbi.nlm.nih.gov/pmc/articl....

pituitary.org.uk/informatio...

B12 299 (200-910)

B12 far too low

Have you been supplementing since this result

If you haven’t been supplementing do NOT start until retested ….see where results are first

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 a week later add a separate vitamin B Complex 

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

Highly effective 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...

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

Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

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 folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until over 500

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

[Kari55 in reply to SlowDragon]

I’m not vegan or vegetarian but I don’t eat meat every day, maybe 2x a week.

About the Sheehan syndrome, wouldn’t it occur straight away after the haemorrhage? It happened in 2019 and my TSH was 1.35 in 2022. 🤔

[SlowDragon Administrator in reply to Kari55]

I don’t eat meat every day, maybe 2x a week.

so you need to significantly increase iron rich foods in your diet

Developing Hashimoto’s could be the cause of your poor vitamins

Sheehan can take years to diagnose

Did you breast feed

[Kari55 in reply to SlowDragon]

Yes I breastfed what I could for 16 months. After haemorrhage I really struggled with supply and was pumping like crazy to feed my twins. It was very difficult time.

[SlowDragon Administrator in reply to Kari55]

So probably not Sheehan

Just Hashimoto’s

[SlowDragon Administrator in reply to Kari55]

My ferritin was 16 (10-200) in June but only 3 in 2022.

Did you get iron infusion in 2022?

What’s GP prescribed to improve your anaemia since June

Are you vegetarian or vegan

Look at increasing iron rich foods in diet

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

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

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.

healthunlocked.com/thyroidu...

Posts discussing Three Arrows as very effective supplement

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Iron patches

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron

healthline.com/nutrition/he...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Ferritin range on Medichecks

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

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. ‘

[Kari55]

thank you so much! Will read through all of it. I didn’t have an infusion, I was just supplementing with iron fumarate.

[SlowDragon Administrator in reply to Kari55]

You must feel shattered with such low ferritin levels

Are you still on iron supplements, how many per day

Ferrous fumerate notorious for being slow to improve levels and/or difficult to tolerate

[Kari55 in reply to SlowDragon]

I feel awful and I have 4-year old twins to look after, work and recently house renovation 🤦🏻‍♀️ I stopped taking iron a few months ago as it was wrecking my stomach. I’m thinking of trying heme iron tablets now as they meant to be gentle on stomach.

[SlowDragon Administrator in reply to Kari55]

Get FULL iron panel test 3-4 times a year if self supplementing

Stop iron supplements 3-5 days before test

Lots of members on here have made great progress using Three Arrows iron ….info in previous reply

I have the opposite issue….high ferritin (over 300) so never taken iron

[Kari55 in reply to SlowDragon]

Thank you so much this is all very helpful. Just checked my order with cytoplan and it looks like I ordered b12 from them so I hope that’s ok. Will get Thorne next time. I’m seeing a GP tomorrow so will see what tests I can get otherwise I will get Medichecks.

[Kari55 in reply to SlowDragon]

Unfortunately the GP refused to check my ferritin, folate, B12 and vit D. She said it was all checked in June and were in normal range. She did mention that my iron might show higher now, that I have inflammation in my body. Not sure how this works but someone mentioned the same to me on a different forum.

Also, a question: is it ok to post again about endocrinologist recommendations but ask for pm messages. The Thyroid UK list has a few doctors most of them aren’t endocrinologists and my insurance won’t cover it. And I can’t afford to see them. Thank you!

[SlowDragon Administrator in reply to Kari55]

There’s also a list of endocrinologists via Thyroid U.K….private and NHS

did you get that?

Yes you can write a post asking for information by private message regarding a particular endocrinologist/doctor

What were your vitamin results in June

You can retest via Medichecks or Blue Horizon

[Kari55 in reply to SlowDragon]

I only got list of practitioners and GPs, there seem to be just that list there.

My results in June were:

Ferritin 16 (10-200), it was 5 in Feb

Folate 11.7 (3-20)

B12 229 (200-910)

I will try to ask next week in the hospital if they can add these in , if not I will do Medichecks.

[SlowDragon Administrator in reply to Kari55]

Ferritin 16 (10-200), it was 5 in Feb

Folate 11.7 (3-20)

B12 229 (200-910)

good grief these are terrible

Ferritin is deficient

Presumably GP did full iron panel test for anaemia

Did you get iron transfusion

Or what did GP prescribe

[Kari55 in reply to SlowDragon]

GP said it’s all in range so all good and that a menstruating woman would not have much higher iron than 16. She said non menstruating woman would have 30. I now know these are low and not great at all do need to take things in my own hands.

[SlowDragon Administrator in reply to Kari55]

GP said it’s all in range so all good and that a menstruating woman would not have much higher iron than 16. She said non menstruating woman would have 30.

Good grief that’s complete and utter rubbish

Change GP

[SlowDragon Administrator in reply to Kari55]

Here’s link for how to request Thyroid U.K.list of private Doctors by email

but there’s also link for list of recommended thyroid specialist endocrinologists

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

thyroiduk.org/contact-us/ge...

[SlowDragon Administrator]

Folate and B12

Are you vegetarian or vegan

Low B12 symptoms

b12deficiency.info/signs-an...

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

Ideally, if not vegetarian or vegan…..GP should test for Pernicious Anaemia before you start on B12 injections or daily B12 supplementation

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

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

Highly effective 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

Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

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 folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...