Any advice for raised cholesterol and high antibodies please?

[CirceBaby]

Hello,

TSH 0.44 mIU/L (0.55 - 4.78) -2.6%

Free T4 (fT4) 1.55 pmol/L (0.89 - 1.76) 75.9%

Free T3 (fT3) 2.74 pmol/L (2.3 - 4.2) 23.2%

T4:T3 Ratio 0.566 

Thyroglobulin Antibodies (TgAb) 3.7 IU/mL (≤ 4.5)

Thyroid Peroxidase Antibodies (TPO) 1292.1 IU/mL (≤ 60)

C-Reactive Protein (CRP) 0.5 mg/L (≤ 10)

Folate - Serum 36.10 ug/L (≥ 5.38)

Vitamin B12 800 nmol/L (211 - 911) 84.1%

Vitamin D 99.86 nmol/L (30.00 - 100.00) 99.8%

Ferritin 55.4 ug/L (10.00 - 291.00) 16.2%

These are my latest results taken at 9.15 am prior to eating, on water only. I’m taking 75mcg of levo brand Eutirox ( I’m in Spain). I’ve improved my vit D since my last test, when I was under range.Since my last test, about 8 weeks ago, I have been eating liver at least three times a week, as well as some red meat, with an orange or juice for better absorption. I’ve improved my ferritin ( from 49.70) and folate ( from 17.88). But my total, ldl and hdl cholesterol levels have risen, with total cholesterol at 220 ( <200). I take Igennus super b complex, vit D3 and K2, berberine and rhodiola. Some other tests out of range:

Creatine/urine 0.27 ( 0.60-1.80), urine analysis 1.006 (1.010-1.030), transferrin 194 (250-380), bilirubin indirect ( 0.27-0.85). Should I be concerned about any of these?

I have a dry mouth and eyes, and what feels like nerve damage @ shoulders, neck, hands and feet most of the time. I have occasional stabbing pain under my right shoulder blade, I think relating to food intolerance. Since beginning of Jan I developed right knee and right wrist problems, weak and painful but not every day.

I have an appointment with an endo on the 23rd of Jan. This will be my second appointment with this one, but in my experience I seem to have a lot of tests done, then the doctors have no idea how to interpret them.

If you have any advice on how to reduce my high antibodies I’d be really grateful. I’m eating a clean diet- sugar, alcohol, caffeine, grain, and dairy free. Though I’ve recently introduced L. Reuteri dairy yoghurt, which doesn’t seem to be adversely affecting me, though I can’t be sure. I used dairy as I can’t get the right milk brands here to make coconut yoghurt and my attempt at cashew L. Reuteri was inedible. I have lost a little weight since starting on eutirox but have lost quite a bit of muscle mass. I walk and have better energy but not enough to do weights or yoga, especially with the nerve damage pains.

Sorry for the length of the post- I’m just trying to give as much info at the start as I can. Looking forward to any advice if you are able to respond. Thankyou.

[SlowDragon Administrator]

These are my latest results taken at 9.15 am prior to eating, on water only.

Was last dose levothyroxine 24 hours before

How much do you weigh in kilo?

You say that you are grain free, are you checking for hidden gluten in ingredients

Keep working on improving ferritin

Vitamin D

Vitamin D 99.86 nmol/L (30.00 - 100.00) 99.8%

Was this test done in Spain as result will be ng/ml

In Spain the units are ng/ml not Nmol

And if your result is 99ng/ml that’s very high

How much vitamin D have you been taking

99ng/ml = 247nmol

Suggest you stop vitamin D for at least 2-3 weeks

Then restart at much lower dose

[CirceBaby in reply to SlowDragon]

Vit D is 99.86 mg/mL. I’ve been taking 10,000 IE daily.

[SlowDragon Administrator in reply to CirceBaby]

So that Vitamin D is much too high

Suggest you stop for a month

Restart at perhaps 3000iu daily

Retest 3-4 months time

Too much Vitamin D is toxic

Test twice a year

healthunlocked.com/thyroidu...

