New results - opinions please: Hi all, Got my... - Thyroid UK

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New results - opinions please

Griffo_•

8 months ago•5 Replies

Hi all,

Got my bloods done again. For this round I was taking 100mcg of levo monday - friday and then 75mcg on the weekend.

Other things I'm taking are:

- Omega 3 supplement

- 50 mcg B12

- 3000iu vitamin D

The dr has now put me on 100mcg for all days of the week:

Thyroid

Free Thyroxine: 13.78 pmol/l [10.4 - 19.4]

Thyroid Stimulating Hormone: 3.895 mIU/l [0.55 - 4.78]

Free T3: 4.45 pmol/L [2.6 - 7.1]

Thyroid Peroxidase Antibodies: > 1300 U/ml [<60 H]

Thyroglobulin Antibody: 1.2 U/ml [<4.4]

Triiodothyronine (T3): 1.41 ng/ml [0.6 - 1.81]

T4: 105 nmol/L [59 - 154]

Nutritional Health

Zinc: 18.2 μmol/l [11.1 - 19.5]

Folic Acid: 12.3 μg/l [3.8 - 26.8]

Vitamin B12: 499 ng/l [197 - 771]

Magnesium: 0.831 mmol/l [0.700 - 1.100]

Bone Health

25-OH Vitamin D: 82 nmol/l [50 - 375]

Corrected Calcium: 2.35 mmol/l [2.20 - 2.60]

Liver Health

Albumin: 45.9 g/l [35.0 - 50.0]

Iron Status

Iron: 16.7 μmol/l [5.8 - 34.5]

Ferritin: 28.77 μg/l [19.999 - 300]

Transferrin: 2.41 g/l [2.00 - 3.80]

Transferrin Saturation: 27.7 % [20.0 - 50.0]

Total Iron Binding Capacity: 60.2 μmol/l [44.8 - 80.6]

I'll get it tested again in a couple of months after being on 100mcg daily again.

Drs comments:

RE: thyroid - "Even though your thyroid hormones look stable and within normal range your TPO antibodies remain raised, do you think it might be a good idea to get an opinion/ reassurance from an endocrinologist soon?"

RE: Vitamins and everything else - "As you can see below your vitamins and minerals are all within normal limits, your vit D might be optimised by pushing it to 100 although it is OK at 82. In addition your iron and transferrin are in range but low in range, maybe a month of multivitamins with iron would help to increase this level slightly."

I still aren't sure what an endo will do, but I guess i'm happy to see one. I was ready to get a referral to Dr Annice Mukherjee, but nobody messaged with their experience seeing her.

I don't consider my hormones to be ideal, as i'm still very symptomatic. I was ok, but recently i've been having anxiety and nausea again, and i'm not sure if relevant, but my brain is like a cabbage! I can't remember anything!

Love to hear your thoughts guys!

Thank you so much

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SlowDragonAdministrator8 months ago

well you’re likely to need further increase in Levo

Just increasing by 50mcg per week isn’t going to improve your levels much

How much do you weigh in kilo

You could request increase to 125mcg 3 days per week and 100mcg 4 days

Retest in 6-8 weeks

Free T4 (fT4) 13.78 pmol/L (10.4 - 19.4) 37.6%

Free T3 (fT3) 4.46 pmol/L (2.6 - 7.1) 41.3%

Most people on just Levo, when adequately treated will have Ft4 at least 70% through range

Guidelines of dose Levo by weight

approx how much do you weigh in kilo

Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)

cks.nice.org.uk/topics/hypo...

bnf.nice.org.uk/drugs/levot...

Some people need a bit less than guidelines, some a bit more

Ferritin is deficient

Are you vegetarian or vegan?

Are you now on iron supplements?

High thyroid antibodies confirms autoimmune thyroid disease (hashimoto’s)

Have you had coeliac blood test

Are you on gluten free diet

Griffo_• in reply toSlowDragon8 months ago

Thank you for the reply SlowDragon !

I'll request the increase you mentioned. To answer your questions:

Approx how much do you weigh in kilo?

I weight around 75kg

Are you vegetarian or vegan?

Vegan

Are you now on iron supplements?

No. I was taking a 5mg spray by BetterYou. Should I give that a go again?

Have you had coeliac blood test?

Yes. It was negative. Dr said that I could possibly still have an intolerance to gluten though.

Are you on gluten free diet?

No. I'm trying to have as little gluten as possible though. Should I try a completely gluten free diet?

Thanks!

SlowDragonAdministrator• in reply toGriffo_8 months ago

75kg suggests eventual daily dose of approximately 120mcg Levo

As a vegan with Hashimoto’s you are always going to struggle with iron/ferritin

Likely to need to supplement virtually continuously

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

If taking any iron supplements stop 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods like pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue

healthunlocked.com/thyroidu...

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:

Females 18 ≤ age < 40. 30 to 180

Females 40 ≤ age < 50. 30 to 207

Females 50 ≤ age < 60. 30 to 264l

Females Age ≥ 60. 30 to 332

Males 18 ≤ age < 40 30 to 442

Males Age ≥ 40 30 to 518

The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.

Griffo_• in reply toSlowDragon8 months ago

Thank you. One thing i find really odd is that i've been taking 3000iu of vitamin D and I have lower levels of vitamin D now than previously when I either took none, or took 1000iu.

EDIT - In fact, it's the lowest it has been since I first tested in August last year.

Also, one thing I've forgot to mention SlowDragon is that I've been going to the gym 5 times a week and also trying to lose weight (well, lose fat). Does this generally mean you need more thyroid hormones as i'm more active?

SlowDragonAdministrator• in reply toGriffo_8 months ago

Which vitamin D are you taking

A tablet or mouth spray

Common with Hashimoto’s to need higher dose vitamin D, plus a separate magnesium supplement

Try increasing to 4000iu daily and retest in 2-3 months

You may need higher dose in winter

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