What do I do next ?: Hello lovely people , I have... - Thyroid UK

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What do I do next ?

Shazamm profile image
7 Replies

Hello lovely people , I have only posted a couple of time before but find all of the knowledge and info on here very helpful. To that end , I hope someone can help. Recent blood results below

TSH 0.01 (0.27-4.20)

Free T4 17.3 (12.0 - 22.0) 53% through range

Free T3 5.1 (1 (3.1 - 6.8) 54.05% through range

Reverse T3 25.0 (10.0 - -24.0)

Iron 14.2 (5.8 - 34.5)

Ferritin 122.00 (13 - 150)

Magnesium &B12 both top end of ranges

I still have many of the usual hypo symptoms , tired, weight gain, constipation etc . I take 100/125 levo (Gp prescribed) and due to poor conversion, 15.65 T3 (self sourced) GP has already tried to reduce levo due to suppressed TSH . Any suggestions on what to change would be gratefully received.

Thank you in advance

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Shazamm
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SlowDragon profile image
SlowDragonAdministrator

was test done as recommended

just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

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

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options 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

is your hypothyroidism autoimmune

Have you tested BOTH TPO And TG antibodies

no B12, folate or vitamin D results

What vitamin supplements are you taking

You probably need dose INCREASE in Levo

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3

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

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

Shazamm profile image
Shazamm in reply toSlowDragon

Hello Slow Dragon, thank you for your reply

Yes Test was at 8.45AM as usual

Vitamin D 102 (50 - 200)

Folate 9.13 (8.83 - 60.8

Vitamin B12 530 (145 - 569)

Active B12 118 (37.5 - 150)

Anti -Thyroglobulin Abs 104 ( <115)

Anti - Thyroidperoxidase Abs 386.0 (<34)

Cortisol (Random) 25.0 (10.0 - 24.0)

I take Zinc 25mg, Vitamin D3 25ug and Omega 3 Fish oil 1000mg in the morning and Magnesium Glycinate X 2 1500mg in the evening. I used to take Selenium but levels came back too high on a blood test some time ago so GP told me to stop taking it

SlowDragon profile image
SlowDragonAdministrator in reply toShazamm

Folate far too low

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance

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...

Shazamm profile image
Shazamm in reply toSlowDragon

thank you , I will try the B vitamins as you suggest . I had coeliac test when I was diagnosed Hashimoto about 10 years ago. It was negative but I tried gluten free for about 4 months and didn’t find that it made any great difference. With regards to your 1st reply and increasing Levo , would you leave T 3 as it is ?

SlowDragon profile image
SlowDragonAdministrator in reply toShazamm

Only change one thing at a time

I would increase levothyroxine perhaps by 50mcg PER WEEK (125mcg 6 days per week and 100mcg once per week)

Retest 6-8 weeks time

Shazamm profile image
Shazamm in reply toSlowDragon

I will give it a try. Thank you so much for taking the time to reply.

SlowDragon profile image
SlowDragonAdministrator in reply toShazamm

Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

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...

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