Thyroid UK
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Newbie - symptomatic on levothyroxine

Hi all,

I have been diagnosed hypo 17years ago and put on Levothyroxine. Most of the time my dose was 125ug, but recently it has been increased to 150ug (due to pregnancy). My dose was kept stable because my blood tests were always “good”, although my GP always told me to take my levo as normal in the morning before blood was taken. Nevertheless, I always had hypo symptoms and just learned to live with them, as I didn’t know that I could be feeling any better.

About 6 weeks ago I saw a dermatologist abroad (private visit) about my detaching nails and white skin around my eye. She suggested some blood tests and that’s how I found out about my vitD deficiency and high fasting sugar (detailed test results below). The dermatologist suggested taking 2000IU vitD daily.

Upon return to UK, I saw my GP who ordered tests to check for diabetes among other things (again, test results below). He said my iron is a bit low and I should take iron pills. I told him that iron pills upset my stomach, so he said I need to eat more meat then. I started reading here whether low iron can be behind my fatigue, muscle aches and memory problems. I learned a lot, so asked my GP practice for my blood test results and found that my iron level was actually much worse than I expected. I told GP I changed my mind about taking iron pills, and he prescribed 3x Ferrous Fumarate daily.

On the advice from PA forum, I wrote a letter to my GP asking him to consider treatment of low B12 level. While awaiting his response, I decided to post here asking for your advice on my blood results. One smart person told me to take one step at a time, so I want to start with supplementation first to see if that will make me feel more like myself (do I still remember what that is though?)

My worst problems are: fatigue, memory issues and persistent hypo symptoms despite taking levo. My fatigue started affecting my relationship quite bad now. Other symptoms: balance issues, ringing in the ears, numbness/tingling sensation in 3 outside fingers of both hands, memory and concentration problems, forgetting easy words (like remote control or keys), irritability, impatience and mood swings, sleep disturbances, increased susceptibility to and length of cold/flu, sensitivity to cold, easy bruising and wounds taking long time to heal.

I will appreciate any help, comments, advice…

My latest blood results are:

On 30th June 2017 (while in the middle of 3week long cold, done in the afternoon after taking levo in the morning – as per GP’s guidance)

Thyroid function:

TSH --- 0.2 mu/L [0.2-6]

Free T4 --- 18.4 pmol/L [10-20]

Blood haematinic levels:

Serum iron --- 5 umol/L [5-33] Borderline low

Serum transferrin --- 2.71 g/L [2.15-3.8]

Serum TIBC --- 62 umol/L [36-77]

Saturation iron binding capacity --- 8% [15-50] Low

Serum vitamin B12 --- 308 ng/L [180-910]

Serum folate --- 16.7 ng/ml [5.4-24]

Serum ferritin --- 55 ug/L [10-291]

Diabetes tests:

Plasma glucose --- 8.2 mmol/L [3-6] High

HbA1c --- 33 mmol/mol [<42]

Serum CRP --- 27 mg/L [<10] High

Serum osmolality --- 301 mmol/Kg [285-295]

Renal profile:

Serum sodium --- 140 mmol/L [135-145]

Serum potassium --- 4.2 mmol/L [3.5-5.3]

Serum urea level --- 5.2 mmol/L [2.5-7.5]

Serum creatinine --- 71 umol/L [53-100]

GFR calculated abbreviated MDRD --- 81 mL/min/1.73m^2 (NOTE: Stage2, CDK only if other evidence of renal damage)

Neutrophil count --- 4.65 10*9/L [2-7.5]

Lymphocyte count --- 1.3 10*9/L [1.5-4.1] Low

Monocyte count --- 0.3 10*9/L [0.2-0.8]

Eosinophil count --- 0.19 10*9/L [0.04-0.4]

Basophil count --- 0.03 10*9/L [<0.2]

Percentage neutrophils --- 71.9%

Percentage lymphocytes --- 20.1%

Percentage monocytes --- 4.6%

Percentage eosinophils --- 2.9%

Percentage basophils --- 0.5%

Full blood count:

Total white cell count --- 6.5 10*9/L [3.8-11]

Haemoglobin estimation --- 137 g/L [115-165]

Platelet count --- 236 10*9/L [150-450]

Red blood cell (RBC) count --- 4.59 10*12/L [3.8-5.8]

Haematocrit --- 0.41 [0.36-0.47]

