Can anyone help with explaining these results? Been feeling more and more run down, hair loss, weight gain I just can’t shift despite eating well and not a lot, added to which we’ve been unsuccessful in conceiving. Been to the GP several times and fobbed out with various excuses/explanations so finally got private tests done.
Vit D - 53nmol/L
TSH - 3.33mu/L - range 0.27-4.2
T4 - 15.2pmol/L - range 12-22
T3 - 4.6pmol/L - range 3.1-6.8
TPO - 176 iu/ml
Cholesterol - 4.4mmol/L
High dentist lipoprotein - 1.35mmol/L
Non-HDL cholesterol - 3.05mmol/L
Triglycerides - 1.12mmol/L
HbA1c - 29mmol/L
HB - 131g/L
Ferritin 57ug/L
TSAT - 39%
B12 - 141pmol/L
Folate 9.1ug/L
I know the TPO is bad but not entirely sure what to do now, back to the GP, find someone privately?
Thanks in advance.
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Bumblebob
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Raised TPO suggests autoimmune activity attacking your thyroid
But I'd suggest you need to tackle your very low Vit D and folate, is the B12 'active' or 'total'?
Who was the test with? Did it have a range for the folate?
Ferritin is on the low side so worth increasing iron rich foods or asking GP for a full iron panel to see where your iron serum levels are before thinking of supplementing
If attempting to conceive I'm really surprised the GP hasn't told you to take folic acid, though we always recommend methylfolate as it doesn't need converting
Thank you for the reply! Everything with ranges I’ve posted (apart from TPO which was over 35 was out of range). B12 is active and all of that category was marked as ‘normal’.
Our thyroids need good levels of folate, ferritin, B12 and Vit D to create and convert hormones so if these are lower it can have a knock on effect.
To create Vit D you need a reasonable amount of sun exposure without sunscreen ( think its around 20 minutes a day) but we don't all make enough especially at this time of year so supplementing is recommended even in the summer just at a slightly lower dose
The autoimmune attack can often be slowed by cutting out gluten and or dairy which seems to confuse the body for some people, is there any history of autoimmune in the family?
Tested pretty much at 9am, no food but I may have had a cup of tea or at least part of one at that point (skimmed milk no sugar). Not sure how much difference that would make. The test, annoyingly, doesn’t mention anything about timing or fasting.
No, the labs and GP's don't realise what a difference it can make even though it is well known TSH has a circadian rhythm which rises overnight peaking around 9am before dropping off for the rest of the day 😕
It's also always good to replicate the same conditions/ timing with each test making them comparable
I wondered about Vitamin D levels decreasing as we age - I live in Hawaii and play tennis for at least two hours about 5 days a week and have a long beach day regularly and my levels have significantly decreased even with supplements at a higher dose. Appreciate your input 🌺
Mine drops in the summer if I don't supplement and I'm outside a lot 🤷♀️ could be that my magnesium levels were low (everything else was at the time when I found the forum and became enlightened!)
I like the sublingual D3 and it needs to be one with K2 to direct calcium to your bones rather than clogging up your arteries or somewhere else you don't want it.... amazon.co.uk/Anumegeo-Vitam...
Really important to have good levels to protect your bones if pregnancy is around the corner too
I’m a little be unsure about just taking supplements. Surely it’s questionable that so many of my levels are low when overall diet and lifestyle is good? Should I be seeing my usual GP about the TPO level? They have ignored my concerns to this point, and I’ve just dug out two old blood tests which have similar levels of everything (no TPO test) from November last year and March this year. So frustrated
I’m a little be unsure about just taking supplements. Surely it’s questionable that so many of my levels are low when overall diet and lifestyle is good?
Poor vitamin levels are a RESULT of autoimmune thyroid disease
Low thyroid leads to low stomach acid and poor nutrient absorption regardless of how good your diet may be
Low vitamin levels tends to result in lower TSH as thyroid not working well
First step is always to improve low vitamin levels by supplementing to maintain OPTIMAL levels
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's 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
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
GP's generally aren't interested in vits and mins levels unless out of range and they aren't very knowledgeable or forthcoming with suggestions about optimising levels... though nowadays they have realised that taking Vit D year round is recommended but they don't want to provide it and when they do it doesn't contain K2
They ought to acknowledge your raised TPO puts you at a higher risk of becoming hypothyroid but they won't act on it until your TSH is above 10 unless pushed when you have 2 above range results
Autoimmune hypothyroidism is often a very slow loss of function over years
Your other results are all good, cholesterol, glucose, TSAT suggests reasonable iron levels
You'll find that everyone here optimises their vits and mins levels with supplements as it makes such a difference
Yes, it comes as a horrible shock when you realise all the times your tests have come back marked 'Normal' when things can actually be desperately low as their ranges only really flag up when you need crisis care ☹️
Yes it’s a bit depressing the set up in the UK. I spent many years living overseas where there was much more focus on preventative care and optimal health.
