Thyroid UK
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Supplements, Timings, Dosages, etc...

Oh dear....

Following my last anxious post, it was suggested that I approach the PA group for advice on what supplements to take, when, how much and for how long.

I had made the decision to try and help myself and to start taking supplements while waiting for what might turn out to be a pointless Endo appt.

Alas, that didn't go to plan as the feedback in the PA group was more or less 'why are you going to supplement', your levels are ok and the TUK group isn't necessarily handing out correct advice. Does anyone have any idea why the PA group would contradict the advice given here?

I've read, re-read and read to my husband all of the links that both groups have referred me to, almost all have been the same links and I am quite happy that supplementing is my way forward. It's that or going mad with anxiety.

So I'm back here today, hoping for complete guidance on...

1. What to take

2. How much to take

3. How long to take it for

4. The best time in my day to take it

Just a reminder I'm now on 125mcg Levo, updated prescription 2 days ago following recent blood test. I am also day 2 into being gluten free. Other results were...

TSH 4.97 (0.35-5.5) which I understand I'm aiming for 1.

Free T4 10.4 (10-19.8) which again I understand needs to be in upper half of range , 15+?

TPO 1175 (0.0-60.0)

B12 295 (211-911) take Solgar or Jarrow's Methylcolbalamin lozenge under tongue?

Folate 9.45 (>5.38) needs to over 12, Solgar or Jarrows Methylfolate?

Ferritin 67.3 (10-291) needs to be mid range eg 140, Ferrous Fumerate with Vit C

I currently take my Levo between 6-7am, breakfast as 8am, lunch 12.30pm, tea 6pm.

I understand I need to leave 7-10 days before starting each new supplement, so if you think I should start them in a certain order that would be helpful too.

A big thank you to this group and the hope it provides. ☺☺

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Oh dear janey1234 that's a disappointing reaction from the PA group. Are you sure the suggestion here was for all supplements or just for advice on your B12 level? With your range, a result of 295 when the bottom of range is 211, I would have thought they were the very people to advise :( . Anyway, as they are a B12 group primarily, maybe they don't know what us thyroidies need regarding other supplements.

For your thyroid results, yes you are aiming for a TSH of 1 or below, FT4 in the upper third of range so that's 16.54+ in your range, and FT3 in the upper quarter if you can get it done. But that is a general guide, it needs to be where it is right for you to feel well, so it's not set in stone, you have to find the right place for you.

B12 (general comment here as I do not have experience of B12 deficiency), it is said that the PA Society recommends 1000. Solgar or Jarrows sublingual methylcobalamin lozenges (under the tongue), 5000mcg daily to start and further down the line you can reduce to 1000mcg. Sublingual goes directly into the blood stream so can be taken without food. Should be in the morning as B vits can be stimulating.

Folate - I am unfamiliar with and do not understand when it's put as >. My folate test had a range and it's recommended to be at least half way through the range. My folate was at the very bottom of the range and I increased mine by taking Thorne Basic B x1 daily. In 2.5 months it was at the very top of the range. I didn't supplement with a separate Folate supplement. Probably says take with food, again as it's B Vits take in the morning, no later than lunchtime, so as not to disturb sleep.

So you could take your B vits with breakfast but no later than lunchtime.

Ferritin - yes, half way through range, take iron supplement with Vit C, 4 hours away from Levo and 2 hours from other supplements. You'd have to see what the pack says about taking with food, I've seen it advised with food and on an empty stomach. Whatever time it suits but take into account the timing of Levo and other supplements. When supplementing it's recommended to retest when you've finished the course as you don't want to go too high in range. You could take at lunchtime or evening depending on when you took the B vits.

As you have Hashi's are you going to supplement with selenium as it helps reduce the antibody attacks?

And did you get Vit D tested as that's another important one?

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Hello SeasideSusie , yes i forgot to add my vit D which was good at 116 ☺.

How long would you suggest the B12 dose at 5000 before moving too 1000 and then do I continue on 1000 for life?

On the Folate the > means 'more than' apparently, I had to ask, and I think someone in an earlier post recommended a level of over 12. Maybe someone else will comment on this and clarify and how much, how long, etc I should take it.

re Ferritin & Vit C how much do I need to take and again for how long?