Interesting info that too much vitamin D can be an issue

Vitamin D over 200nmol ( 80ngml )

Too much vitamin D will affect gut bacteria/biome

See discussion at 2hour through video

youtu.be/n1Qm5x7Lxgc(Not working as expected?)

Taking too much vitamin D is not a good idea

chriskresser.com/vitamin-d-...

[CirceBaby in reply to SlowDragon]

I cook everything from scratch, so don’t think I’m getting hidden gluten. I was supposed to test for celiac at this last test, but after trying three days of eating gluten in prep for the test, I abandoned the idea. I knew that 6-8 weeks of eating gluten prior to testing wouldn’t work for me.

[CirceBaby in reply to SlowDragon]

I weigh 46kgs

[greygoose]

There's a 99.9% chance that your high cholesterol is due to your very low FT3. Raise the FT3 level and the cholesterol should drop. Cholesterol is made in the liver and has little to do with diet.

High antibodies are just an indication that you have autoimmune thyroid disease. Lowering them will not help you - even if you could - because they are the result of the disease, not the cause. Do you know how Hashi's 'works'? They have a job to do keeping the blood clean, so I'm not even sure that trying to reduce them is a good idea. They are not attacking your thyroid, they are not attacking anything. Just keeping the place tidy.

[CirceBaby in reply to greygoose]

Thanks for your reply 😁That’s interesting about the antibodies. Maybe I should have said how to reduce my autoimmune response?! I suppose I’ve just been looking at how to improve my levels of. Ferritin, folate, etc. as advised from my last post. Not considering my levels of thyroid hormones I’ve never been diagnosed with Hashimoto disease, but I do have Graves’ disease, and have since been on eutirox since July 2024, after RAI in March 2024.

How would you suggest I or my doctor try to increase my FT3?

[greygoose in reply to CirceBaby]

You cannot reduce your autoimmune response. At least, as things stand at the moment no-one knows how to do it. Maybe one day...

But as you don't have a thyroid, your autimmune response isn't going to affect you, anyway.

Free T4 (fT4) 1.55 pmol/L (0.89 - 1.76) 75.9%

Free T3 (fT3) 2.74 pmol/L (2.3 - 4.2) 23.2%

According to those results, you are a very poor converter. You do have some room to increase your levo but your conversion rate is so bad that is not going to raise your FT3 enough to make you well. And I very much doubt that optimising your nutrients is going to do anything for your conversion, either, it's too bad. So, the only thing you can do is to procure some T3 and that that along with your levo. Levo alone is never going to make you well.

[CirceBaby in reply to greygoose]

Could you please tell me how much T3 / liothyonine (or NDT) and T4 I should start with, given these results? If possible I will get a Spanish prescription and will try to fulfil it in the Uk using the list of pharmacies. Or else I’ll try sourcing privately with recommendations from members here.

[greygoose in reply to CirceBaby]

If I were you, I wouldn't change your levo at all, given that result. Endos always want to reduce the dose, but taking T3 will reduce your FT4 anyway, so best to keep on the same dose.

For the T3, you follow the protocol for taking any hormones: start low and increase slowly. With T3 that means starting on 5 mcg (or 6.25 mcg, depending on the size of the pill) and staying on it for at least two weeks before increase by 5 (or 6.25). And see how you go from there. But always hold for six weeks on the same dose before retesting.

[CirceBaby in reply to greygoose]

Hello greygoose, well you were right, my doctor wants to me to reduce my weekly levo to 5 days @ 75mcg and 2 days @ 50mcg . She says the results tell her I’m being over treated, and there’s no need for a trial of T3. She is happy with my ferritin level at 55,40 despite that half my hair has fallen out since starting levo. She never once asked how I’m feeling or if I felt improved in any way! She wants me to see a haematologist as some other blood results are concerning her a little.

I think will stay as I am as per your advice and add in Liothyronine in a few weeks when I can get some.

Thanks for your help.

