I wondered if anyone could help me out with interpreting the results I've just obtained from Blue Horizons, please?
Blood taken at 9am (earliest I could book nurse, as I failed to draw blood successfully myself), after fasting. I take 100mg Levothyroxine (in the night, well after and before food and any supplements). I stopped taking all vitamin supplements 2 weeks before blood was drawn for the results below.
I've previously been diagnosed with Hashimoto's. My levothyroxine brand is 'accord', and I've been on this brand for many years.
I opted for the more comprehensive blood test due to my symptoms of fatigue, brain fog and low mood. These could be due to perimenopause, but I'd rather check the below before considering HRT.
Thankyou in advance for your time.
TSH - 3.78 mlU/L
Free T4 - 14.9 pmol/L
Free T3 - 3.6 pmol/L
T4 Total - 74.4 nmol/L
Anti Thyroglobulin - 167 IU/mL
Anti Thyroidperoxidase - 180 IU/mL
Cortisol (random) - 241.0
Vitamin D - 53 nmol/L
Magnesium - 0.9 mmol/L
CRP (no idea what this is) - 1.41 mg/L
Ferritin - 71.10 Mg/L
Serum Folate - 57.70 Mg/L
Active B12 - 81 pmol/L
My previous (NHS) results from 2023 were:
TSH - 1.8mu/L
Serum Vitamin B12 - 382 ng/L
Serum Ferratin - 65 ug/L
Serum Folate - 16.1 ug/L
Magnesium - 0.84 mmol/L
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BornFlippy
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Can you add reference ranges for each test. Ranges vary between labs so are important to quote.
Your very low FT3 is likely the cause of many of your symptoms.
Yorur TSH is far too high and FT4 & FT3 look low. You likely need a dose increase of 25mcgs then retest in 6-8 weeks. You may need to be persuasive with your GP in a nice way.
Point out to them the suggested starting dose in NICE guidelines of 1.6 x weight in kilos = approx final dose.
You only need to stop a B complex that contains biotin maximum 7 days before your test, otherwise you are losing out on the benefit of it. You can replace the B12 & folate during that time with separate supplements.
Vit D is too low. How much are you taking? Most people need a minimum of 3,000ius a day.
Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Many members like the ‘Better You’ range of mouth sprays that contain both bit D & K2. Use this calculator to work out how much to take to get your level to 100-150.grassrootshealth.net/projec...
B12 & folate are good.
Ferritin is not bad but could be improved slightly. 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
Thanks so much Jaydee1507 . I didn't realise the reference levels were important; I assumed they were consistent. I will post again with the info i have. I was taking 'Wassen' selenium A,C & D, which has 5ug of vitamin D. I will seek out the 'better you' range - thanks so much for that recommendation.
I struggle to eat iron rich food, as we're a pescatarian family - I'll check out the link you've provided to see what I can do there. Is there a recomended brand for iron? I currently use Vitabiotocs 'Feroglobin'.
I suspect I will have to try very hard to persuade my GP, as they've refused to increase my Thyroxine in the past when my TSH has been higher (e.g. 4.6).
May I please ask what the FT3 and 4 should be? I feel I need to walk into my GP appointment with some information about this, as they do not test for either of these.
Thanks again - repost of results with reference ranges in brackets below:
TSH - 3.78 mlU/L (Ref 0.27 - 4.20)
Free T4 - 14.9 pmol/L (ref: 12:00 - 22.00)
Free T3 - 3.6 pmol/L (ref: 3.1 - 6.8)
T4 Total - 74.4 nmol/L (ref: 66 - 181)
Anti Thyroglobulin - 167 IU/mL (ref: less than 115)
Anti Thyroidperoxidase - 180 IU/mL (ref: less than 34)
Cortisol (random) - 241.0 (ref: 73.8 - 507.0)
Vitamin D - 53 nmol/L (ref: 50 - 200)
Magnesium - 0.9 mmol/L (ref: 0.7 - 1.0)
CRP (no idea what this is) - 1.41 mg/L (ref: less than 5.0)
CRP is an inflammation marker. Yours appears to be low which is good.
As far as persuading GP you need an increase you just mustn't give up asking. Keep trying different doctors, ask for it as a trial which often goes down well.
Long term you may need some T3 added but for now you need to get Levo increased and raise your FT4 level.
Your frees are very low, T4 29% and T3 just 13% through ranges.It’s recommended on here that both be around 3/4 through range and that TSH be under 1 or at least under 2.The fatigue and brain fog are very typical of low T3.Your ready for levo increase to 125mcg.As you have already found out you are in for a fight with the GP regarding this as you have been refused an increase before with a higher TSH.
Anti Thyroglobulin - 167 IU/mL (ref: less than 115)
Anti Thyroidperoxidase - 180 IU/mL (ref: less than 34)
These confirm the cause of your hypothyroidism is autoimmune
TG antibodies should slowly reduce as dose Levo is increased
TPO antibodies often reduce on gluten free/dairy free diet
Assuming you aren’t already on gluten free diet
Has GP tested for coeliac disease at diagnosis of Hashimoto’s?
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
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
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
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
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