Guidance appreciated on blood results please

[clivevsmith]

•I'm 58, male and live in the UK. 5ft 10in. 13 stone 5lbs (187Ibs)

•Originally diagnosed with hyperthyroidism (Graves disease) in my early 20's.

•Took Carbimazole for about 15 years and then in 1995 had radioiodine treatment - went hypothyroid.

•After a period of adjusting the dosage, having regular TFT's - (I believe the Thyroid Function Tests in those days were TSH, FT4 & FT3) – was put on 150 mcg Thyroxine for about 15 years (always the same packaging, so probably same manufacturer) and when it became Levothyroxine about 5 years ago, there seems to been many different manufacturers, as packaging keeps changing.

•Tested annually and assumed (wrongly) I was having the TFT test but on the last test discovered it was TSH only.

•Always “normal” – but comment this year from Doctor “we might be over medicating you”.

•Result last 6 years now discovered was TSH - 2010 2.0, 2011 1.4, 2012 1.3, 2013 1.2, 2014 0.86, 2015 0.44. Hence comment from doctor.

•Added about 14Ibs weight over last 10 years despite good diet and exercise.

•Health OK except diagnosed with “chronic idiopathic urticarial” – basically a rash and nobody knows why. Started about 5 years ago. Some months fine and others flares up. Research suggested could be different manufacturer’s fillers? As previously “normal” not thought the rash was Levothyroxine related before now.

•Doctor unable to prescribe anything else other than Levothyroxine, reluctant to refer to endocrinologist and would only test TSH. So went private. He prescribed Purified Thyroxine in Calcium Phosphate to see if rash abates. Should get these tablets this week.

•Having read this forum and the book “Stop the Thyroid Madness” since seeing the specialist, I would like to try NDT when I see him again next month. Not sure whether NHS will pick up the ongoing bill, but they have for 28 tablets of the Purified Thyroxine which cost £300!

•Decided to get proper blood results as a base for future reference and guidance from you kind people on this forum.

•The blood results received today are:

Test Patient Result Normal Range Units

CRP 1.80 <3.0 mg/L

Ferritin 100.5 30 – 400 ug/L

Free T4 22.42 12 - 22 pmol/L

Free T3 4.85 3.1 - 6.8 pmol/L

TSH 0.27 0.27 - 4.20 IU/L

T4 Total 142.9 64.5 - 142.0 nmol/L

Anti-Thyroidperoxidase abs 14.2 <34 kIU/L

Anti-Thyroglobulin Abs 28.7 <115 kU/L

Vitamin B12 270 142 - 725 pmol/L

Serum Folate 15.73 10.4 - 42.4 nmol/L

I would really appreciate your comments please and any guidance gratefully received.

[Marz]

Your B12 is LOW and needs to be nearer the top of the range. Are you supplementing ? It could help the skin rash too. How about VitD ? That too is anti-inflammatory and could help Low B12 is a neurological condition so can affect nerve endings in the skin causing the rash. I suffered before I started b12 injections.

Your Ferritin is GOOD.

You are only over medicated - in my non-medical opinion - if the FT3 is over range - which it is NOT.

b12deficiency.info/signs-an...

You sound to be very much on the case - so wishing you well....

[Clutter]

Welcome to the forum, Clivevsmith.

Low TSH doesn't mean you are overmedicated. >145mcg is considered to be a suppressive dose so I'm surprised your TSH is not lower. Your FT4 is a gnat's over range which is also okay as your FT3 is within range. Antibodies are negative for autoimmune thyroid disease (Hashimoto's).

There are 3 generic brands of Levothyroxine, Mercury Pharma 25mcg, 50mcg & 100mcg, Actavis (also known as Almus) 50mcg and 100mcg and, Wockhardt 25mcg. Patients can insist pharmacists supply the generic which suits them best and do not have accept whichever make the pharmacist wishes to dispense.

Ferritin is optimal halfway way through range but 100 is good. I would only supplement iron if you feel fatigued.

B12 is low as Marz has pointed out. PA Soc say 1,000 is optimal. I would supplement 5,000mcg daily for 6-8 weeks and then reduce to 1,000mcg which should be a sufficient maintenance dose. Take a B Complex to keep the other B vits balanced. Folate is excellent.

I'd be inclined to try the purified Levothyroxine for 2 or 3 months to see whether the rash improves. it can take 8 weeks to clear the generic Levothyroxine completely from your system. You'll at least have 'evidence' that the generic Levothyroxine caused it if it clears. NDT prescribed on a named patient basis may be cheaper than the purified Levothyroxine but it isn't licensed for UK use. NHS doctors aren't trained to use it or interpret bloods on anything other than Levothroxine so you may have difficulty getting it prescribed although you can buy it online without a prescription.

[clivevsmith]

Thanks for the replies. Really appreciated. Any other comments still welcome, as the more information I receive the better

Can someone advise what is the best B12 complex supplement available in the UK please? This appears to be my first priority.

I would like to try NDT after the purified thyroxine. In case the NHS cannot provide this, could someone PM me details please of a reputable online source and the cost.

Thanks again.

[Patsy74]

Hi you can get Armour thyroid from America by going on the web site but be careful about getting the correct dosage. Thyroiduk have an equivalency chart and will guide you to get the correct dosage. I have been using this preparation now for the last four years as I could not tolerate levothyroxine. It is not a perfect cure but at least I have found it is more consistent than some professionals seem to suggest. There is an excellent book 'Your thyroid and how to keep it healthy@ by Dr Barry Durrant-Peatfield. Worth getting through the library and reading before taking any action as above. I too had Graves Disease, followed by RAI treatment and dramatically went hypo within two months. I have kept a complete daily record of all my medication since starting treatment so I know what is working and what is not.

Hope this is useful even if only to know others have similar experiences and believe you me I have little faith if the narrowness of knowledge some doctors are showing, well from my experience anyway

Pat

[Patsy74]

NDT tablets can be obtained from International Pharmaceutical Services .com. You can place an order with them and pay via Lloyds Bank ( they have there own English account with this bank) so all is above board. I have found them extremely helpful and you can get exemption to paying Vat- ref Schedule 8 of VAT Act 1944 group 12.

To claim exemption you need to get a prescription first, possibly from a private source (Keep and just send a photo copy) for proof, once sorted out it is then easy to reorder, well so far any way !!

[clivevsmith]

Thank you Pat for taking the time to reply.

I'm hoping the consultant will prescribe me NDT and that my GP will agree to repeat prescriptions on the NHS. But if not, at least I have an alternative now.

Clive