Just received my lab results from Blue Horizon. My TSH is still raised but my T4 looks to have increased in last few weeks since increasing dose slowly from 50mcg to 62.5mcg levothyroxine. Does my T3 look Ok? This is my first T3 test.
I’m still feeling quite poorly, have been in bed for nearly 3 weeks now and was worried that I had adrenal issues making me feel so unwell. The cortisol result is marked as normal but I’m not sure how to interpret it fully. I’ll post cortisol result in comments as don’t think I can attach 2 files here.
I’m working on increasing, B12, Iron and Vit D levels using advice given in earlier posts.
Antibodies are also high - does this mean I have hashimotos?
Thanks in advance.
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Your vitamin D is too low. With your result I would supplement with about 4000 iU per day, until you have raised your level to somewhere between 100 - 150 nmol/L. Note there are some people who don't tolerate vitamin D very well (although I haven't read why this might be) so buy a small quantity first, then only buy more if you tolerate it.
Testing magnesium is unreliable. Less than 1% of the body's magnesium is found in the bloodstream, and the body will prioritise keeping magnesium in blood by stealing it from bones, muscles and soft tissues to keep it at the right level, if necessary. Any excess magnesium is excreted via the kidneys if the kidneys are functional. So, you could supplement magnesium if you wanted to, as long as your kidneys are functional.
Serum ferritin level is the biochemical test that most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency. However:
Ferritin levels are difficult to interpret if infection or inflammation is present, as levels can be high even in the presence of iron deficiency.
Ferritin levels may be less reliable in pregnancy.
and to diagnose anaemia (note, haemoglobin is tested as part of a Full Blood Count) :
Anaemia is defined as a haemoglobin (Hb) level two standard deviations below the normal for age and sex.
In men aged over 15 years — Hb below 130 g/L.
In non-pregnant women aged over 15 years — Hb below 120 g/L.
In children aged 12–14 years — Hb below 120 g/L.
In pregnant women — Hb below 110 g/L throughout pregnancy. An Hb level of 110 g/L or more appears adequate in the first trimester, and a level of 105 g/L appears adequate in the second and third trimesters.
Postpartum — below 100 g/L.
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Your folate is a little bit low - I try to keep mine around 20 nmol/L. I supplement with methylfolate at a dose of 1000mcg, about three times a week.
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Your B12 is too low. Active B12 should be somewhere between 100 - 150 pmol/L, Serum B12 should be about 1000mcg/L. I supplement with methylcobalamin at a dose of 1000mcg, about three times a week but my B12 is at a good level for both Serum and Active.
Thank you humanbean. I am taking sublingual B12 daily, alongside a total blood formulation for Iron that contains 45mg elemental iron, B complex and folate. How long should I stay on the sublingual B12?
I bought Vitamin D +K2 drops but haven’t started them yet, is it OK to start this now too?
Do you have any idea how fast your B12 rises with supplementation? I know I absorb it fairly well, so I wouldn't take it for longer than 3 months before a retest if I was actively trying to raise my level. But if your level rises slowly I would retest after 4 - 6 months.
When I just want to maintain my levels I would reduce my dose to 1 or 2 doses a week then retest B12 after 6 months. Once I know my maintenance dose I would test less often e.g. every 9 - 12 months.
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For iron, I would do an iron panel first. It is possible for ferritin to be low while serum iron is high, or vice versa. Different patterns of results can tell you different things about your health.
Note that having high levels of B12 isn't dangerous. But having high levels of serum iron or ferritin is dangerous because the body can't lose excess iron very easily and it is poisonous at high levels.
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
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
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
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.
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.
Thanks SlowDragon. Yes, test was done as per protocol. I’m on 50mcg Accord and 25mcg Mercury Pharma which I cut in half as had panic/ anxiety on full 75mg. Trying to work up slowly, shall I stay on 62.5 for 6 weeks or increase sooner?
Have even started eating liver in an attempt to raise iron 🤢
Antibodies are also high - does this mean I have hashimotos?
Had GP never tested antibodies
Yes confirms 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.
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
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
if 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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Cortisol test
High morning cortisol and T3 (and weight gain)
High cortisol=causing high antibodies?
Cortisol 46 advice please
Tremors and NDT - is there a connection?
