Hi everyone! I've read many threads and responds in this forum to try to educate myself more, understand and manage my symptoms. I've been experiencing symptoms for years and self-diagnosed myself with Hashimoto through private lab. Fatigue, low heart rate, dizzy spells, anxiety, stomach issues (mild gastritis and esophagitis), and for the past few weeks I have swallowing and breathing issues. Other symptoms are so difficult to describe, such as feeling weird in head. Some days I can't function at all. Been to doctors and they don't seem to worry, so I'm not given any medicines.
This is my recent blood test result, hope to get help on interpreting it. Taken in the morning around 8.30am, fasting.
TSH 1.80 (0.30-4.64)
FT3 4.49 (3.13-6.76)
FT4 18.5 (11.9-21.6)
Anti-TPO 944.9 (<34)
Cortisol 15 (6-28)
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Iron 22.7 (6.6-26)
TIBC 56 (49-77)
UIBC 33 (40-62)
Iron saturation 41% (15-50)
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Vit B12 497 (138-652)
Folate 11.6 (7-46.4)
Ferritin 100.3 (14-233)
Transferrin 28 (16-45)
Vit D 59.4 (50-125)
I notice that UIBC is low. Should I be concerned? I never take iron supplement. For B12 - Folate - D3, could you suggest how much dosage to start now and for how long? Any recommended brands? I read that some took the Better You, so I was thinking to order that. Other brand I have in mind is Jarrow B12 plus Folate. Do you think that this is also a good brand to start? Any other suggestions are welcome.
Thank you so much for your help.
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TheRightSide
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Well, first of all you should know the levels of someone with no thyroid problems (euthyroid).
TSH around 1
FT4 and FT3 round 50% through the range. We always translate to percentages because the ranges vary from lab to lab, so looking at percentages makes it easier to compare results.
So, your TSH is on the high side, but not as high as one might expect with that low FT3. So, one has to ask: at what time of day was the blood draw for this test,
TSH is highest before 9 am, then drops sharply until it's at its lowest around midday. So, we always recommend having the blood draw before 9 am, and before breakfast, because some foods/drinks can affect TSH levels.
Your FT3 is too low, which is what is causing your symptoms, but your FT4 is high-ish. So, one could conclude that you might be coming down from a Hashi's 'hyper' swing, and the TSH hasn't quite caught up yet. The TSH moves more slowly than the thyroid hormone levels.
So, a doctor looking at these results would conclude that you don't need treating because the TSH is well in-range, and that's about all they look at. Although they might possibly look at the FT4 and say, well, that's high, so you don't need anymore - because the usual treatment is levothyroxine, which is T4. They wouldn't look at the FT3 because they rarely know what that is. They don't understand antibodies, and know nothing about symptoms. So, that's why your doctor isn't worried about your results, I'm afraid.
With your high antibodies, your TSH would have to be at least over-range, and/or your FT4 below range, on two consecutive NHS tests. And that can be difficult to acheive because not only antibodies, but all the levels can fluctuate due to the nature of the disease. You just have to catch it at the right time. It's all wrong, of course, but that's the way things stand at the moment, I'm afraid.
Vit B12 497 (138-652)
Lowish. Should be at least over 550. I would suggest taking a B complex, not just B12. The Bs all work together and need to be kept balanced. Thorne Basic B is a good one, or Igennus.
Folate 11.6 (7-46.4)
Could be higher so taking a B complex won't hurt it.
Ferritin 100.3 (14-233)
That's not too bad, and your serum iron is good, so I wouldn't recommend taking iron tablets. Just make sure you get plenty of iron-rich foods in your diet.
Vit D 59.4 (50-125)
This is much too low, of course, but I can't advise about vit D because I don't know much about it. Hopefully, someone else will come along and tell you all you need to know. But, if not, write a new post just asking about that.
Thanks so much greygoose for your help. I just edited the post, the blood was taken in the morning at around 8.30am, fasting. I guess there's no need for me to check this with my GP? Last time it already seems like he couldn't do much and dismissed my issues. Are there any ways to improve the symptoms (considering that all levels can be fluctuating) apart of supplementing and going gluten free or dairy free? And since I'm not taking any medicines, does it mean that I shouldn't bother much about all these symptoms? I'm just worried it could be something else, for example muscle weakness or adrenal things.
