I was hoping to get some advice on my latest blood tests. I have previously been diagnosed with Hashimoto, taken levo for a number of years, excluded gluten from the diet (tpg went down drastically after that yay), then been over medicated for a while, then went down on a dose again and again and again until a year ago was told to settle on 25ng levo a day. My TSH has been slowly increasing and last month I felt all the old symptoms again - tiredness, horrible acne, dizziness, slight swelling in the throat, brittle nails, hair falling out etc. I will increase the levo while waiting for an appointment (guessing 37.5 is the first step or straight to 50?) but any other supplements that you'd recommend? Iron, b12, d?
Results from week ago (monitormyhealth) and from Nov last year, both fasting prior to taking levo:
TSH 5.58 range 0.27-4.2 (Nov 3.38 range 0.3-4.2)
FT3 4.6 range 3.1-6.8 (Nov 4.2 range 2.4-6)
FT4 19.4 range 12-22 (Nov 13.9 range 9-23)
Vit D 42 (Nov 42)
Folate 3.9 (Nov 8)
Active B12 35 (Nov active not tested, B12 was 217)
Ferritin 19 (Nov 39)
HB 142 (Nov 135)
I booked an appointment with Roseway Labs as well, not sure if they can offer any useful advice or medication now though.
edited to add reference ramges
Written by
malvisia
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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
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
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
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 264
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.
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
thank you for all the suggestions. Yes I'm still on gluten free diet and not intending to change as it definitely helped, was considering trying to eliminate lactose but a bit worried my diet would be really restrictive after that.
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Advice on test results 
Please help to interpret test results and recommend supplements
Test Results - Help Please
Advice Needed Please on Medichecks Results
