Please help to interpret test results and recommend supplements

Hello all,

It has been a while since I last wrote on here, but it's that time again.

Was diagnosed with Hashimoto's in August this year and put on 25 mg levo. Was tested again in October and levo was increased to 50 mg. Latest bloods from 12 December look much better:

TSH 2.110 (0.270-4.200)

FT4 18.1 (12.4-20.4)

FT3 5.93 (3.66-6.72)

Antibodies have remained more or less the same since August.

TPO 92 (<34)

TG 253 (<115)

Convinced doc to put me on 75 mg of levo and hope this will finally optimise my levels (would like my TSH be closer to 1 and FT3 higher), next bloods are due in February.

Also got some other stuff tested.

Ferritin 39.0 (13.0-150.0)

Is this too low although in range? What would be optimal here?

Vitamin D 18.5 (anything under 20 is classified as deficient, so that is not good). Lab range says 30 and above would be the desired level and over 100 is toxic level.

Vitamin B12 332 (197-771)

Is this optimal or rather low?

I'd appreciate your thoughts and recommendations for suitable supplements.

Thank you and happy holidays!

Kilbu

14 Replies

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  • Kilbu77 Ferritin is very low. It needs to be at least 70 for thyroid hormone to work properly and it should be half way through it's range, I've seen it said that for females it should be 100-130. You either need to eat liver once a week which is great for raising ferritin, or supplement with Ferrous Fumarate (from Amazon) one tablet twice daily, taking each tablet with 1000mg Vit C to aid absorption and help prevent constipation. Iron supplements need to be taken 4 hours away from thyroid meds, other supplements and meds as it affects their absorption.

    B12 is also too low. Anything under 500 can cause neurological problems. Recommended is top of the range, even 900-1000. You can supplement with Solgar or Jarrows sublingual methylcobalamin lozenges 5000mcg daily for 2-3 months then reduce to 1000mcg daily as a maintenance dose. Let it dissolve under the tongue to get directly into the bloodstream, don't chew or swallow as stomach acid destroys it.

    When taking B12 we also need a B Complex to balance the B vits. Look for one containing methylfolate (natural) rather than folic acid (synthetic).

    B vits are stimulating so best taken in the morning, no later than lunchtime.

    Recommended level for Vit D is 100-150nmol/L and as you are in the UK I am assuming that is the unit of measurement of yours. You can supplement with D3 and a loading dose would be in order if you can tolerate it. My level was 15 and I started with a loading dose of 40,000iu daily for 2-3 weeks then reduced to 5,000iu daily. If you don't want to start that high I would suggest 10,000iu daily for 6-8 weeks then reduce to 5,000iu daily. Retest in the spring to stay within the recommended level.

    When taking D3 we also need K2-MK7 and magnesium, important co-factors. Vit D aids absorption of calcium from food and K2 directs the calcium to bones and teeth rather than arteries and soft tissues. D3 and K2 are both fat soluble so should be taken with the fattiest meal of the day. D3 should be taken four hours away from thyroid hormone.

    Magnesium comes in different forms, check here to see which would suit you best and as magnesium is calming it's best taken in the evening naturalnews.com/046401_magn...

    Don't start all supplements at once, start with one, give it a week or two and if no reaction then add in the second one, wait another week or two, again if no reaction, add in the next, etc. That way if you do have any adverse reaction then you will know what caused it.

    As you have Hashimoto's, have you adopted a gluten free diet as recommended in reply to your first thread here on the forum? This has helped many members reduce antibodies and consequently antibody attacks.

    In case you haven't already seen them, info on Hashi's here:

    stopthethyroidmadness.com/h...

    stopthethyroidmadness.com/h...

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

    Gluten/Thyroid connection:

    chriskresser.com/the-gluten...

    Hopefully the increased dose of Levo will bring your TSH down as a suppressed TSH will help reduce antibody attacks, as will supplementing with selenium L-selenomethionine 200mcg daily.

  • Thank you very much! I will start adding these step by step. In the meantime I ordered vitamin D3 from Amazon; 50,000iu. It is recommended to take one weekly...with my levels, can I try and take it every other day? Or would it be too much?

