Any further advice on Blue Horizons results greatly appreciated :)

Hi, I have been feeling lots better over the last couple of months and decided to take the Blue Horizon Thyroid 11 test rather than go back to my GP and feel like a hypochondriac! My results are back and I just wanted to get some feedback if possible.

Just for info, I have been taking B12 5000mcg for 6 weeks followed by 1000mcg for the next 6 weeks and then reverting back to 5000mg again on a cycle since March this year. I have also been taking my B complex everyday. I don't take any other medication. I have also got my GP to increase my levothyroxine to 75mcg about 3 months ago. I have been 100% gluten free since March.

I feel so much better in every way (not feeling so tired and not needing a nap every day, joints & muscles not aching anywhere near as much, feeling in much better mood, periods back to being regular etc etc but just want to check whether I am doing any damage by lowering my TSH to this level.

Any feedback would be greatly appreciated.

Biochemistry

CRP0.70 (<5.0 mg/L)

Ferritin 97.6 (20/150 ug/L)

Thyroid Function

TSHL0.25 (0.27-4.20 IU/L)

T4 Total 79.9 (64.5 – 142.0 nmol/L)

Free T4 14.87 (12-22 pmol/L)

Free T3 3.98 (3.1 – 6.8 pmol/L)

Immunology

Anti-Thyroidperoxidase abs Anti-Thyroglobulin Abs H318.4 (<34 kIU/)

Anti-Thyroglobulin AbsH766.4 (<115 kU/L )

Vitamins

Vitamin D (25 OH) 54 - (Deficient <25nmol/LInsufficient 25-50 Consider reducing dose >175)

Vitamin B12 593 - (Deficient >140 pmol/L - Insufficient 140-250 Consider reducing dose >725)

Serum Folate 24.65 (10.4-42.4 nmol/L )

The doctors comments from Blue Horizons were as follows:

The thyroid stimulating hormone (TSH) level is low. If you are already taking thyroxine, dose adjustment may be necessary - you should discuss this with your usual doctor. If you are not taking thyroxine, it would be wise to keep an eye on this level - either by reference to previous results if known or by checking TSH again in 6 months’ time or so. There is a possibility that hyperthyroidism (overactive thyroid gland) will develop if the TSH fails to rise (a low TSH implies excessive thyroxine production from the thyroid gland). The finding of a positive thyroid antibody result in addition increases the possibility of your having autoimmune thyroid disease, such as Hashimoto's thyroiditis or Grave's disease.

Thank you :)

15 Replies

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  • It doesn't matter how low your TSH gets, once you are on thyroid hormone replacement. The TSH is only relevant if it goes high. Yours is just fine.

    However, your FT4 and FT3 are still far too low for you to feel well. You should have had a blood test at your doctor's 6 weeks after your increase to 75 mcg - doctors should know that, but they rarely seem to! - and your dose increased to 100. Then, another test after six weeks, etc etc etc until all your symptoms have gone.

    When you go for a blood test, you should make it as early as possible in the morning, and fast over-night. And leave 24 hours between your last dose of levo and the test. If you didn't follow that procedure for the last test, then your TSH will be lower than normal - it's certainly low considering your FT3.

    So, if I were you, I would go back to my doctor and tell him it's time he did another test. :)

  • Thank you Greygoose. I will book an appointment for another test. I'm just a bit nervous of going back to my GP as she said that if my TSH was less than 1, she would decrease my dose ..... and I feel so much better, but I will bite the bullet and go.

    I did take the blue horizons test first thing in the morning and had nothing to drink or eat before I took it. Also, I take my Levo at night so I didn't take it the night before the test.

  • Oh dear! You have a very ignorant doctor, then! I didn't realise that. The last thing you need is a decrease in dose!

    But, maybe your Frees are not actually as low as they at first appear. If you take your levo at night, and you skipped the dose the night before the test, that means that you left about 36 hours between your last dose and the test. That might be a bit too long - we usually say 24 hours. That could explain your low FT4, but I don't know how that would affect your FT3. So, that test isn't completely reliable then, is it. The TSH will be ok, as it was first thing and fasting, but the Frees are probably a bit off.

    I don't know what you can do about your GP, but she certainly isn't doing her job very well! Can you change her? That's a very unsatisfactory state of affairs.

