Bloodtest results help understand

[Tinyowl99]

Hi all you lovely people Got my blood results back followed protocol as usual could anyone help with results please

I've got more results to add but new to this and don't know how to add them all could anyone help please

[FallingInReverse]

Hi Tinyowl, you can add more pictures by adding a reply (like this one). You can add only one picture per reply, but you can add as many replies as you need.

[Tinyowl99]

Thanyou I feel silly not knowing how it works I have 4 pages to add

More test results

[FallingInReverse in reply to Tinyowl99]

Great! So that’s 2 you’ve added. You said you age. 4. Add the other 2 you have - one per reply.

Hoping you have a free t4 and a free t3 in there?

[SlowDragon Administrator]

Hopefully you have also had tested

Vitamin D, folate, B12 and ferritin

Ft4 and Ft3

TSH 2.83

Was test done early morning for highest TSH

Looking at previous post you are on levothyroxine

Your current levothyroxine dose is

125mcg 4 days aweek & 150mcg 3 days a week for last 2 months

which brand of levothyroxine

Do you always get same brand

Exactly what vitamin supplements are you taking

Have you had coeliac blood test

Are you on gluten free or dairy free diet

[Tinyowl99 in reply to SlowDragon]

Thank you for your help your so kind I'm on levothyroxine 125mcg 4 days a week & 150mcg 3 days a week same as you I always have accord because I have bad reactions to the fillers but done this over 3 months slowly I was on 100mcg but went back down to 75mcg because my hair was falling out on different makes and by 3 washers I had a freezer bag full of hair I feel no different on 75mcg to 150mcg apart from I feel worse on 150mcg more joint pain extreme fatigue weight gain bloated constipation heartburn heart palpitations stiffness dry skin very low sex drive swollen legs feet tummy hands and arms sweating brain fog just to name a few I also have body shaking inside as if your nervous or starving all the time and bad headaches im so fedup with it all thank you for all been so kind

Blood results

[SlowDragon Administrator in reply to Tinyowl99]

Next step is to get FULL thyroid and vitamin testing

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

presumably it is?

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.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

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

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common as we get older

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

What vitamin supplements are you taking

Also VERY important to test TSH, Ft4 and Ft3 together

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

Test day AFTER taking 125mcg

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

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

[SlowDragon Administrator in reply to Tinyowl99]

assuming your hypothyroidism is autoimmune

You need coeliac blood test via GP

as per NICE Guidelines if not already on gluten free diet

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

Or buy a test online, about £20

Hashimoto's frequently 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

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...

[pennyannie]

Hello Tinyowl ;

Once on thyroid hormone replacement we generally feel best when the TSH is towards the bottom end of the range and likely under 1 -

and think the guidelines suggest that once on T4 thyroid hormone replacement the TSH should be maintained under 2.

You will be experiencing hypothyroidism with a TSH over 2 and years ago treatment was started when the TSH was 3 or over -

Your current TSH reading of 2.83 and much too high and considering you have been on doses up to 150 mcg T4 daily - am questioning if you have issues absorbing the tablets -

and here is a liquid of T4 :

We generally feel best when the T4 is in the top quadrant of its range with the T3 tracking just behind at around 60/70% :

Currently your T4 is at around 70% with your T3 coming in at only 32% through it's range.

The accepted conversion ratio - when on T4 only - is said to be 1 / 3.50 - 4.50 T3/T4 with most people feeling at their est when they come in this little ratio at 4 or under - so if I divide your T4 by your T3 - i'm getting your conversion coming in at 4.42 - so a little wide of the centre - and confirming you are struggling to convert the T4 - Levothyroxine.

I now aim to maintain ferritin at around 100 - folate at 20 - active B12 around 125 ( serum B12 500++ ) and vitamin D at around 125.

Conversion can also be compromised by any physiological stress ( emotional or physical ) antibodies, inflammation, depression, dieting and ageing -

I can't see the other vitamins and minerals nor inflammation or antibodies -

I had alopecia around the time of the 11 plus - and have some idea how upsetting this can be - it's likely a combo of auto immune issues and low iron stores - but I can't see any details on these -

White blood count and neutrophil count both a little high - but I don't know enough to say much other than your body is under stress with much inflammation which you already are well aware of.

