Would be grateful for your thoughts on my blood... - Thyroid UK

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Would be grateful for your thoughts on my blood results before endo apt please, still feeling exhausted and weak. Thank you

Hopetoheal22 profile image
12 Replies

Hello, I’ve had an underactive thyroid for 8 years after having my first child, looks like Hashimotos.

Currently taking 100mcg levothyroxine and 15mcg liothyronine (10mcg on waking and 5 around 3pm).

Also on HRT patches as am mid 40s and perimenopausal.

I’m gluten free, have had SIBO in the past. Going on liothyronine last year seemed to help gut issues and not so bloated now.

Head injury 15 years ago, fatigue started after that.

my blood results seem better than they have for a long time but I feel more exhausted (despite sleeping better) and physically weaker than ever. Brain fog and concentration still awful. Whole body aches. Always hungry! I’m probably a low weight for my height but slowly gaining weight.

Blood test at 9am, didn’t take meds before. Last dose of levo was about 26 hours before test. Last dose of liothyronine 3pm day before.

I’d love your thoughts on my results please. Ferritin is better than normal (usually low 30s) and everything looks ok but I am really struggling energy wise 😬 Hard to get up and move, everything feels very difficult.

I’m an active person and really aching all over for days after moderate exercise. Also low mood.

I take vitamin C, D, fish oils and magnesium. Sometimes iron supplement but can cause constipation.

Thanks so much in advance for your wonderful wisdom, it’s greatly appreciated 🙏 😊

I’ll upload a photo of results.

Some FBC results:

HGB 123 (range 115-157)

Platelets 152 (150-450)

HCT 0.367 (0.370-0.490)

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Hopetoheal22
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Jaydee1507 profile image
Jaydee1507Administrator

Free T4 (fT4) 16.2 pmol/L (12 - 22) 42.0%

Free T3 (fT3) 5 pmol/L (3.1 - 6.8) 51.4%

The FT3 is a false low due to longer than 8-12hrs for last dose of T3.

Your FT4 is a little on the low side. Suggest increasing Levo slightly.

We need OPTIMAL levels of vitamins for our thyroid hormone to work well.

B12 is too low. Aim for over 500 serum B12.

Are you vegan or vegetarian? If not:

B12 - do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...

If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.

If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.

cytoplan.co.uk/vitamin-b12-...

amazon.co.uk/Better-You-Boo...

No result for folate`.

Folate is included in a B complex.

B complex suggestions: Slightly cheaper options with inactive B6:

amazon.co.uk/Liposomal-Soft...

Contains B6 as P5P an active form:

bigvits.co.uk/thorne-resear...

healf.com/products/basic-b-...

Explanation about the different forms of B6:

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

B complex comparison spreadsheet:

healthunlocked.com/thyroidu...

Ferritin should be around 90 - 100 for best use of thyroid hormone. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc

Link with ideas for dietary iron:

dailyiron.net/https://three...

Hopetoheal22 profile image
Hopetoheal22 in reply toJaydee1507

Thank you so much for your quick and helpful reply Jaydee. I eat meat, fish and a little butter and cheese. Good idea to take B12 / B complex thank you; I’ll start that. Maybe some symptoms of low B12 - i feel very weak and I am finding walking and speaking harder than normal, also vision can be blurry (seeing optician next week) and feel low and hard to remember things.

Should ask for a PA test next time I see my doc?

I could ask for higher levo dose but didn’t really feel better til I added T3.

Thank you for reminding me to eat more red meat etc. I feel better when I eat more of it. Never known my ferritin to be more than in the 50s. I do have quite heavy periods, sometimes few days, sometimes a week or more which doesn’t help.

Thanks again for your help! Much appreciated. I hope you’re well 😊

Jaydee1507 profile image
Jaydee1507Administrator in reply toHopetoheal22

Its worth asking your GP for PA blood tests. MMA & homocystine. If you don;t eat much red meat then thats likely why your B12 is low though.

For ferritin try eating chicken liver pate a few times a week.

Its not all about T3. People on combi therapy usually need around 70% through range for both FT4 & FT3.

Hopetoheal22 profile image
Hopetoheal22 in reply toJaydee1507

Thank you Jaydee. I’ll make more chicken liver pate, was delicious last time.

As I last took my meds the day before the test, I wonder if my T4&T3 were at a good point in the range the day that I took them? I always assume testing 24 hours later sees them at their lowest point? I feel especially exhausted every day from 3pm onwards!

