Thyroid UK
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Questions for gp?

This is my first post so hello to everyone. Due to see gp next week. Have had bad reaction to 7 weeks of Levothyroxine but result of TSH is now normal. Is it too early to ask about other meds? These r my results:

29.11.16 Vit D 20nmol/L. TSH 35 , B12 normal, folate normal, ferratin not tested. Now on B3 800IU daily

20.12.16 TSH 36.3 freeT4 10.4, free T3 4.2 anti thyroid Microsomal ab 0.6IU/ml

9.2.17 TSH 3.52

Grateful thanks to thyroid uk and this forum for keeping me sane.

9 Replies

normal means nothing on any test

its vital that you get the actual results and the ref ranges for all tests inc ferritin,folate,b12 because unless all are truly optimum the conversion process of t4 into t3 cannot work


stillhopeful B12, Folate and Ferritin - did they give results and ranges or just say 'normal''. If normal then that's not good enough, ask for the actual figures with ranges then come back for advice on those.

Vit D at 20nmol/L is deficient, and 800iu D3 will never raise it. 800iu isn't even a proper winter maintenance dose for someone with a decent level. Did you have a loading dose to start? Hopefully you did. If so, can you please give details of what you had then we can possibly suggest a decent maintenance dose for you.

When supplementing with D3 we need it's important co-factors

D3 aids absorption of calcium from food and K2-MK7 directs it 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. Take D3 four hours away from thyroid meds.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

Your TSH is still to high, and it would be good to have FT4 tested, FT3 as well if possible. 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.

What do you mean by 'other meds'? If you've had a bad reaction to Levo, there are other brands you can try, and if you also react to those there is a liquid Levothyroxine.

Anti-thyroid microsomal antibodies are the Thyroid Peroxidase antibodies (TPO). Do you have the range for that test? It's not possible to say whether you are positive or negative for autoimmune thyroid disease without the range.


20nmol/L means you are severely deficiency in vitamin D3.

Go back to the GP and inform him/her you have been told each area has a protocol laid down by haemologists for primary healthcare professionals to follow for patients who are severely deficient in vitamin D3 and can s/he follow it as advised.

You can actually find some of them on Google so if you know the name of your two nearest NHS trusts, or if in Wales one of your nearest healthboards, you can search for them, and print the protocol out to show your GP they are not treating you correctly.

Even the most useless protocol I've seen puts someone at your level on about 4500IU of vitamin D3 per day for 3 months.

The reason the GP has prescribed you 800IU supplements is to get you to go away as prescribing a proper amount of D3 to get you to at least 50nmol/L takes money out of their budget. There are comments under Pulse articles complaining of the cost of prescribing vitamin D3 supplements to patients.


Welcome to the forum! Glad you have found us! Lots of help on the Thyroid Uk site about how to take your medication, some fo's and don'ts and it may sound daunting and complicated but it's not once you get into a good regime. Lots of help around if you ever have any questions and a bit of important advice, always ask for a copy of any results and make sure you get the ranges as well as they vary from lab to lab. Doctors often tell us things are normal but that's not always best for us and often optimal is high in the range! Things. An take a while to settle down as well as nothing moves quickly in the Thyroid world, patience is needed to give out body time to change.

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Thank you to all who replied. I really appreciate it. I am sorry I have been so long getting back to you. I had to look things up and got tired . Bye the way I am a 57 year old woman who has had chronic fatigue syndrome for 20 years. I am lucky that my practice has patient access so I can look up results on line going back many years. Here recent ones with ranges when I have them.

29.11.16 Serum Vit D 20.1 nmol/L range 80-150nmol/L

I did have a loading dose of 2x20,000 daily for 1 week and since then have taken 1,500 daily as I didn’t think 800 was enough. Due for another blood test soon.

B12 523 pg/mL range 187-883 pg/mL

Serum folate 11.1 ng/mL range 3.1-20.5 ng/mL

Ferritin not tested.

TSH 35 mIU/L range 0.35-4.94 mIU/L


TSH 36.3 range 0.35-4.94 mIU/L

Anti thyroid Microsomal Ab 0.6IU/mL no range given

(D)Thyroid function test Abnormal Negative (not sure what this means)

Serum free T4 level 10.4 pmol/L range 9.01-19.05 pmol/L

Serum free T3 level 4.2 pmol/L range 2.63-5.7 pmol/L


TSH 3.52 mIU/L range 0.35-4.94 mIU/L

Thanks Seaside Suzie for the links on vitamins and health. Will check those out and advice on protocol from Silverfox.


stillhopeful At least you had a decent loading dose, it would have been better for two weeks rather than one, but it was a good start. You now need to be on 5000iu daily until your next test and only if you've reached the recommended level of 100-150nmol/L should you reduce. 1500iu daily (or even 2000iu) would be a winter maintenance dose when you've reached the recommended level. If you're a person who goes out in the summer sun when it's at it's highest, with no sunscreen on a good amount of skin exposed, then you probably wouldn't need to supplement in the summer.

A decent D3 supplement is

It's important to take D3's co-factors mentioned above.

You could do with boosting your B12. It's not too bad, but recommended is very top of the range, even 900-1000. Buy some Solgar sublingual methylcobalamin nuggets 10mcg and take one daily, dissolve under the tongue to get directly into the bloodstream, don't chew or swallow as stomach acid destroys it.

Folate should be at least half way through it's range, yours isn't quite there. When taking B12, we need a B Complex to balance the B vits. Choose one with methylfolate rather than folic acid and that will also boost your folate level.

Ferritin needs to be tested. It should be half way through it's range, with a minimum of 70 for thyroid hormone (our own or replacement) to work properly. T4 can't convert to T3 unless it's 70.

I honestly don't know about your antibodies, whether they are positive for autoimmune thyroid disease (Hashimoto's) or not. The surgery must have a range, or should check with the lab. If you are positive for Hashi's then you would benefit from trying to reduce the antibodies and adopting a strict gluten free diet helps, as does supplementing with selenium.

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Just checked, my treatment is the correct protocol for Vit D deficiency -for Buckinghamshire Health Trust. I guess we are behind the times on this.

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Not behind the times saving NHS budgets as it is impossible to get up to 80nmol/L on that level of supplementation alone in winter.

Anyway luckily you found this forum to help sort your health out yourself.

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Have decided to get my test for Vit D done and then see Doctor and report my troubles with levothyroxine. Do not want to up my dose for levothyroxine (50mcg) as feel much worse on the the stuff than when my TSH was 36. Will ask for Ferritin test as suggested and improve my vitamins as I have the energy to tackle stuff. Thanks for help


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