help!

[Sweetpea1234]

hello. This is my second follow up set of private thyroid results - I’ll post the first set in the comments. Any thoughts on what is going on here?

[Sweetpea1234]

ahh so blurry!! Sorry! I’ll post the results here:

TSH: 1.6

T4 (free): 16.7 (11.9-21)

T3 (free): 5.06 (3,1-6.8)

Anti-tg: 328 (>115 = high)

Anti-TPO: 53.6 (0-32)

thyroxine binding globulin: 16 (6.3-22.7)

[SlowDragon Administrator in reply to Sweetpea1234]

High TPO and TG thyroid antibodies confirms autoimmune thyroid disease, also called Hashimoto’s

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

What time did you do test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options including vitamin levels and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[greygoose]

As per your last blood test: numbers difficult to read, you have Hashi's but your TSH and Frees are saying you're not hypo yet.

In other words, nothing is going on.

So has anything happened/changed in the last five months?

[radd]

Sweetpea1234,

Elevated thyroid antibodies evidence some thyroid gland destruction (Hashimotos), but the body is good at working harder to offset hormone deficiencies.

In Hashi the attacks (gland destruction) can come and go over months or many years, and therefore hormones and antibodies fluctuate. Hence your previous high TSH but a present level that is normal. However, TSH will eventually stay risen if thyroid hormone levels start declining and remain low.

Your present thyroid levels are good but will start to reduce as gland destruction progresses. You are in good place to minimise gland damage by taking action to reduce antibodies and the heightened immune response. The antibodies not only mop of gland damage but TPOAb is being shown to have other negative effects on the immune system including inviting other autoimmune conditions.

[SlowDragon Administrator]

previous post 5 months ago

healthunlocked.com/thyroidu...

Shows iron and ferritin were deficient

Aiming for ferritin at least over 70

Have you retested iron and ferritin levels

What have you been doing to improve anaemia

Low iron and ferritin will frequently significantly lower TSH

Essential to maintain OPTIMAL vitamin levels

What were vitamin D, folate and B12

Exactly what vitamin supplements are you taking

As you have Hashimoto’s, confirmed by high thyroid antibodies you need coeliac blood test if not already on gluten free diet

[SlowDragon Administrator]

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.

Most common by far is gluten.

Dairy is second most common.

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines

nice.org.uk/guidance/ng20/c...

Or buy a test online, about £20

Assuming test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

With loads of vegan dairy alternatives these days it’s not as difficult as in the past

Post discussing gluten

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

Ferritin below 30 is deficient

cks.nice.org.uk/topics/anae...

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

Stop iron supplements 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

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

Great replies from FallingInReverse

re ferritin and Three arrows

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great reply by @fallinginreverse

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...

Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

healthunlocked.com/thyroidu...

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:

Females 18 ≤ age < 40. 30 to 180

Females 40 ≤ age < 50. 30 to 207

Females 50 ≤ age < 60. 30 to 264l

Females Age ≥ 60. 30 to 332

Males 18 ≤ age < 40 30 to 442

Males Age ≥ 40 30 to 518

The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.

[Sweetpea1234]

ok thanks everyone. To answer a few questions.

Test was taken fasting at 8:00am

Iron: 12.8 (5.8-34.5) was previously 5.2

Ferritin: 20.24 (10-120) previously 13.46

Total cholesterol: 3.1

Folic acid: 15.7 (3.8-26.5) previously 2.6

Vit D: 72 (50-375)

B12: 671 (197-771)

Feels like a ticking time bomb which doesn’t sit comfortably with me. I had really bad stomach issues two years ago and was in and out of hospital - had biopsies for celiac but came back negative and I had genetic testing too which came back low risk.

[SlowDragon Administrator in reply to Sweetpea1234]

So folate, B12 are much improved

What have you been taking

You can now experiment with trying just a daily vitamin B complex

Vitamin D needs to be higher

How much vitamin D are you taking

Are you also taking daily separate magnesium in afternoon or evening

Ferritin still has long way to go

What are you taking

So as you have had negative coeliac blood test you can consider trying gluten free diet

Many, many Hashimoto’s patients are astonished to find gluten free diet is extremely beneficial or absolutely essential

[Sweetpea1234 in reply to SlowDragon]

thank-you. I have been taking a Bassetts woman’s multivitamin which has 10ug vitamin D and 400mcg folic acid and 4.2mg iron amongst other things.

I am going to research the effects of going gluten free. Interested to know if the effects are really sensitive like in the case of celiac disease - a slip up in gluten intake can have massive impact - is it the same with thyroid and gluten? I will research this.

[Sweetpea1234]

thank-you. I have been taking a Bassetts woman’s multivitamin which has 10ug vitamin D and 400mcg folic acid and 4.2mg iron amongst other things.

I am going to research the effects of going gluten free. Interested to know if the effects are really sensitive like in the case of celiac disease - a slip up in gluten intake can have massive impact - is it the same with thyroid and gluten? I will research this.

[Jaydee1507 Administrator in reply to Sweetpea1234]

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SlowDragon