Re gluten free/vegan/dairy free etc I am quite strongly opposed to the ultra processed nature of a lot of vegan alternatives from both a health and environmental impact but something to look into, thank you.
Sorry stupid question, the NICE suggest referral to endo for hypothyroid or subclinical but the NICE thresholds are over 10 TSH or over 4TSH. Mine is 3.3 so I’m not going to get anywhere with NHS am I? My GP already requested an endo opinion when my TSH was 2.84 last year after over 6 months TTC and endo said it was a normal level. Sorry if I’m being daft here.
It’s a sad state of affairs we leave things until they’re really bad in this country before addressing them.
Well, it's not just in the UK. It's in other countries, too. But, there's not much else you can do when it comes to autoimmune thyroiditis. There is no treatment or cure for the Hashi's itself. All you can do is take thyroid hormone replacment when you become hypo, to replace the hormone your thyroid can no-longer make enough of. Thyroid hormone replacement is going to have no impact on the disease itself, it will just keep you alive and - hopefully - healthy. But, in order to take thyroid hormone you need to be hypo - no point in starting it before. And as far as most doctors are concerned (they don't have much understanding of thyroid) you are not hypo yet because your TSH is still within the range (they don't understand ranges, either). So, as yet, there's nothing for them to address.
I spent many years living overseas where there was much more focus on preventative care and optimal health.
But there's no way you can prevent Hashi's. Nor can you predict who is going to get it nor what will trigger it.
My GP already requested an endo opinion when my TSH was 2.84 last year after over 6 months TTC and endo said it was a normal level.
Despite his grand title - Endocrinologist - very few endos actually know anything about thyroid. From the title you would imagine that they know all about the endocrine system and all the hormones. But they don't. Most of them are diabetes specialist and know next to nothing about anything else. And very often they make things worse rather than better with their lack of knowledge. So, an endo isn't automatically the right person to see - unless you know of one that comes highly recommended by his patients, not by his fellow doctors. Unless you know of one like that, you're better off without one!
Completely understand your point re Hashimoto’s but as far as I can see the mentality to only treat hypothyroidism when TSH is over 10 (or sometimes between 5-10 ) seems far too late when there are a number of studies that have optimal TSH is below 2.5 (e.g miscarriage rates are higher between 2.6-4 than under 2.5). This is my point on preventative healthcare, why wait until things are really really bad before addressing. Particularly in the case of Hashimoto where, as you say, there is no cure so you will end up hypo but let’s just leave someone to the point they feel truly awful before treating?
Actually, there's no such thing as an 'optimal' TSH, because we're all so different and TSH is so unreliable. But if there were an optimal TSH level, it would be more around 1 than anything else. But I thought you were talking specifically about Hashi's, not thyroid in general.
Part of the root of the problem is that thyroid problems affect mainly women. And doctors just do not take women seriously. This has been discussed on here many times, and most of us have experienced this from time to time. Doctors think all women exaggerate and are whinging attention seekers and hypochondriacs. My worst experience was when I had a back op and they doused the wound in iodine. I am allergic to iodine and the pain was indescribable. But all they said was 'oh, it can't be as painful as all that!' They refuse to believe you can even have symptoms with a TSH below 10! And they are excrutiatingly ignorant about how it all works, what a TSH is, and how it works, and the endocrine system in general. They are also terrified of hormones! All this adds up to incredibly poor care and the desire to diagnose as few people as possible so that they don't have to look after them.
But, you've got me going on my pet peeve, now. And it's hard to shut me up. All I'll say is that I live in France and it's not much better here! I've been hypo since I was about eight years old and no-one even tested my thyroid until I was 55. And during that time I saw a lot of doctors both in the UK and France. And then I was diagnosed by accidnet... But if you want to know more about that, it's all on my profile.
I don’t think it is something to shut up about, I agree with you entirely and more of us should continue to highlight the disparity in women’s health treatment.