Thank you, I’ll ask for those tests

Jaydee1507 profile image
Jaydee1507Administrator in reply toHopetoheal22

Thats why we suggest to test 24hrs for Levo & 8-12hrs for T3, otherwise its guesswork. Perhaps make a note in your calendar when you are testing to remind you of the timings.

Litatamon profile image
Litatamon in reply toHopetoheal22

Proprioception, not knowing your body in physical space, is a classic symptom of b12 deficiency. This causes walking issues. But gait changes & foot drop are early symptoms on their own.

Do know that the PA test is 50% fallible. Telling you that because bizarrely enough a high majority of doctors are unaware of that fact. You probably should not start supplementing until you have the test. And there are many other reasons for b12 deficiency besides PA. Everything you listed about speaking, feeling weak, remembering and vision can be due to b12 deficiency.

Please do not expect any doctor, including specialists, to understand what b12 deficiency can do to a body. Not only do many not understand but they can make choices that can affect one's outcomes adversely. I will find you some great links and post them below. It is really important that you fully educate yourself, so that you are prepared for doctor's erroneous statements, if the issue is b12 deficiency.

I would also suggest you consider pushing for a sleep study to cross things off as well. Sleep apnea can cause some of the issues listed as well.

Obviously some of these issues can be due to the thyroid, but it is good to cross many possibilities off.

All the best to you.

Outstanding PA/b12 deficiency video -

youtu.be/QqjyAeOLyKM?si=Thv...

Great concise b12 deficiency links, contain medical footnotes -

stichtingb12tekort.nl/engli...

stichtingb12tekort.nl/engli...

stichtingb12tekort.nl/engli...

stichtingb12tekort.nl/engli...

Hopetoheal22 profile image
Hopetoheal22 in reply toLitatamon

Hi Litatamon, thanks so much for your wisdom, information and the video, those poor people 😔 . So important to raise awareness so others don’t suffer like that. Pretty sure I don’t have sleep apnea but then I’m not sure how I’d know 😆

I’ve bought some spray B12 and tablet vitamin B complex so hope that helps.

Thanks again, I hope you’re well

SlowDragon profile image
SlowDragonAdministrator

Currently taking 100mcg levothyroxine and 15mcg liothyronine (10mcg on waking and 5 around 3pm).

Which brand Levo are you taking

Which brand T3

Do you always get same brand at each prescription

Suggest you experiment with taking T3 as 3 x 5mcg per day

5mcg waking, 5mcg mid afternoon and 5mcg at bedtime

many people find last dose at bedtime improves sleep

Or if T3 keeps you awake…..waking, noon and 6pm initially

Try slowing moving last dose towards bedtime 3-4 months later

Day before test always split as 3 doses …….last 5mcg dose T3 at 8-10pm

Ferritin

Continue working on improving low ferritin by increasing red meat to daily. Plus liver or liver pate once a week

Want ferritin nearer 100 for good conversion of Ft4 to Ft3

Would agree that you need small increase in Levo

Push for 25mcg increase……but initially only increase by 12.5mcg daily. Retest in 8-10 weeks

SlowDragon profile image
SlowDragonAdministrator

Low B12 symptoms

b12deficiency.info/signs-an...

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

NICE guidelines on B12 and testing

healthunlocked.com/redirect...

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.

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...

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...

SlowDragon profile image
SlowDragonAdministrator

other things to consider in few weeks/months

Try dairy free diet

Look at testing zinc and selenium like

Also

Vitamin D - are you taking vitamin K2 as well

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...

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 and at least 2 hours away from T3

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...

Hopetoheal22 profile image
Hopetoheal22 in reply toSlowDragon

Thank you so much SlowDragon, very interesting and helpful 🙏 I’ll try those things before I ask for a T4 increase.

Lots of room for improvement in my results.

Not sure which brands, I’ll check but think T3 brand definitely varies.

Thanks again, I really appreciate your help and wisdom, and I hope you’re well 😊

Hopetoheal22 profile image
Hopetoheal22

Thanks so much for your advice and wisdom 🙏 update : endo said my results are fine, which I do agree with - they’re as good as they get for me, but B12 does seem lower than usual so I’ve got some B12 spray and a B complex which I’ll take as you’ve advised, thank you 😃 I guess won’t do any harm? I’ll eat more red meat too 😋

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