Mean corpuscular volume (MCV) --- 89.3 fL [85-105]

Mean corpusc. haemoglobin (MCH) --- 29.8 pg [27-32]

Mean corpusc. Hb conc. (MCHC) --- 334 g/L [310-360]

Blood tests done 21st June 2017, privately abroad (due to seeing dermatologist about nails detaching)

Liver function tests:

Total bilirubin --- 0.35 mg/dL [<1.2]

ALT (Alanine aminotransferase) --- 23 IU/L [<33]

AST (Aspartate aminotransferase) --- 14.6 IU/L [<35]

Kidney function:

BUN (Blood Urea Nitrogen) --- 13.68 mg/dL [6-20]

CRP --- 0.18 mg/dL [<0.5]

Glucose --- 103.4 mg/dL [60-100] High

Iron --- 79.8 ug/dL [33-193]

25(OH)D3 --- 23.8 ng/mL [Normal is >=30] Low

TSH --- 0.21 ulU/ml [0.27-4.2] Low

6 Replies
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Hi & welcome moniacho,

The low TSH could be if you took your dose the morning before your test, always take levo on it's own with water away from other medication/supplements. I can't see a FT3 result (which is not surprising as labs won't do them if in range).

Your description of symptoms still indicates being Hypo and the numbness/bruising etc. often B12 & iron related - so should improve with supplementation, it takes a while sometimes. If you take iron tablets with orange juice it helps avoid constipation & take iron 4 hours away from Levo. I had awful shin & joint pain before I discovered I was low in Vit D.

I can't comment on the high blood sugar, except perhaps a low carb diet may help. J :D

Reply

Hi Spareribs

Thank you for your comments. Yes, I now believe that my low TSH was due to taking levo before blood test. On my next visit, I will ask GP to repeat TSH and T4 and this time I won’t take my levo before. I’ll ask about T3 test as well, who knows I might be lucky.

Do you know how long it takes for iron supplements to work? I bought some vitB12, but I don’t take it at the moment as I hope GP will act on low B12. Oh, I do have knee pain as well (didn’t remember to mention), so it might be due to lack of vitD. Did you supplement vitD? How much and for how long?

Reply

I supplemented 5000IU vitD drops daily Oct-May, then a spray occasionally, now I have a gel tablet when I feel achey, it took about 2 months for the pain to ease (shins were more painful to start with & ribcage). Vit D helps absorb calcium, so don't take extra, K2 & magnesium help too.

I've never taken iron (I eat pate, liver, greens etc.) hopefully someone will chip in with suggestions.

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just in case it's helpful - Michael Mosely was talking about his raised blood sugar levels, link...

healthunlocked.com/thyroidu...

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Thanks for that Spareribs , I watched it few times - very informative, but I don't know if I could manage on 600 calories twice w week. I don't really have a sweet tooth (I crave salty stuff usually) but I do like bread, potatoes and bananas :( Will have to look into the Mediterranean diet. But thats next, first the iron, vitD and vitB12.

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Reply

Moniacho

25(OH)D3 --- 23.8 ng/mL [Normal is >=30] Low

"The dermatologist suggested taking 2000IU vitD daily."

I think you need more than that. The recommended level when measured in ng/ml is 40-60 according ring to the Vit D Council. Personally I would go for 5000iu D3 daily for 6 weeks then reduce to 5000iu alternate days. Retest after 3 months. City Assays do a fingerprick blood spot test for £28 vitamindtest.org.uk/index.html

Retesting with City Assays will show the result in nmol/L and the recommended level is 100-150nmol/L.

If you want a suggestion for D3 then this is a good one bodykind.com/product/2463-b...

When taking D3 there are important cofactors needed vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, 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 naturalnews.com/046401_magn...

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Take 1000mg Vit C with each iron tablet.

Start eating liver regularly, no more than 200g a week, and include lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

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Folate level is OK, it should be at least half way through it's range and yours is. With B12, anything under 500 can cause neurological problems, it's recommended for us Hypos to be at the very top of the range, even 900-1000. See what your GP will do about it but if he wont prescribe anything you can buy sublingual methylcobalamin lozenges and to balance all the B vitamins you will also need a good B Complex.

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It would be useful to see a full thyroid panel done under proper conditions ie early morning, overnight fast and leave off Levo for 24 hours. Thyroid Antibodies would be useful too. Blue Horizon and Medichecks both do a test that includes them all.

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