    It is lots of supplements, how do you fit them all into a day? I work in a very busy office and often forget to eat... I try and take my levo very early in the morning and on an empty stomach. I will eat breakfast about 2 hours later. Should I perhaps try and take D3 and B12 at the lunch time and ferritin in the evening? Am also on metformin 3 times a day (for PCOS) which I take with meals. I understand I cannot take it with together with ferritin?

    Trying to go gluten free, but have not quite succeeded. :(

    Thanks again!

  • Kikbu, you can try 50,000iu alternate days and see how you go. if it suits you then use that dose for a month then maybe reduce to once a week. It is important to retest because Vit D builds up in the body and you don't want to reach toxicity level which is 220nmol/L plus. Once you've reached 100-150 a good maintenance dose is 2000iu daily, re-testing once or twice a year to keep an eye on your level.

    We have to try and find a routine for supplements. If you get up in the night for the loo, why not take your Levo then? That keeps it well away from food and supplements.

    No problem with D3 at lunchtime as long as it is taken with dietary fat. If your D3 is a softgel containing some oil, then that is fine and could be taken with something like a full fat yogurt, a sandwich with butter, or something similar, likewise the K2.

    B Complex can be taken with breakfast. B12, as it's sublingual, doesn't need to be taken with food.

    If taking Ferrous Fumarate twice daily then that could be a problem with timing. This is why I always suggest eating liver once a week, saves all the faff of an iron supplement.

    I have no knowledge of metformin and taking supplements so it would be a good idea to look into this to make sure the suggested supplements are fine to take alongside it.

  • Thank you!

  • Can you please clarify if your vitamin D3 is 50,000IU or 5,000IU it is really important.

  • Also if your ferritin level is low then just eating food however iron rich it is will not give you enough iron to raise your ferritin level - you need to take iron supplements.

    Where you cannot take two iron supplements a day then you need to fit in one. You should also eat the iron rich food as well. You do need to still test as the intervals already stated to confirm no iron overload issues.

    Once you get your iron level to half way in the range then you can try and maintain it with just eating the right food. Again you will need to have a test to confirm you are doing so.

    in regards to fitting your supplements in the day you need to set alarms on your mobile phone plus calendar appointments on your office computer. In addition take in snacks with you to work so you can take all your tablets with food. Plus make sure you have a refillable water bottle on your desk. Before you go into a meeting check whether an alarm is likely to go off in the next hour, take food & supplements with you and put your phone on vibrate on our person.

  • SeasideSusie Kilbu77 said 50,000IU NOT 5,000IU.

    One every other day is far too much.

  • It is 50,000iu. It is recommended once weekly. Twice a week?

  • Your lab result are confusing can you state the units they are in please.

    30 is the US measure of being OK and that is in ng/mL. In the UK the minimum labs think is adequate is 50nmol/L However on thyroid UK it is recognised these figures should be around 100nmol/L (40ng/ml)

  • The recommended maximum of vitamin D3 is 10,000IU per day as this is the level you are unlikely to have any side effects.

    In your case this would be ONE 50,000IU tablet every 5 days.

    The reason for this is mental as in nature you would get sun everyday not once every 5 days if you were in the right climate. The second is as someone who was prescribed 3 20,000IU tablets a week I found I was in severe pain on the 4 days I didn't take a supplement though I was in pain anyway.

  • Vitamin D is ng/mL (under 20 is deficiency, mine is 18.5; desired level is 30 to 100 based on the lab ranges)

    Ferritin is ng/mL

    B12 is pg/mL

    Thyroid levels are the common UK units.

    Thank you both!

  • OK this is helpful.

    On thyroid UK it is recognised these figures should be around 100nmol/L (40ng/ml)

    The reason why I raised this is vitamin D is fat soluble and very rarely do people take too much so end up being ill. However when they do they end up being put in the medical literature as a case study. I do not want thyroid UK blamed for a mistake in units.

  • Sorry my other post isn't clear. Instead of taking your 50,000IU D3 supplements every 5 days, go out and buy 10,000IU D3 supplements and take one every day for 6-8 weeks. Then wait 5 days get retested for vitamin D. Once you a re-tested start a new thread and someone will tell you what level of supplements you should take.

    You can get a vitamin D testing kit from City Assays. cityassays.org.uk/

  • Thank you!

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