  • Oh no, I thought that I was doing the right thing stopping my doe the night before!! Oh well, I suppose that I will have to wait to do the full set of tests again with Blue Horizons in about 6 months. I could change my GP, but my original GP at that practice who has been brilliant with our family over many years, took no interest in my thyroid issues at all. When he left and I went to another GP in the practice, I thought that she would be a bit more understanding, but certainly not ..... she says that none of my symptoms are to do with my thyroid, but she is happy to give me HRT or anti-depressants!!! Why do so many of us have to put up with this all of the time from our GP's?? It makes me really dread going to the GP at all!!

    Anyway, one final question, would it be worth me taking any Vitamin D through the Winter or not worth it?

    And also, I wanted to take some Cod Liver oil for my joints and wanted to check that this is ok to take with my other medication?

    I honestly can't believe that I am happy to take tablets after never taking anything all of my life!!!!

    Thanks again

  • It is right to stop levo for 24 hours. But 36 hours is a bit too long. So, when you are due a test, it would be a good idea, the day before, to take your levo in the morning. That will leave a 24 hour gap. And it really won't matter that much. Then go back to your normal evening dosing.

    I think doctors get funding points, or some such thing, for prescribing antidepressants - don't know about HRT - but they get nothing for thyroid hormone replacement. It's a rotten system, I know. But she says that about the symptoms because she doesn't have the slightest idea about thyroid symptoms. Ask her if she thinks your symptoms are symptoms of depression. I bet she won't be able to answer that. It's just more financially viable for her to assume depression. She's very ignorant, that's all.

    I think you most definitely should take vit D3 over the winter, yes - and probably for the rest of the year, too. Your vit D is rather low. You need it more like 100. But, remember to take vit K2 with it, because the D3 will increase absorption of calcium from food, and the K2 will make sure it goes into the bones and teeth, and not the tissues.

  • Ok thanks, I will make sure I leave that gap for my next test.

    That is the only way that I managed to get my increase in Levo as I said to her that she was keen to offer me anti-depressants when I wasn't diagnosed with depression and she was also keen for me to trial HRT when she had tested me for the menopause which had come back negative, so why wouldnt she give me an increase in medication for hypothyroidism which I was diagnosed with!!! She did agree very reluctantly and said that she would put it on file to say that she didn't agree with me having it, but then went on to say that it could be doing me more harm in other ways long term. Again, I explained that HRT also has long term side effects also and I was willing to take the risk with Levo!!! I really don't understand enough about the thyroid ...... I do have lots of books etc to read through, but havent got there yet ...... but all I know is, after taking advice from people on this forum, I feel lots lots better!!

    Could you give any pointers of the best vitamin D and vitamin K2 to take please or are they all the same?

    Thanks again

  • I think you'd be better off posting a new question about vit D, asking just that. I don't know a lot about it.

    All I can say about your doctor is that all doctors are pretty ignorant about thyroid, but yours is more ignorant than most! :)

  • Ok, thank you Greygoose :)

  • You're welcome. :)

  • I'm so glad I read that reply greygoose! I normally take my Levo approx 2.00 a.m. and have an appointment for a blood test at 8.50 tomorrow morning so I'm not sure when to take my next dose? I'm probably wasting my time anyway as they most likely will only test for TSH and T4. I am definitely considering Blue Horizon in future.

    (Apologies Jillycee for hijacking your post :-) )

  • Sorry, a bit late to avise, now. :(

  • Jillycee,

    TSH is low but you aren't over medicated because both FT4 and FT3 are within range. As Greygoose said, low TSH is irrelevant when you are taking Levothyroxine but I doubt your GP will agree or be amenable to increasing dose.

    Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism. 100% gluten-free diet may improve symptoms and reduce antibodies.

    chriskresser.com/the-gluten...

    thyroiduk.org.uk/tuk/about_...

    It's possible that your joint and muscle aches are due to suboptimal vitamin D. 75-200 is replete and most people are comfortable around 100. I would supplement 5,000iu D3 daily for 8-12 weeks and then reduce to 5,000iu alternate days and retest in 6 months. Take vitamin D 4 hours away from Levothyroxine.

    ____________________________________________________________________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thank you for that info Clutter. I have been 100% gluten free since March this year, so hopefully this will continue to help.

    I will start taking D3 at the doses you have mentioned. Grey goose mentioned the K2 also, are you aware of the best D3 & K2 to take? If not, I will re-post as Greygoose mentioned.

    I take my Levo at night, so I presume I would be ok to take the D3 in the morning with my B12 and Complex?

    Thank you :)

  • Jillycee,

    I'm currently using Doctor's Best D3. I don't use K2 but from what I've seen K2 MK7 is the form to take.

    Take D3 with the fattiest meal of the day as fat helps absorption.

  • Thank you for that info Clutter, really useful :)

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