Hypo since centre 2000,

[Stemar]

New to this so hope for some advice, never took much notice of my bloods before but having fought for Parathyroid surgery I decided to take control and understand this hypo. Had full thyroid bloods done via medicheck last week and results are :-

TSH 0.858 (0.270-4200

Free thyroxine 19.89 (12.000-22.000)

Total thyroxine 112.2 (59.000-154.000)

Free T3 4.08 (3.100 -6.800)

Thyroglobulin antibody 58.060 (0.000-115.000)

Thyroid peroxidase 30.59 (0.000-34.000)

Vit B12 233.2(140.00-724.000)

Foliate 12.99 (3.890-26.800)

Vit D 53.12 (50.000-200.00) on 800 per day for 2 years have increased this since results

CRP-high sensitivity 8.1 (0.000-5.000)

Ferritin 237.9 (13.000-150.00) advice . Re check in 6 weeks but GP monitoring blood sugar levels in Feb as this has been high normal since parathyroid surgery in June

[SeasideSusie Remembering]

Stemar B12 below 500 can cause neurological problems. Recommended level is very top of 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. Dissolve under the tongue to get directly into the bloodstream, don't chew or swallow as stomach acid destroys it.

Folate is a bit low. Recommended is at least half way through it's range so that's at least 15.34. When supplementing with B12 we also need a B Complex to balance the B vits. Look for one containing methylfolate rather than folic acid, it doesn't have to be a very high amount, something like 200mcg methylfolate will do. Thorne is a good make.

For your Vit D aim for 100-150nmol/L which is the recommended level. I would be taking 5000iu D3 daily throughout the winter then reducing to 5000iu alternate days. Retest in the Spring.

When taking D3 we also need it's important co-factors K2-MK7 and magnesium vitamindcouncil.org/about-v...

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 fat soluble so should be taken with the fattiest meal of the day.

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

I don't know anything about parathyroids so can't comment, but high CRP and high Ferritin can be due to inflammation or infection.

Your TPO antibodies, although not over range, are quite high. A positive result would confirm autoimmune thyroid disease aka Hashimoto's but one negative result doesn't rule it out. You could repeat at some time in the future. Or you could just go completely gluten free which helps reduce antibodies and helps many people with Hashimoto's. Also, supplementing with selenium L-selenomethionine 200mcg daily helps lower antibodies and helps convert T4 to T3.

Your FT3 isn't in balance with your FT4, it's a bit low. If you don't feel optimally medicated this could be why. What dose of thyroid meds are you on?

[Stemar in reply to SeasideSusie]

125, been on 200 for years but they reduced last year when I was having heart palpatations , could have been caused by high calcium level while they left me to wait and see with para trouble but that's all sorted now

[SeasideSusie Remembering in reply to Stemar]

Generally the aim of a hypo patient is for TSH to be 1or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges if that is where you feel well. FT4 is normally best in the upper third, and FT3 is normally best in the upper quarter, if that is where the patient feels well.

Your TSH is in a good place.

FT4 19.89 (12.000-22.000) - this is 78.9% through it's range, so that's good.

Total thyroxine 112.2 (59.000-154.000) - a good amount of T4 is showing in your blood.

FT3 4.08 (3.100 -6.800) - this is only 26.4% through it's range, generally most people would need this to be around 5.9 to feel well.

So, how do you feel?

Your results show that you are not converting T4 to T3 anywhere near well enough. If you aren't feeling well then this could be your problem. Unfortunately your GP won't know anything about this. He will say your FT3 is in range so you must be fine, or it's not your thyroid causing any problems. They only see 'in range', which is why you were told your B12 was fine.

Do you have any results from when you were on 200mcg levo?

Was your dose reduced from 200 to 125mcg gradually or in one go?

[Stemar in reply to SeasideSusie]

Didn't bother querying any medical practise until last year, just did as I was told, so no haven't got any results from when I was on 200mg, they did reduce it over about4/6 months . Can't say I feel ill but still getting a lot of bone pain but have increased my Vit d over the last few days and don't feel as stiff or so achie. Sugar levels are high but not diabetic yet , not sure if to take b12 k2 or anything else at the moment until that's sorted .

[SeasideSusie Remembering in reply to Stemar]

Stemar As you are taking D3 you need to take it's co-factors as mentioned. If you don't take K2-MK7 then the extra calcium from food will be going to soft tissues and arteries. If it gets deposited there then there's the danger of kidney stones, calcification of arteries etc. K2 will direct the extra calcium to bones and teeth where it is needed.

Your bone pain should improve as your Vit D level reaches optimal, so you should take the dose I suggested then re-test in the Spring.

Your B12 is very low and I've pointed out the risks of not increasing the level. Some information -

b12deficiency.info/signs-an...

Improving your B12 levels won't be deleterious to your sugar levels, nor will taking K2.

Once all your vitamins and minerals are at optimal levels then thyroid hormone has the best chance to work.

Better conversion of T4 to T3 will be helped by selenium, and a better balance of T4:T3 will help. With your results I would be considering the addition of T3.

Hypothyroidism is linked with diabetes, optimising your thyroid will lessen the chance of diabetes developing.