Thank you xx

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janey1234 Good news about your Vit D :)

With the B12, with it being so low (bear in mind I am not medically trained) I think I would supplement with 5000iu for 4-5 months. You can't overdose, excess B vits are pee'd out. Then 1000iu daily for life. I never had low B12, mine was about 660 when I was tested but I still started supplementing 1000iu daily. I know further testing is pointless once supplementing but as it's part of the Blue Horizon bundle I use it's been tested twice since, second time 990 and third time 1200 so it does show the supplements have increased it. I've dropped back a bit now, I supplement a few times a week.

I know that > means more than, but I just don't get the logic of it at all. It can be one point over, or 100 points over, but surely there comes a point when it gets too high and without a range you don't know that point. I'm just glad that BH uses a range (I'm a simple soul :D ).

Ferritin - are you going to use Ferrous Fumarate as suggested by Bluebug in your previous thread healthunlocked.com/thyroidu... ? If so, then do as she suggests and finish the course and retest. You need 1000mg Vit C with each iron tablet which will aid absorption and help prevent constipation.

Good luck with gluten free, I must admit to being so glad I don't have Hashi's and don't seem to have any problems with gluten.

Are you being re-tested for thyroid levels 6 weeks after this latest increase in dose?

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I would have been shocked if my Vit D had been low bearing in mind I almost live in the garden☺

I shall order my B12 later today, thank you for that.

Re the Folate, am I right this is in the B Complex supps and do you continue to take these for life too? I can't remember if I'd I read somewhere that you need to take B complex and B12 together to avoid an imbalance of B vits. I may have misread something in another moment of 'fog'.

And......almost there, thanks for bearing with me.... having looked into the Ferrous Fumerate at Amazon (where I shall order the other bits) , is there a dosage level to look out for?

Yes my thyroid bits are being retested in about 6 weeks

So greatful for your time on a Sunday x

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Yes, if you go for the Thorne Basic B there is 400mcg methylfolate in it as well as the other B vits. If you take B12 then B Complex is needed as well, but once you're on a maintenance dose of B12 and your folate is at optimal level (at least half way through range) you could look for another B Complex with a lower level of folate (Nutrisorb liquid Methyl B Complex has 100mcg methylfolate and lower levels of the other Bs so that could be good as a maintenance B Complex and I'm sure there are others).

With the Ferrous Fumarate it should say one tablet twice a day and that is what's recommended to raise ferritin. That gives about 130-140mg elemental iron. If that bungs you up you might need to change to Iron Bisglycinate which is more gentle bit contains only about 20-25mg elemental iron. Wait and see how it goes.

To keep your eye on ferritin and folate levels, if your GP won't test then it's easily done through Blue Horizon with one of their fingerprick tests.

Just ask if there's anything you're not sure of :)

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By jove...I think I've got it! At least I think so 😆

Forever in your debt and hopefully on the way to recovery too....thank you so much x

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1 more quickie....If i take my levo an hour before breakfast (6-7am), can I take the B12 & Bvits at breakfast (8am) or does there need a longer gap between them and the Levo?

As before...thank you x

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If you take your levo nearer 6am then after breakfast would be OK. I'm more inclined to leave as long as possible which is why I take thyroid meds when I get up in the early hours for the loo, so that's any time between 4-7am. Then, as I can't get up early, then I feed the dog and cat first, it's usually between 9.30-10am when I have breakfast.

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Thank you...I keep waking up through the night, checking my watch and so don't get a solid nights sleep. Maybe changing to just before bedtime for my Levo might be the way to go. X

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Many members take it at bedtime and find it works better. Give it a try and see how you get on :)

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Me again..sorry ☺

I'm on Amazon's website looking at the Solgar Sublingual Methylcobalamin and they are labelled as 5000mcg rather than 5000iu. Is that the same thing?

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Yes, sorry janey1234 , my mistake. B12 is in mcg, it's Vit D that is in iu. I use Solgar, dissolves in about 45 seconds under the tongue (don't chew or swallow).

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Brilliant! Finger poised to pay...thanks again xxx

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My B12 is in iu - mcg and iu for B12 are the same

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The < >symbols seem to be regularly used but I agree it seems odd to have a single point.

