opinion on blood labs for thyroid and vitamins/iron please

[Crankyoldbag]

hello

Sorry for a very complicated post. I’ve been taking NDT since 03/23 increasing from 1/4 grain through to 1gr morning/1/2 grain afternoon at 01/25. Initially diagnosed as having poor T4-T3 conversion. I started getting severe GI symptoms related to long standing h.pylori infection March 25. Decided to bomb it with quadruple abx as had already tried lots of natural stuff at this point. Finished treatment 1 week ago. Started getting severe anxiety/insomnia around the same time as GI symptoms increased so cut back to 1/2 grain NDT morning and nothing afternoon. For the last 2 weeks have had incredible fatigue, weak legs, dizziness and the insomnia continues.Almost to the point where am reluctant to leave home. Currently taking low dose xanax and zopiclone to help with anxiety/sleep.

i would like your opinion on 2 things. Whether i need to continue NDT at all (initial FT3 on diagnosis was only slightly below normal).

how to increase my iron very quickly without taking iron supplements which will irritate gut?

Initial labs 03/23:

TSH. 1.36. (Range 0.35-4,94) FT4 14.2. (Range 9.01-19.04) FT3 3.67 (range 2,43-6.01)

Ferritin 94 ng/ml (Range 10-204)

Vit D 157 (range 30-60ngml)

B12 - 575 (range 138-652pmol/l)

Labs before severe gut upset and abx treatment 02/11/24: TSH has become suppressed by now:

TSH 0.04 FT4 12.61 FT3 4.38

Vit D - 165 B12 - 344 ferritin -87 ngml

Labs today after 1 month on 1/2 grain NDT and severe GI distress and abx treatment :

TSH 1.17 FT4 - 14.41 FT3 - 4.53

Vit D - 140 nmol Vit B12 - 451 Ferritin- 33 ng

the ranges are the same for all labs.

feeling very rough with the low ferritin and have absolutely no idea whats happening with thyroid anymore. Have ordered 3 arrows heme iron and eating lots of iron rich food. Chicken livers tomorrow. Lots of probiotics. I also did a recent cortisol 4 point test which showed a CAR cortisol awakening response of 228% so raised above average cortisol from 30 mins after waking throughout the day until 8pm.

awaiting private endo response next week

[greygoose]

First of all, can you put the ranges for all those results, please? Results without ranges are meaningless because ranges vary from lab to lab.

Whether i need to continue NDT at all (initial FT3 on diagnosis was only slightly below normal).

Why would you think you don't need to continue it? If you're hypo - and you were obviously diagnosed as hypo - you need thyroid hormone replacement for life.

What do you call 'normal'? If you mean your FT3 was slightly below range the is wasn't slightly low, it was very low. A euthyroid (normal) FT3 would be around 50% through the range. So, yes, I think you do still need to take it.

And it's probably not just the low ferritin that is making you feel rough, but also because you drastically reduced your NDT.

As for your low ferritin, you probably have low stomach acid - it's low stomach acid that allows the h pylori infection to thrive, not high acid, as doctors insist - and that means that you're having trouble digesting food and absorbing nutrients. What is the h pylori status at the moment?

Do you take vit C with your iron? That can help with gut irritation and avoid constipation. It is also essential for absorption of iron.

[Crankyoldbag in reply to greygoose]

I only completed the abx treatment 5 days ago and have to wait another 3 weeks to do a breath test for h.pylori. When i posted my initial labs from 2023 a few weeks ago i think you commented that you weren’t sure why i was being medicated on a very marginally below optimal FT3. On the advice of my functional doc she doesn’t want me to take iron supplements as my gut will be too sensitive after the full on abx treatment. She suggests iron rich diet now and eventually 10-20mg elemental iron if ferritin levels do not pick up after 3 months. She suggests iron maybe lower as used omeprazole during h.pylori treatment which reduces stomach acid even further.

Since 3 arrows is heme iron perhaps this will be gentler on the gut?

I’m eating iron rich food with every meal plus high strength Vit C breakfast and lunch

i have added ranges. They were all done with same lab

[greygoose in reply to Crankyoldbag]

No, I didn't say that. I suggest you reread your posts and see what I actually did say - especially this one:

healthunlocked.com/thyroidu...

The omeprazole certainly won't have helped your iron levels.

[Crankyoldbag in reply to greygoose]

I would like to add my folate levels which i omitted.

Nov 24. Folate 22.4 ngml (range 7-46)

Feb 25. Folate 33.1 (same range)

April 25 Folate 25.1 (same range)