Has your doctor any thoughts on this print out ?

[Tinyowl99 in reply to pennyannie]

Thank you pennyannie I haven't spoken to doctor yet but she didnt want to see me unless she thought there was a problem with my results!!!!

I asked her to do my TSH Free T3 Free T4 antibodies inflammation ferritin folate B12 Vitamin D iron & full vitamins & minerals but to me it doesn't look like she as done them all. I asked about liquid T4 but she didn't answer me

I take folic acid 5mg

Better you D3 & K3 spray 3 sprays

Selenium 200 mg

magnesium citrate 444 mg & vitamin B complex

cod liver oil

I stopped these a week before bloods

I have graves disease don't know if that changers since I had radioactive iodine doctor nor endocrinology tell you anything just don't seam to be getting any where with them endocrinology just says TSH in range and fobs me off with its menopause or fibromyalgia i'm getting to point where I give up with them they just seam to want me to stay filling like this

Someone as said it doesn't look like i convert my T4 to T3 very good which I told doctor but to be honest I don't think she knows anything about thyroids the two doctors that did have left the practice all she says is lets get you better

Someone suggested I give a note to doctor when i go with all bloods I want doing & see what she says or do I just pay private and get them over and done with

I feel I don't have the energy to keep getting nowhere with them

A lot of stuff I don't understand & feel like I'm just learning from books & what I read on here

I've had Coeliac test which came back negative I have high cholesterol & now they telling them to which what I eat because I could become diabetic where does it stop

[pennyannie in reply to Tinyowl99]

Hey there :

Well there is a problem and you need to see her -

You are not converting well the T4 into T3 and increasing the Levothyroxine is not solving the problem - but making you more unwell - your body aches and throbs, you can't think straight and at risk of loosing your job and you have no energy to keep going.

My doctor refused to run the blood tests for me - I used Medichecks as they sent a nurse to my home to draw the blood as I was in no fit state to go anywhere - with crippling brain fog and anxiety.

I did manage to get referred back to endocrinology - first time since RAI thyroid ablation in 2005 - and also had to have an endoscopy and colonoscopy as my ferritin was at 22 -

anyway in the time it took for all these appointments to come through - back in 2017/18 - I started working on myself and reading up as best I could - I have dyslexia and that was off the scale - and ended writing out everything I thought relevant several times over - like learning a script - and recited it all out loud to myself and things started to register and make sense and reading this forum daily reinforced my understanding.

By this time I had decided that if the NHS were not prepared to help me I would do it for myself - and I've been self medicating since 2018 and much improved.

So - first off your doctor can't initiate anything other than request / action liquid T4 - and you need a referral back to the hospital endocrinology department :

The good news is your TSH is in the range - as this was used against me as mine was stuck down at 0.01 and given as the reason I could not trial T3 :

You will do better with a small dose of T3 ( which is around 4 times more potent than T4 ) and a reduction in your T4 dose -

Your thyroid - when well - would have been supporting you on a daily basis with around 10 mcg T3 + 100 mcg T4 daily - so this gives you an idea where you might start feeling better -

but first off we need the ferritin, folate, B12 and vitamin D at good solid levels and you can start working on these yourself in preparation for switching to a combination of T3 / T4 thyroid hormone replacement.

There are a couple of books I forced myself to read and reread - with pencil and ruler to underline and mark as I ploughed through them -

Your Thyroid and How To Keep It Healthy - written by a doctor Barry Durrant-Peatfield - to enable patients to better advocate for themselves -

and Elaine Moore's first book - Graves Disease A Practical Guide - though we now have her website which you may find easier - elaine-moore.com

Obviously if you can afford to go privately there is less of a mountain to climb -

but first off we do need optimal core strength vitamins and minerals of ferritin, folate, B12 and vitamin D - while you read up and consider your next best move.

Thyroid UK the charity who supports this patient to patient open forum hold a list of Private / NHS endo and thyroid specialists - maybe get the list - see who's is there - ask for feedback on anyone - and just consider all the options while you rebuild your basic core strength which has likely been ravaged by the RAI.