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Hi Janey, I think you are being a bit unfair to the PA group. The general advice was that you probably need to supplement B12 but, since any tests for this and underlying causes are meaningless after supplementation, that you check with GP for other tests first. Also whilst there is some crossover of members, that group is not expert on thyroid issues and that is mostly what is in your post. Your B12 is in the grey area of quite possibly causing symptoms, advice you were given - as mine is (278 for me) - and I use the solgar 5000 sublinguals. You should take a good B supplement with that to balance and I have Jarrow B-Right for that (includes plenty of methylfolate). Your iron levels are not desperately low but a bit higher could be useful. As you have Hashis (again the same as me), selenium is recommended along with the gluten free that you have now started. I take Jarrow selenium synergy 200 a day. How is your vit D - have you had it tested? Since your B12 is low I would be inclined to address that one quickly.

For me I take levo at bed-time as I found it easier to fit in supplements. With breakfast I take selenium, vit B, B12, vit D (better you 3000 spray), vit K2 (for calcium to bones), with evening meal zinc and magnesium citrate 400. When I was taking iron I took it along with 1000 vit c after lunch so it was 4hrs away from everything else.

Due to the Hashis I personally have gone further and take L-glutamine powder and probiotics for gut healing. I found a book "The Immune System Recovery Plan" by Susan Blum very helpful in understanding the bigger picture - that GPs gnerally seem not to know - and taking control and helping myself back to health.

Good luck xx

Gillian

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I am sorry, I didn't mean to offend anyone. Having spent most of Friday in tears following my docs appt and my anxiety levels rocketing, I was hoping to just start afresh, a new day in control of my health and making steps to help myself with clear instructions on what supplements to take and when, etc.

I've seen 4 different GPs who have all given me incorrect information about being HypoT and the only help & understanding / guidance I have had has been here.

Maybe I shouldn't have posted in the PA group for clarification on supplements but it was suggested that I did just, to check the correct supps, doses, etc.

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Hello again

May I ask, how long do you need to take the Selenium for?

I have been tested for Vit D, 116 which was good ☺

I will start the B12 & B Vits first.

Thank you for your advice x

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Hi Janey, as I understand it the selenium would be ongoing as it helps to suppress the anti-bodies but don't take too much - tablets are generally 200mcg each but 400/day is a toxic level, so one only.

BTW your ferritin is only slightly low and too high is dangerous so I would be inclined to take 1 iron tablet a day with a vit c and have levels checked again. This especially applies if you are post-menopausal as your body has no way of getting rid of excess. And yes Marz is absolutely right, you are definitely still under-medicated so should look to keep increasing dose but the supplements should help you use what you do have now more efficiently. If these and increasing doses still don't help, then you really should have free T3 tested to ensure you are converting FT4 to FT3.

Good luck, hope you feel better soon.

Gillian xx

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Thank you.

I shall start the Ferritin last of all.

My Levo has only just been increased last week to 125mcg, so early days for a reaction but fingers crossed.

Alas not post menopausal...still got all that to look forward to ☺

Again thank you for your time and patience. I really am grateful xx

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Just one more question...as you take your Levo before bedtime, how long do you leave it after food and drink? This may work out easier for me ☺

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Yes I was struggling to have it early enough to leave correct gap between levo, breakfast and supplements, especially when taking iron, which needs to be 4 hours away from everything else so that is why I changed. I tend to have dinner between 6-7pm and take magnesium & zinc with it then levo about 11pm. It needs to be 4 hours after such supplements but I believe 2 hrs minimum after food.

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Think that may be the way to go. B's for breakfast and bedtime with Levo. Thanks again x

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I agree re ferritin, get it up to 80 and see how you feel.

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I agree too. Going to see how I feel with my Levo increase and Bvits first :-)

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I think you will so much better when your TSH is 1 or under and your FT4 is higher in the range. Your FT3 is quite possibly on the floor - based on your FT4 result - so it's no wonder you are tearful and feeling unwell. I would be too :-)

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Hopefuly my latest increase will kick in and bring my levels to a better place x

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What's "PA"?

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Pernicious Anaemia :)

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Thanks!

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