[greygoose in reply to CirceBaby]

Oh dear. They really haven't got a clue, have they!

[CirceBaby]

Thankyou for your reply Greygoose. I thought conversion might be the problem about six months ago, especially after 2 RAI treatments, but in the absence of finding a doctor to prescribe T3, I concentrated on nutrient optimisation. The doctor I have the upcoming appointment with said she would consider prescribing it if I needed it, but the difficulty would be in sourcing it. I think maybe that means it’s not available through pharmacies here in Spain.

[greygoose in reply to CirceBaby]

No, I don't think Spanish pharmacies do carry T3. Probably the nearest pharmacy would be in France, but I don't know if they would accept a Spanish prescription. French pharmacists are a funny lot!

[CirceBaby in reply to greygoose]

Haha, you’re probably right. I just read that within the EU you should be able to fulfill any Eu prescription, but rules are there to be broken!

I’m just having a look at helvella’s blogspot for Thyroid Hormone Medicines. That should keep me busy, though not as busy as her! What an amazing effort she has made. Thankyou!!

I am in the Uk in three weeks and have friends coming here almost every month from the UK who can bring meds with them. So I thought the UK would be an easier route rather than having meds stuck in customs with admin clearance fees. But at the end of the day it all comes down to what I can afford.

If you do have any advice on dosing I would appreciate it, so I can compare to what this new doctor advises. Hopefully she will prescribe it, but I can’t be sure.

[helvella in reply to CirceBaby]

Things might have changed but, until a few years ago, while pharmacies could legally recognise and dispense against prescriptions from other EU countries, there was nothing to force that.

Germany pharmacies seemed to be pretty good, but many others weren't.

T3 is particularly expensive in the UK. My UK document has prices and links to the main database which has prices. Private prescriptions will always be more than NHS prices.

helvella - Thyroid Hormone Medicines - UK

The UK document contains up-to-date versions of the Summary Matrixes for levothyroxine tablets, oral solutions and liothyronine available in the UK. Includes injectables and descriptions of tablet markings which allow identification. Latest updates include all declared ingredients for all UK-licensed products and links to Patient Information Leaflets, Dictionary of Medicines and Devices (dm+d), British National Formulary, NHS Drug Tariff, etc. PLUS how to write prescriptions in Appendix F.

Now also includes latest pricing information from dm+d..

Also includes links for anti-thyroid medicines (but not product details).

Direct link to PDF:

📄 dropbox.com/s/bo2jzxucgp9hl...

Blog last updated 28/12/2024 - documents are regularly updated

Link to blog:

helvella.blogspot.com/p/hel...

My world liothyronine document is less comprehensive and needs revision but might help.

helvella - World Liothyronine

Contains a list of liothyronine products from around the world including brief details.

Direct link to PDF:

📄 dropbox.com/scl/fi/ooslwy2j...

Blog last updated 28/12/2024 - documents are regularly updated

Link to blog:

helvella.blogspot.com/p/hel...

[CirceBaby in reply to helvella]

thankyou!

[greygoose in reply to CirceBaby]

Helvella is a man.

[CirceBaby in reply to greygoose]

Should have used “them”!

[Capan24]

I don't eat dairy either and watch the sugar content in food. One brand of yogurt I found that was really good is Forager unsweetened vanilla cashew yogurt. I don't know if they carry that by you. I eat it plain with blueberries, but sometimes I add a scoop of my chocolate protein powder in it. It gives it a nice flavor and I get a added boost of protein too.

Dairy free

[CirceBaby in reply to Capan24]

Thankyou for the tip! I’ll definitely look out for it when I’m back in the UK. I have very little choice in the way of bought food where I am in Spain though. One day I hope to crack the cashew version of this “yoghurt”, then it’ll be ‘bye ‘bye to dairy!

[JumpJiving]

CirceBaby Watch or listen to this Zoe podcast - youtu.be/euSd9bsFwxc?si=nLY...(Not working as expected?)

Important to get to the end as the language used is a bit woolly in places