He could supplement to get Vit D up to recommended level of 100-150nmol/L.
Ferritin could do with being half way through range (160), eating liver once a week should raise that.
He could do with an increase in Levo as TSH is too high and FT4 too low. The aim of a treated hypo patient is for TSH to be 1 or 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.
You can hide the liver quite easily in things like casserole, cottage pie, curry, bolognese sauce. If he has iron supplements he needs to take them with 1000mg Vit C with each tablet and 4 hours away from thyroid meds, other supplements and medication as iron interferes with their absorption.
Lamb's liver is fine, or chicken liver might have a milder flavour. I've not used chicken liver as I'm happy with lamb's liver. If you use a butcher, ask which is mildest.
Does he like pate? That's another way of getting liver.
Make a stew of some kind that you know he will eat.
Fry the liver. Mince it up, then put it into the stew a few minutes before serving it.
Or alternatively, mince it up while still raw and put it in the stew 10 minutes before serving.
If he comments on the flavour say you are trying out a new combination of herbs or a different brand of stock cubes.
I'm not usually a fan of being under-handed with food (or people), but if I eat stuff I don't like for the good of my health, then I don't see why other people won't!
Vitamin D 61 is sub optimal, around 100nmol/L is optimal. Your son should supplement 5,000iu D for 6-8 weeks and then reduce to 5,000iu alternate days and retest in May.
Folate is deficient. Your son's B12 is fine but needs folate to work. My GP prescribed 5mg folic acid for a couple of months to correct my folate deficiency. Lower dose folic acid or methylfolate are available without prescription.
I edited my post above as I missed that your son is taking 150mcg Levothyroxine. He is still under medicated and dose should be increased to 175mcg. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.roberts@thyroiduk.org.uk if you would like a copy of the Pulse article to show your son's GP.
It takes 7-10 days for a Levothyroxine dose increase to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.
Your son should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after his blood draw.
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