[Tinyowl99 in reply to pennyannie]

Hi pennyannie thankyou for you reply I will try getting back in to see my doctor this week I'm waiting for appointment to go to see my endocrinology sometime in August he doesn't believe in T3 medication I asked him last time and shut me off point blank really I should of asked who I could be referred to but I doubt he will give me any information as he wouldn't even talk about T3 medication he doesn't believe it's my thyroids that are making me feel like this because he say levels are in range and would normally just refer me back to doctor but because I told him all my symptoms and said I wasn't happy he would do more tests and see me again.Which still hasn't helped me the more levothyroxine I take the more symptoms I get I can't even get through the day without been completely exhausted even just small jobs are a big task for me my normal self would be clean house top to bottom in 2 days now its over 7days

How do I strengthen my vitamin what is the optimum level the vitamins need to be at or is everyone different and how do I look for endocrinology that would help with T3 & T4 thankyou

[pennyannie in reply to Tinyowl99]

I know now I need my ferritin at around 100 - folate around 20 - active B12 125 ( serum B12 500++ ) and vitamin D ar around 125.

If you go into openprescribing.net - and then go into analyse - you can find out by surgery and / or ICB area how supportive your area is in writing prescriptions for T3 or Natural Desiccated Thyroid -

but I'm not aware there is a facility to see if new prescriptions are being written as opposed to just honouring existing prescriptions - but you can get an idea by the numbers month on month over a period of months.

For T3 just enter - Liothyronine as the drug and then look again and for NDT - enter Armour as the drug which is the leading the brand the NHS is meant to prescribe :

[Tinyowl99 in reply to pennyannie]

Do you take high dosage to get your levels up and do you take them individual do you do it with food & vitamin tablets i know my doctors did prescriptions for Liothyronine but my hospital doesn't support it I cant seam to get it to work this time talk about brain fog most days I cant even function.

I don't even know what to say to my doctor other than

my vitamin levels are to low

I'm not converting my T4 to T3 very well

which I have already said to her

I also asked for T4 liquid

how would you approach this

sorry i feel so useless and not really sure if i'm using or replying on site correctly i'm not great with technology think i need lessons lol

I will order these books I have ordered a few but like you I have to keep going over them and under line parts

[pennyannie in reply to Tinyowl99]

If your vitamins and minerals are in the NHS ranges your doctor is not obliged to help you -

I originally supplemented all 4 vitamins and minerals individually with high doses to build up my core strength -

now I'm able to maintain ferritin by eating liver weekly -

and take tablets for the B12 , folate and vitamin D.

Your vitamin D at 63 needs building up to around 125

and I can't see results for ferritin, folate or B12 :

[Tinyowl99 in reply to pennyannie]

Thank you pennyannie sorry I've had trouble getting back on site ferritin 64ug/L (15.0-150.0)

Folate I can't see it last July I was low on this and given supplements by doctor since then I've taken everyday

B12 blank

under it is Serum vitamin B12 level (xe2pf) 582(197-771.0)

I think I'm going to have to do it with better for you iron spray as I can't stand the smell of liver or kidney to get my ferritin levels up

I managed to speak to another doctor which I wasn't happy about specially when i felt like the other doctor was starting to listen to me this one thinks there more going on then just my thyroids there trying to fob me off with fibromyalgia & menopause I don't think she had aclue she told me to stay on same dose till I see endocrinology next because my tsh level low!!! according to her but with my level still been high in range than should be I'm going to try going up to four days at 150mcg she as referred me for a second opinion to King's Mill hospital if anyone know what endocrinology like that would be great I just want to feel some what normal with no banging headache everyday and getting up refreshed after sleep instead of not feeling more tired than when I went to bed

[FallingInReverse]

One minor question - are you actually taking 1480 mg of magnesium … daily? Or is that a typo?

[Tinyowl99 in reply to FallingInReverse]

Hi FallinginReverse ye sorry was over type just edited it it should of been 444mg this is what is says in the bottle