Hi just wondered if I could get some help with my test results. To put this in context I have been feeling exhausted for the last couple of months. I've recently started doing some weight training - I've been easing in gently with 1-3 sessions a week at only 30 mins long. However I've been finding myself feeling drained, weak and shaky afterwards and taking a good couple of days to recover from each session. Very frustrating as I'm very keen to get fit again! I had bloods taken last Friday and the results are as follows:
TSH 0.26 (0.30-4.20)
Serum Free T4. 12.3 (9.0-19.0)
B12 528 (180-900)
Serum Ferritin. 48.1 (30-336)
Serum Folate. 4 (3.0-20)
Serum Iron 28.8 (11-30)
Serum transferrin. 2.59 (1.8-3.6)
Transferritan sat index 45 (16-50)
Serum vitamin D 138 (50-250)
I am currently taking 125mg of Levothyroxine
Any help would be much appreciated!
Written by
ctw0410
To view profiles and participate in discussions please or .
Thanks for coming back to me. Yes to confirm test was carried out at 9am and i didn't take levithyroxine for 24 hrs although I did have breakfast. Always the same brand if Levothyroxine - Teva. I was taking a multivitamin but stopped about 2 weeks before blood test as I didn't want it to affect results.
Do you think I'm taking too much Levothyroxine as just under range.
Should I take a supplement for low folate?
What do I do about low ferritin if iron stores are ok?
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 2 per day and/or may need separate methyl folate couple times a week
Suggest initially you alternate a separate folate and B complex as your folate is so low
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
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
Low ferritin
Are you vegetarian or vegan
As your iron is high you can only improve ferritin by 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.
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.
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
GP should have tested for coeliac at diagnosis…..did they
If not
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
I'm not surprised you are exhausted and until you get your thyroid hormone levels built up the range, exercise and getting fit will leave you even more fatigued and taking longer to recover from the getting fit - please stop punishing yourself - try non pressurised activities such as walking and swimming - and ' kinder ' ways towards a better health and well being.
It is a vicious circle and until your thyroid hormones are strong and solid and your core strength building blocks of ferritin, folate, B12 and vitmin D are up and maintained at optimal levels in their ranges - stressing the body out is a negative feedback and not helping you.
We do not have a T3 reading - and it is T3 that runs the body - much like fuel runs a car -
T4 - Levothyroxine is a pro-hormone that needs to be converted in the body into T3 and generally speaking the T3 runs behind the T4 reading -
So we generally feel best when the T4 is up in the top quadrant of its range at around 80% with the T3 tracking behind at around 70% through its range.
Currently your T4 is at just 33% through its range and much too low to be doing much and likely your T3 following suit and towards the bottom of its range -
Everywhere I researched suggested that ferritin needs to be at least over 70 for any thyroid hormone replacement to work well - and I can confirm that was pretty much true in my own recovery-
I now aim to maintain my ferritin at 100 - folate at around 20 - active B12 125 ( serum B12 500++ ) and vitamin D at around 125.
Once your core strength building blocks of ferritin, folate, B12 and vitamin D are optimal you may well find that your dose of T4 will need to be reduced a little as you will then be more able to utilise and convert better the T4 into T3 -
We can live without T4 but we can't live without T3 and why to reply fully we need a T3 and T4 from the same blood test draw.
Sadly your doctor is probably only looking at your TSH - and decided that you do not need a dose increase and likely a dose decrease - as you TSH below its range - but this will be a retrograde step - does s/he know you have a thyroid AI disease and the TSH a very unreliable measure of anything onceany taking form of thyroid hormone replacement ?
I should have looked back first - as to your diagnosis - do you have Hashimoto's - a thyroid AI disease - as many forum members find the research and suggestions of Dr Izabella Wentz of value - and she write as thyroidphamacist
Thanks so much for coming back to my post. I think that you're right it's better to take a step back and focus on more gentle exercise until my levels are at a better level. It's so frustrating as I've heard that weight training is the way forward and I'm so keen to get back in shape! I will definitely look up Izabella Wentz. Thanks for the recommendation
Yes but you can't go forward and stay going forward until you have enough fuel in the tank - namely thyroid hormones - T3 & T4 circulating in your blood stream -
to allow you to get done all that you want to do in the day, and to repair, replenish and restore your body over night so you are as bright as button the following day to do it all over again.
Currently you look to be running on ' almost empty ' - at just 1/3rd of your total capacity were this your car - I'm sure you would be looking to run better and further by stopping off and refuelling at a petrol station.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Test results. 'Help'
Help with test results please!
Help with blood results
