Advice please - Are levels low enough for nhs help or should I buy supplements?

[jamiface]

Diagnosed hypothyroid in Feb or March this year, have had problems with carpal tunnel, pins and needles, tinnitus anosmia fatigue depression constipation brain fog memory weight gain etc for more than a dozen years, probably twice that long actually

I asked GP for tests for vitamin levels and antibodies to see if there is owt I can do to help the levothyroxine work. Doc did most of blood tests I requested, but I really wanted both antibody ones 😔 to see whether it is hashimoto's or not.

Results:

Serum vitamin B12 level 397 ng/l [ 197 - 771 ]

Serum folate level 4.8 ng/ml [ 2 - 18.7 ]

Serum ferritin level 81 ng/ml [ 13 - 150 ]

Serum total 25-hydroxy vitamin D level 39 nmol/L [levels should be >75 nmol/L at all times. Levels 50-75 are probably suboptimal, long term may lead to clinical effects. Consider safe sun exposure, diet, supplement. Levels 25-50 indicate deficiency, supplementation is indicated. Levels >25 suggest severe deficiency-may need pharmacological preparations...]

I requested both the antibody tests, but only this one was done

Serum thyroid perioxidase antibody concentration 17 kU/L [ <34 ]

Please could any of you wonderful experts by experience help with whether I need to buy supplements and if I do, then which ones and when would be best to take them , please?

Thank you in anticipation

[jamiface]

After searching for hours through answers to other posts, I gather I'm low in vit B12, vit D and folate, but ferritin is ok?

[Saggyuk]

Hiya Jamiface

Don't take it personally, sometime people log on and only go so far back so sometimes posts get missed and sometimes answering your own post can make it look like someone's already responded

First off, are your thyroid levels optimal? many docs under-medicate so post these results also for advice if optimally medicated. I always get tinnitus when hypo. You will often need increasing doses and re tests after 6-8 weeks to get to adequate levels - has your doc been doing this?

B12 isn't the worst I've seen, but can be bad for some people so depends on if you have symptoms. It is hard to over load on B12 so won't really harm you to get to a more optimal level anyway - I am not the best at which types/doses though but sublingual methylcobalamin is normally best, you could try 1000mcg and see how you go maybe?

Folate should be half way through range so could do with being higher.

Vit D definately could do with being higher - again I'm not the best but I've got mine up on 3000iu D3 capsules. You might want a higher dose to be honest but ask for better advice on here tomorrow as Vit D is not one you want to overload in so also want to retest after 2/3 months before going down to maintenance dose.

Ferritin can be misleading so wouldn't want to say level is fine without seeing full blood count.

You might want to get your T3 levels tested to ensure you are converting the T4 into T3 as well as the other thyroid antibodies. Most GPs are not able to request T3 levels. You can pay for you own tests if doc wont do and you really feel the need - info for these can be found on thyroiduk website but most of us use medichecks or blue horison. Medichecks do "thyroid thursdays" with discounts on thyroid tests every thursday.

My best suggestion in regards to my own health problems and experience as also tired and very ill for twenty years was to go gluten free. many of us hypos find this beneficial and reversed nearly all my problems including a diagnosed autoimmune sleep disorder and most the pain I had everywhere. It's definitely worth a go for three months but must be 100% gluten free. Otherwise looking for cause of any stomach issues like constipation as will always help and indicates issues (IBS doesn't exist in my opinion lol) as is checking your blood sugar levels with a cheap pack from pharmacy.

Hope you feel better soon

[jamiface in reply to Saggyuk]

I reckoned my post had been overtaken by all the others and people wouldn't scroll back that far anyway 🤷🏼‍♀️ Thank you for replying

February test results, no meds

Serum free T4 level 12.7 pmol/L [11.0 - 23.0] Slightly raised TSH, suggest repeat in 6 months to check trend

Serum TSH level 5.0 mU/L [0.27 - 4.5] Outside reference range

Test results from late May on 25mcg levothyroxine

Serum free T4 level 15 pmol/L [11 - 23]

Serum TSH level 2.4 miu/L [0.27 - 4.5]

7th June Doc then upped my dose to 50mcg levothyroxine (after saying results normal, no further action, which, of course I challenged from what I've learnt from here)

I've only been on 50mcg for three weeks now, so no blood test due yet. In some ways I feel better, but in others, worse. I felt much worse after about seven weeks on the micro dose I was initially on. I personally, feel there's quite a way to go on the hypoT front, which is why I asked doc for the other blood tests, to try to find out if there are other things she or I can do to help, like vitamin/mineral levels, would gluten free help if it isn't Hashimoto's?

Should I ask GP for a full blood count? She should be able to do that test, right? Looks like I am going to have to save up to get both antibody tests done, might wait until after next GP thyroid test if doc/lab don't test the free t3 (which I will ask them if they can do, but not holding my breath for that one 😂)

I do tick a lot of the boxes on the vitamin B12 deficiency symptoms page.

My blood sugar seems to be fine ( I purchased a testing kit when it was on sale in Lidl, cos I was curious ) despite both my sisters being T2 diabetic, my late Mother was T2 also, her Father was T1 diabetic and her Mother T2. As far as I'm aware, my brother isn't diabetic (yet) My late Father was hypothyroid but that may have been because he was prescribed amiadorone(?) My Father also had Parkinson's Disease (which he had symptoms of for at least 8 years before diagnosis, thanks to every GP at our surgery 🤦🏼‍♂️)

I had a noticeable goitre on admission to psychiatric ward some 26 or so years ago, but no tests were done (I suspect ) because I'd been diagnosed with a mental health problem, and there's never anything physical to cause that, is there 😡 😤 I'd assumed the feeling under-par ever since then was due to the antidepressants cos I didn't challenge doctors back then.

