Hi everyone, I posted a while ago about getting all my underactive thyroid symptoms back, joint pains, fatigue, anxiety and others. I’d had test results saying my TSH was low, but the dr was saying that it was satisfactory.
I managed to speak to another dr and she ordered full blood tests. My results came back and they were:
T4 - 18.8 (normal 11.0 - 21.2)
T3 - 4.9 (normal 3.1 - 6.8)
TSH - 0.06 (normal 0.27 - 4.20)
Ferritin - 20 (normal 13 - 150)
Folate - 5.9 (normal 3 - 20)
B12 - 500 (normal 197 - 771)
Vit D - 107
Tests were taken early morning before I took Levothyroxine (100mcg) and before food. 24 hours after last dose.
I have a telephone appointment with the dr tomorrow. I’m guessing by looking at the above I may need to supplement iron and folate as they are normal range but low?
Do you think that should likely be my next steps?
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Button83
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Your free results are still on the low side and an increase of Levo would help. Your GP may be reluctant though as your TSH is below range.
Vit D is good, assume you are already supplementing.
B12 is only just OK and is a serum test. The active B12 is better so your result is possibly too low and supplementing may help you.
Folate too low. If you started a good methyl B complex that contains both B12 & folate that will improve some of your symptoms and help your body use your thyroid hormone properly.
B complex suggestions: Slightly cheaper options with inactive B6:
Ferritin is deficient. Your GP should prescribe a supplement for you, NICE guidelines state a level of 30 or less is deficiency. If GP doesn't then you can buy supplements over the counter. Take with orange juice or anything containing vit C to help it absorb. Ferritin is very slow to raise. Also increase iron rich foods in your diet.
Like Jaydee1507 suggests, in the first instance I would work on improving B vitamins, folate and ferritin. I experienced similar symptoms when these were deficient.
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
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
You are a poor converter, but I really would not increase your levo - or only by a very, very small amount which probably wouldn't have any effect on your FT3 - because if your FT4 is too high it will make your conversion worse, not better. It would be better, before doing anything, to improve your nutrient levels, but if that doesn't work you would need to procute some T3, either on prescription or bought on-line.
hey Buttons that sounds a bit rough for you. I’d also suggest you may be a poor convertor T4 to T3. Have you considered trying T3? I’d also I’d suggest you have poor ability to absorb iron. My ferritin is similar to yours (last test 29 so it climbed one point in 4 months 😂) I’m now going onto the heme iron for a month and retesting. Have you tried supplementing with iron? Three arrows was suggested here so I bought a three month supply as it was cheaper. Some of your symptoms may be related to low iron levels as much as low T3. Good luck it’s hard being so exhausted. 💜
I'd get a full iron panel done for a clearer picture as your deficiency might well be significant. Folate needs to be much higher. My B12/iron specialist said to aim for 14-20. I had low folate and got my levels up nicely by doubling my methyl folate to 800 mcg for about 4 months.
just to update. Dr suggested I try 100 Levothyroxine one day and 75 the next. I also asked to be prescribed iron. I’m just looking into B complex vitamins to add as well.
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