TSH levels dropped no medication : Hi all. I... - Thyroid UK

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TSH levels dropped no medication

On_Point profile image
7 Replies

Hi all.

I paid for a private test and my TSH levels were 9.2 so the doctors sent me for a test a week later and it’s come back at 4.42. My home test I did at 7am, doctors one at approximately 9.15am. Is it normal to fluctuate that much ?

My Thyroid peroxidase antibody test came back the same at 106 and the doctor has written ‘raised , confirms diagnosis of hypothyroidism’ . All other test came back normal apart from my ferritin at 6.9, that has been low in the past as a vegetarian. She did do a celiac test but looking online that can take up to two weeks to come back.

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On_Point
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7 Replies
SlowDragon profile image
SlowDragonAmbassador

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Your ferritin is EXTREMELY deficient

What’s GP doing

You need FULL iron panel test for anaemia

cks.nice.org.uk/topics/anae...

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

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Difficult as vegetarian

Eating iron rich foods like (ideally) liver or liver pate once a week plus red meat daily , 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

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.

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

what are your B12, folate and vitamin D results

What vitamin supplements are you taking

On_Point profile image
On_Point in reply toSlowDragon

I had

Serum iron 18.7 normal range

Transferrin saturation 23% normal (20-50% range)

Serum transferring 3.2 normal , is that a full iron panel?

Vitamin D was 53 adequate ( private test)

I’m not 100% sure what else the doctor tested for as it was a telephone consult and I just had a text with a number on that I had to give to the phlebotomy clinic. She definitely said she was testing for celiac over the phone and I mentioned my ferritin had been low in the past. She said she would test for everything links to fatigue. As for the Ferrintin is just say OTC iron supplements.

So far test results for

Full blood count

Hb A1C- diabetic control

Transferring

Thyroid peroxidase antibodies

Liver function test

Serum lipids

Renal profile

Serum free T4 levels

TSH level

Thanks as always for you reply.

SlowDragon profile image
SlowDragonAmbassador in reply toOn_Point

As for the Ferritin is just say OTC iron supplements.

With Ferritin at 6.9 that’s ridiculous to say OTC supplements

Serum iron 18.7 normal range

Serum transferring 3.2 normal

Please add ranges

Transferrin saturation 23% normal (20-50% range)

Will flag  humanbean and  FallingInReverse to comment

Yes you need to start iron supplements

retest 3-4 times a year if self supplementing.

Posts discussing Three Arrows as very effective supplement (but it is derived from meat)

Great replies from  FallingInReverse

re ferritin and Three arrows

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great reply by @fallinginreverse

healthunlocked.com/thyroidu...

Ferrodyn supplement

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

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

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

SlowDragon profile image
SlowDragonAmbassador in reply toOn_Point

You need to test B12 and folate

As a vegetarian you presumably supplement B12 anyway?

If not you should do

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency.

Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

In-depth article on different forms of B12

perniciousanemia.org/b12/fo...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

perniciousanemia.org/b12/le...

And why aiming to keep B12 over 500 recommended

perniciousanemia.org/b12/le...

Great reply by @humanbean on B12 here

healthunlocked.com/thyroidu...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need separate methyl folate couple times a week

Post discussing different B complex

healthunlocked.com/thyroidu...

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70

SlowDragon profile image
SlowDragonAmbassador

Sorry should have ready previous posts

Vitamin D

healthunlocked.com/thyroidu...

You are presumably working on improving this

Did GP test B12 and folate

humanbean profile image
humanbean

I am making the assumption throughout this reply that you live in the UK. If you live elsewhere then some of the links I give won't be accessible. Please tell us where you live - it makes it much easier to reply if we don't need to cater for other countries.

.

I agree with  SlowDragon Being told you only need OTC iron supplements with a ferritin of 6.9 is outrageous, and makes me wonder how you can live with a level that low! And you exercise too! I certainly couldn't.

It would be a good idea to tell us the units of measurement for your results just in case yours are unusual.

The units of measurement for my own ferritin levels are always microgram/L or μg/L.

I tried using OTC supplements to raise my very low iron and ferritin and got nowhere (in 2012/2013). I knew almost nothing about iron at the time. I discovered that OTC iron supplements in the UK contain, at a maximum, about 15mg of iron. When I finally persuaded my GP to prescribe some iron supplements she prescribed tablets containing 69mg pure iron per tablet (Product was called 210mg ferrous fumarate), three times a day. Those doses have now been officially reduced. See the BNF link further on.

Being vegetarian reduces your choice of iron supplements a lot. If you can stomach the idea of eating animal based supplements then the choice is much greater.

The main supplements that doctors prescribe (when they feel like it) and which are suitable for vegetarians are the "iron salts". There are three prescribed in the UK.

Ferrous Fumarate, Ferrous Gluconate, Ferrous Sulfate

These can all be bought without prescription in the UK from pharmacies only, with a pharmacist's permission. If you are ever refused then go to another pharmacy.

Ferrous Sulfate is extremely difficult for almost everyone to tolerate, so I would suggest you avoid that like the plague.

I took Ferrous Fumarate 210mg for 7 or 8 years at various doses, and I always took it with food. It probably slowed down my absorption but it was the only way I could tolerate the pills. And, very, very slowly, my ferritin and iron actually rose.

I have never tried Ferrous Gluconate but it gets mentioned on the forum from time to time and some people have improved their iron levels with it.

For official info on dosing and choice of products the NHS prescribe see these links from the BNF (British National Formulary) :

bnf.nice.org.uk/drugs/ferro...

bnf.nice.org.uk/drugs/ferro...

bnf.nice.org.uk/drugs/ferro...

.

For lower dose products that doctors don't prescribe :

Iron or Ferrous Bisglycinate - over the counter product, not prescribed, available from pharmacies or supermarkets or online

Contains varying amounts of iron per tablet, a maximum of about 25mg of pure iron per tablet but could be substantially less, so always check the bottle and patient information leaflet.

Liquid products - over the counter products, usually with low levels of pure iron per dose. Some people say they absorb iron better from liquid products than with tablets. but they never worked for me.

Spatone - 5mg iron per sachet

Floradix - 7.5mg iron per 10ml dose

Holland & Barrett - 7mg iron per dose

I tried liquid products but I found them to be very expensive and they don't taste very pleasant. I wouldn't waste my time or money on them.

...

Iron supplements that are derived from animal products...

These are the most popular ones because they are less irritating than iron salts and most people's ferritin levels rise faster than they do with iron salts :

Three Arrows Heme Iron :

healthunlocked.com/thyroidu...

Dosing Three Arrows :

threearrowsnutra.com/en-uk/...

Good luck. :)

FallingInReverse profile image
FallingInReverse

I’ll also pipe in with a quick reply… in addition to everything HB said…

Your iron profile looks very much like mine was a year or so ago. From memory:

My ferritin was 5.

My transferrin saturation percent was about 20%.

I chose to supplement with three arrows heme and now my iron is Goldilocks (not too low not too high) and ferritin is a bit above 30. I’m still working on it, but with optimal iron and tsat%, it’s alright!

You will see people on here talk about infusions. I’m a little spooked to consider blasting myself with iron… but there are people here who swear by them. I can’t speak to that yet.

But if you want more advice on how to start and monitor supplementing, let us know.

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