I started down this rabbit whole in part because I feel crap but also because of failing to conceive, for nearly 18 months now. Despite raising more than one study showing the link between raised TSH and infertility to my GP he is adamant my levels are fine. Todays discovery of the raised TPO has been a surprise and mind blowing this isn’t/wasn’t tested by my doctor.
I don't suppose he fully understands the significance of the antibodies. And he says your levels are fine because they are all in range and he doesn't understand ranges. If he did but know it your TSH is actually saying hypo, even though it is in range. Can you change doctors or see someone else? They're not all quite as ignorant as this one.
That’s what I’m trying to work out at the moment, the TPO test was private and my TSH has gone up since my last NHS/GP test so will see if they will address it now, if not it’ll be a case of seeing who else I can see. I’m in Wales where it appears there are limited specialists.
She has written books... latest one "The Underactive Thyroid - Do it yourself because your Dr won't" having left the NHS to work privately as she agreed with you about the need to treat people earlier... she is over your way, there are various interviews with her available on youtube... youtube.com/watch?v=Sw_n9Uw...
I missed out on having children due, I'm sure, to my undiagnosed hypothyroidism. My TSH does not rise when fT4 falls (central hypothyroidism) so this diagnosis was missed. (They didn't ever do a full thyroid panel). All other tests and scans couldn't find any problem and my TSH 'said' I was not hypothyroid, though I had been hypothyroid for years... So, inability to carry to term and difficulty conceiving was put down as 'unexplained'.
If your GP was sensible enough to refer you to an endo, they might treat you when you go over 5, a friend has just been given levo when her TSH was around 7, her GP put it down as sub-clinical under-active thyroid.
This is kind of my point - saying you don’t require treatment until you’re already unwell is ridiculous. Fully understand you cannot (at the moment) prevent, slow or reverse Hashimoto’s. That doesn’t mean you need to allow if to complete destroy the thyroid before starting hormone replacement when you know exactly what’s going to happen. Why not start earlier to stay within range? And why on early is 4.5/5 considered the upper acceptable limit when there is a significant body of evidence to show TSH should be much longer in a lot of circumstances e.g. pregnancy? We have a low bar in this country for healthcare. Yes of course there’s places that are far worse, I was born and raised in central Africa so am more than aware of that, but that does not make it right just because someone else isn’t as bad as us.
— sorry this reply was directed at another comment that I can’t see now, apologies I’ve gone wrong somewhere but my point remains —
I don't think doctors wait until the thyroid is completely destroyed. It takes a long time, and you'd be far too ill long before that happened for them to continue ignoring you.
Anyway, we all know that thyroid treatment in most countries is appalling. We're all doing our best to try and improve things, but the medical community just doesn't want to know. They are ignorant, don't believe us and just plain don't care. I don't see how things are going to change. But if you have any ideas, I'm sure we'd all love to hear them.
I think you’ll find getting your vitamin levels up that it will start to help. Going gluten free was a gamechanger for me. Literally turned my health around. I know it’s a major food group and I didn’t want to exclude something so much a part of mainstream diet but most gluten is in highly processed foods and keeping my diet clean makes it a whole lot easier on my immune system.
This info here explains why it’s necessary to consider giving a gluten free diet a go. Some people are giving up gluten and they don’t have to but if you’re having autoimmune issues it’s really important to consider it as a first step -
‘Gluten is a protein in various grains, including wheat, barley, and rye. Gluten contains a protein called gliadin, and the molecular structure of gliadin is very similar to transglutaminase - an enzyme that present throughout the body to make chemical bonds. This enzyme is abundant both in the intestines and in the thyroid. If you have AITD, your body is producing antibodies that attack transglutaminase in the thyroid. (1,2)
When you eat gluten, and the intestines are exposed to gliadin, the gliadin leads to zonulin upregulation, which loosens the tight junctions of the intestines and increases intestinal permeability. This intestinal permeability occurs in ALL persons, regardless of if a person has a gluten sensitivity or not (3). Because intestinal permeability increases, the gliadin is then able to make its way beyond the gut barrier and into the bloodstream.
Because of gliadin’s similar molecular structure to transglutaminase (4), the body may tag it in the bloodstream as a foreign invader that should also be attacked. This may then prompt your body in its heightened state to attack both gliadin and transglutaminase, the enzyme prolific in the thyroid, because of their structural similarities. In other words, whenever gliadin is in the bloodstream, the body may raise an immune response to gliadin and also attack the thyroid.’
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