Recent Test Results Advice Please

[Kingsway1]

I am currently taking

Levothyroxine 100mg

Liothryrononine 10mcg ( 5 morning and evening )

Recent Medichecks test results were as follows

TSH

0.27 - 4.2 R

3.96

mIU/L

FREE T3

3.1 - 6.8 R

3.4

pmol/L

FREE

THYROXINE

12 - 22 R

12

pmol/L

• Autoimmunity

THYROGLOBULIN

0 - 115 R

ANTIBODIES

74

KIU/L

THYROID

PEROXIDASE

ANTIBODIES

0-34

R

23.3

KIU/L

My TSH looks to be too high had it tested recently at GP it was around 2

I am surprised re antibodies as when first diagnosed were high what does the normal result mean ? Do I still have Hashimoto's?

Advice would be very gratefully received

[SlowDragon Administrator]

was test done as recommended

Last dose levothyroxine 24 hours before test

If 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

T3 Day before test

Split T3 as 2 or 3 smaller doses spread across the day with last dose 8-12 hours before test

healthunlocked.com/thyroidu...

[TiggerMe]

Antibodies rise and fall but yes if they have been high you still have Hashi's

Were the tests taken under the same protocol? How are you feeling?

Certainly looking like you need an increase with high TSH and low frees, do you see an NHS Endo?

[Kingsway1 in reply to TiggerMe]

I see a private Endo but haven’t seen him for years usually just test once a year at my GP TSH

I haven’t been feeling great so decided to do Medichecks which I used to do when first diagnosed about 8/9 years ago

My antibodies have historically been high so I wondered what the low result meant

I took the test with no medication for 24 hours it was a Wednesday morning so last medication was Tuesday am

What dose would you expect I need ?

Do I need more T4 or T3 ?

Thank you so much

[TiggerMe in reply to Kingsway1]

Could be that you don't have much thyroid left to be destroyed hence the low antibodies?

So this test is giving you a false low for your fT3 if you didn't take your evening dose of T3 as it needs testing 8-12hours after last dose

TSH 3.96 mIU/L (0.27 - 4.2) 93.9%

Free T4 (fT4) 12 pmol/L (12 - 22) 0.0%

Free T3 (fT3) 3.4 pmol/L (3.1 - 6.8) 8.1%

I'd suggest upping your T4 either 12.5 or 25mcg depending on how sensitive you are to it and retest in 8 weeks and then you'll see where your fT3 is after 8-12 hours 🤗

Have you got any old results when you felt well?

[SlowDragon Administrator]

Test was done after fasting on Wednesday morning I had last taken meds as usual on Tuesday am T4 and one dose of T3 no T3 on Tuesday night

So Ft3 result falsely low

Ft4 is true result and is very low

I would agree with TiggerMe get dose Levo increase to 125mcg (even if you initially only increase to 112.5mcg daily)

Which brand of levo is your 100mcg

Do you always get same brand

What vitamin supplements are you taking

Retest thyroid 8 weeks after increasing dose Levo

Also include testing vitamin D, folate, ferritin and B12

[Kingsway1]

Thank you so much !!

Will increase T4 to 125

Will retest in 8 weeks following proper T3 protocol

My vitamins were as follows

FOLATE 24.8

Range >7

FERRITIN 218

Range 30- 332

VIT B12

62.9pmol/L

Range 37.5 - 188

VIT D

62

Range

50-250

Please can you advise and recommend any suitable brands of supplements

I didn’t test any other vitamins

I was GF for 5 years but about 6 months ago began eating small amounts to test and didn’t see many adverse effect

[SlowDragon Administrator in reply to Kingsway1]

I was GF for 5 years but about 6 months ago began eating small amounts to test and didn’t see many adverse effect

Well this could be reason you’re thyroid levels are so very low and now not feeling good

Gut absorption has perhaps diminished now you are eating gluten

Suggest you try cutting it out completely again

[SlowDragon Administrator in reply to Kingsway1]

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 when supplementing

Can test via NHS private testing service

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

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...

Recipe ideas

bbc.co.uk/food/articles/mag...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Too much Vitamin D is toxic

Test twice a year

healthunlocked.com/thyroidu...

[Kingsway1 in reply to SlowDragon]

Thank you so much will put all of this brilliant advice into action

Is my folate too ?

[SlowDragon Administrator in reply to Kingsway1]

Folate looks OK - top of range is not listed ....probably 60

A vitamin B complex will keep all B vitamins in balance

[Kingsway1 in reply to SlowDragon]

Thank you x

[SlowDragon Administrator in reply to Kingsway1]

FOLATE 24.8 Range >7

VIT B12 62.9pmol/L Range 37.5 - 188

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

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 supplements

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus B complex popular option. 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...

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 can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

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...

Low B12 symptoms

b12deficiency.info/signs-an...

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

NICE guidelines on B12 and testing

healthunlocked.com/redirect...

[TiggerMe in reply to Kingsway1]

B12 is low ideally nearer top of range, we generally suggest a good B complex but many need a little extra B12 the sublingual like Nature Provides is handy as you can dose to suit natureprovides.com/collecti...

Vit D you are aiming for 100-150 if you use this calculator you can either take a loading dose and then maintenance or just a raised level for longer... Nature Provides again does one with K2 MK7 which is the better version grassrootshealth.net/projec...

[Kingsway1 in reply to TiggerMe]

Thank you putting all of this into action very grateful