Your doctor wouldn't be in the least bit interested in these results because they're all in-range - except the antibodies, and doubtful he knows what these are.
Symptoms can only be improved by addressing what's causing them. And some of them could be caused by your low nutrients, so yes, you do need to optimise them.
And try gluten/dairy-free, see if it help. It may or it many not. But worth a try.
And since I'm not taking any medicines, does it mean that I shouldn't bother much about all these symptoms?
I don't quite see how that follows. Of course you should bother about symptoms. They are your body's way of telling you something is wrong, whether you're taking medication of not. It's just that at the moment, there's not an awful lot you can do about them.
I'm just worried it could be something else, for example muscle weakness or adrenal things.
Yes, that's a pretty common worry. A lot of people find it difficult to believe that a little thing like the thyroid can cause so much havoc. But it can because every single cell in your body needs thyroid hormone to function correctly. So, you will experience muscle weakness, and more than likely adrenal problems, but they're all symptoms of the low thyroid, not separate diseases. And things should improve vastly when you do finally get treatment for the hypothyroidism caused by the Hashi's. But, I'm afraid, we're not there, yet. So, keep on testing at regular intervals, and don't be put off by your doctors lack of interest. He just doesn't know much about it, that's all.
Thanks again for your respond, greygoose very informative. I've read your responds in other posts as well, so much I still don't understand but I'm still learning to understand. Could you explain me more about hyper swing? Since most of my symptoms are difficult to explain, could it be that my "normal" thyroid levels keep on changing during the day (or perhaps every minutes or hours)? Could the super high TPO affect the levels and symptoms as well? Any certain symptoms I should watch out for when they can be signs of thyroid levels are getting worse?
Since most of my symptoms are difficult to explain, could it be that my "normal" thyroid levels keep on changing during the day (or perhaps every minutes or hours)?
What sort of symptoms are difficult to explain? Hypo symptoms can be anywhere and everywhere in the body and brain. And lack of thyroid hormone is the explanation.
No , levels cannot keep on changing during the day, and certainly not every minute or hour. Let me explain what happens...
As I expect you know, with Hashi's, your immune system is attacking, and slowly destroying, you thyroid. During an attack the dying cells deposit their stock of thyroid hormone into the blood causing levels of T4 and T3 to suddenly rise - yes, that bit happens rapidly. And therefore the TSH slowly follows after, becoming suppressed.
The excess hormone then stays in the blood - for how long is anybody's guess - until it is used up or excreted. That happens slowly. But symptoms don't happen rapidly, because to cause hyper symptoms the hormone has to get into the cells - it doesn't do anything in the blood - and getting into the cells happens slowly.
Could the super high TPO affect the levels and symptoms as well?
No. Antibodies don't cause symptoms or affect thyroid hormone levels. They are there to clean up the blood after an immune system attack on the thyroid.
At the same time as the excess leaks from the dying cells, traces of TPO - Thyroid Peroxidase, a protein necessary for making thyroid hormone - also leak into the blood, where it shouldn't be. So, the TPO antibodies come along to supervise its removal. That's all they do.
Any certain symptoms I should watch out for when they can be signs of thyroid levels are getting worse?
Not that I know of, no. But everyone is different, and every hypo has their own personal symptom list. You have to learn to listen to your body. For me, the first sign that my levels have dropped is that I start getting anxious. If I left it too long before increasing my dose, I would start putting on weight pretty rapidly. But that's me. It's probably totally different for you.
Suggestion for how long shall I consume all the supplements? I'm having D3 and B12+folate now
Only add one supplement at a time, then wait 10-14 days to assess before adding another
Starting with vitamin D, then separate B12, then vitamin B complex, followed by magnesium
Retest in 2-3 months after adding last supplement
Remember 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
as to how long need to take, many find it necessary to supplement vitamin D, magnesium and B complex indefinitely
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