It'd be nice to do more than just survive, I'd quite like to have my life back. The only thing I don't want back is my libido. I'm quite happy without that, thank you very much 😂 (Sorry if that is TMI 😂)

[Saggyuk]

Lol - no that's fine. I'm the opposite and am trying to get my libido back lol! Anti-depressents often reduce libido anyway so might be the cause if you're still on them.

I totally understand re them not taking you seriously if they consider it all to be mental health - we've all been in that position.

Well you definitely are vit D deficient so get that sorted and get your folate up a bit. Also you will need to get thyroid tests done again 6-8 weeks after the increase to 50 levo so yes, might be best to wait until optimally medicated by docs to get further tests done so you can see exactly where you're at after.

Yes, GP can get a full blood count done - this is the most requested tests and very routine so maybe ask your GP receptionist if done already as may have had them as routine when thyroid tests were originally done. At least this will properly check for low iron.

Sometimes an in-depth look at your diet can help. Are you eating enough calories, are you eating a varied enough diet to meeting all your requirements as although the ones tested are most commonly deficient, there's loads of other micro nutrients not normally tested for. You could use a site like cronometer which tracks everything basically in your food in take for a few weeks to see if anything obvious. I found this useful and did raise a few areas in my situation. Other things like iodine and selenium are also required by thyroid so making sure all is okay is useful and making sure these and other things aren't too high also as some things are detrimental if too high like retinol (vit A)

Well, I always consider anything being worth a try when you're feeling rubbish and making everything else optimal is beneficial especially if any digestive disturbances or ongoing fatigue and you seem the type to want to rule out everything properly and in regards to food intolerances, taking the food out for a period of time is the only way really as testing is not reliable. Gluten is the one where you have to do for at least three months but if no improvements, you could try a six week elimination diet to see if intolerant to any other food groups. I would say with family history of Type 1 diabetes and hypothyroid and a goiter previously, it is certainly worth a try of GF.

I did see your previous post many years ago in regards to liver - if this is still not resolved, you may want to take a serious look into this as might cause many problems. Don't mean to offend Maybe get a liver/kidney function test to check all okay especially if diabetes runs in your family. Might also be worth a recheck of blood sugars if this was some years ago and things can change.

I really hope you get to the bottom of it soon though and wish you all the best

[Saggyuk]

Oh I should add, that folate is important along with all the other B vits - maybe a good b complex like thorne basic B that includes folate might be useful.

Also Vit K2 is important for Vit D and is often missing from many people's diet

[jamiface]

Routine tests done in February

Urea and electrolytes

Serum sodium level 142 mmol/L [133.0 - 146.0]

Serum potassium level 4.8 mmol/L [3.5 -5.3]

Serum urea level 6.8 mmol/L [2.5 - 7.8]

Serum creatinine level76 umol/L [45.0 - 84.0]

eGFR using creatinine (CKD-EPI) per 1.73 square metres 77 mL/min [90 - 200.0] Outside reference range

Liver function tests

Serum total protein level 68 g/L [60.0 - 80.0]

Serum albumin level 37g/L [35.0 - 50.0]

Serum globulin level 31g/L [20.0 - 34.0]

Serum alanine aminotransferase level 10 U/L [<33.0]

Serum alkaline phosphatase level 66 U/L [30.0 - 130.0]

Serum bilirubin level 5 umol/L [<21.0]

Haemoglobin A1c level 37 mmol/mol [23.0 - 41.0]

Serum lipid levels

Serum cholesterol 4.6 mmol/L

Serum triglyceride 1.4 mmol/L

Serum HDL cholesterol 1.4 mmol/L

Serum LDL cholesterol 2.6 mmol/L

Serum cholesterol/HDL ratio 3..3 mmol/mmol

Serum non high density lipoprotein cholesterol 3.2 mmol/L

No offence taken, Saggyuk I think my liver survived both my drinking and my anxiety about it 👍🏼

I'll take another look at your advice later when. I've got more time and less brain fog 😊

[Saggyuk in reply to jamiface]

Haha, yes liver isn't screaming anything hugely obvious. Kidneys as well but do you drink enough water lol?

HbA1c test's fine. Only know the Serum cholesterol 4.6 mmol/L - should be under five so that's good. The rest of the cholesterols mean diddly squat to me to be honest lol!

[jamiface in reply to Saggyuk]

I'm always drinking water, cos my mouth feels dry all the time 😊

Cholesterol means diiddly squat to me too 😂

[Saggyuk in reply to jamiface]

Well maybe watch the salt intake then as sodium/potassium/urea although okay are a little higher than optimal but might be the case if dehydrated which is why I asked but if you're always drinking which would lower sodium etc, maybe your salt intake is a little too high anyway which could make you more thirsty. Watch those sugar levels also as nearer the top of the range rather than the lower and could cause dehydration and higher sodium, maybe switch some carbs for a little more protein lol I'm no expert mind you lol.

Just not sure what else to suggest, some people check their cortisol as often a little off but then this normally causes a different imbalance of potassium and sodium rather than them both at that part of the range but I suppose if you've tried everything else, maybe worth a go as two things together might change this????

Yes, I used to have dry mouth all the time but it went away after going GF, I no longer die of thirst after 20 mins without a drink in a shopping centre lol

[jamiface in reply to Saggyuk]

I never add salt to my food, by the way, apart from the very occasional stock cube when cooking, no other salt added by me, and always ask for fries with no salt if I go to a certain fast food 'restaurant'. I just don't like salt. There's probably more than enough salt in our diets nowadays.

[Saggyuk in reply to jamiface]

Hmm so you must just be a little dehydrated then which ties in with your constant thirst. Not sure why this would be though?