Results - advice please

[Sunflower535]

Can I have some advice as to what I should do. Even though my energy levels seem ok, I have been feeling anxious, brain fog, suffering from palpitations and starting to feel low mood too. I wasn't going to get these bloods done until October but then decided I would - regardless of the cost - as I just need to get myself back on track again. I got them done through Medichecks.

I have been taking Selenium and Folate but have stopped the Vitamin D over the summer - not that we had any good weather anyway, but it seems fine I think from memory. I stopped all the vitamins before I got the bloods done for a few days before. I also take Flaxseed Oil Capsules and Magnesium from time to time before bed. I didn't take my Levothyroxine for 24 hours before the test and I fasted before I took the test. The test was done at 9am.

CRP HS - 0.749mg/L Range <3

Ferritin - 64.10 ug/L(Range 30 - 332)

Folate - 19.5 nmol/L - Range >7

Vitamin B12 Active 111.0 pmol/L Range > 37.5

Vitamin D - 156 - Range 50 - 250

TSH 3.280 - Range 0.27 - 4.2

Free T3 - 3.9 Range 3.1 - 6.8

Free Throxine - 21.2 - Range 12 - 22

Thyroglobulin Antibodies 226 - range 0 - 115

TPO - 476 - range - - 34

[pennyannie]

Hello Sunflower :

Once on any form of thyroid hormone replacement the TSH needs to be kept under 2 - and hypothyroid symptoms start developing once the TSH rises above 3 -

Years ago treatment for hypothyroidism started once the TSH rose over 3 :

Since you are with Hashimoto's a thyroid Auto Immune disease you will probably feel better when your TSH is down under 1 and towards the bottom of the range and once on any form of thyroid hormone replacement we should be dosed and monitored by our Free T3 and Free T4 and not a TSH seen in isolation -

though I am fully aware in primary care the TSH is deemed the gold standard - with a T4 reading once in a while and a Free T3 mission impossible.

We generally feel best when the T4 is up in its top quadrant at around 80% with the T3 tracking just behind at around 60/70% through its range at around a 1/4 ratio T3/T4.

Currently your T4 is 91% with your T3 at just under 22% through its range - showing you struggling to convert the T4 into T3 :

Your vitamins and minerals are good - maybe try and get ferritin up over 100 -

Both sets of thyroid antibodies are over range - and your thyroid is becoming further disabled by this AI disease.

Do you have any stomach/gut issues as many with Hashimoto's find they have some level of food intolerance and feel improved restricting gluten, dairy, wheat etc - with many following the research and suggestions of Dr Izabella Wentz who writes as thyroidpharmacist.com

Conversion of T4 into T3 is also down regulated by inflammation, antibodies, any physiological stress ( emotional or physical ) depression, dieting and ageing.

The logical solution is to reduce down your T4 dose a little but add in a small dose of T3 to restore thyroidal hormones and your health and well being.

Looking back I see you had to insist of seeing a consultant to get prescribed T4 :

So I think we are back at square 1 now and need a referral to an endocrinologist.

There is something of a post code lottery within the UK - where some ICB areas are putting financial constraint on NHS trusts rather than recognising and treating medical need.

If you go into openprescribing.net you can see by area and or surgery how supportive your area is, compared to others, in prescribing T3 - Liothyronine.

Obviously if you can afford to go privately there is a very different landscape.

Thyroid UK - the charity who support this forum have a list of recommended endos and thyroid specialists both NHS and Private so just email admin@ thyroiduk.org and many are still open to video consults so distance need not now be an issue.

Similarly Roseway Pharmacy - detailed on the Thyroid Uk Pharmacy page - now offer a consult service ( much cheaper than seeing a specialist ) and prescribes all the thyroid hormone treatment options.

[Sunflower535 in reply to pennyannie]

Thanks. What can I do to improve Ferritin.

[pennyannie in reply to Sunflower535]

Well you could increase your intake of meat especially liver.

There are numerous supplements available OTC - but if you go this route maybe select an iron bisglycinate option - sometimes marketed as a Gentle Iron as it will be ' kinder ' of your stomach -

There have been positive reviews on here about the Three Arrows iron supplement :

[Sunflower535]

Thanks pennyannie. Maybe try eating more meat. My stomach isn't great at times. Don't think I'll ever be able to afford to be seen privately so it looks like I'm going to have to struggle on. I have watched a few you tube videos that say you can reverse the autoimmune end of things by diet. Anything is worth a try especially if it could mean I could avoid medication altogether. I need to research more. Thanks for taking time to reply.