Thyroid UK
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Results

Further to my original post a month ago, thank you all for your replies. I have now had the results of a private blood test done by Blue Horizon as shown below, with comments by their Doctor.

HAEMATOLOGY

Vitamin B12 * 832 pg/ml 197 - 771

Note amended reference range due to change to

Gen II assay.

Folate (serum) >20.0 ug/L > 2.9

Note new reference range effective 03/04/2017.

If no change in dietary habits, a normal serum

folate makes folate deficiency unlikely.

BIOCHEMISTRY

FERRITIN 26 ug/L 13 - 150

Optimum Ferritin level for females : >27 ug/L

C Reactive protein 3.3 mg/L <5.0

ENDOCRINOLOGY

TOTAL THYROXINE(T4) 99 nmol/L 59 - 154

THYROID STIMULATING HORMONE * 4.85 mIU/L 0.27 - 4.2

FREE THYROXINE 15.2 pmol/l 12.0 - 22.0

FREE T3 3.5 pmol/L 3.1 - 6.8

25 OH Vitamin D 62 nmol/L 50 - 200

Interpretation of results:

Deficient <25 nmol/L

Insufficient 25 - 49 nmol/L

Normal Range 50 - 200 nmol/L

Consider reducing dose >200 nmol/L

IMMUNOLOGY

THYROID ANTIBODIES .

Thyroglobulin Antibody * >4000.0 IU/mL 0-115

Method used for Anti-Tg: Roche Modular

Thyroid Peroxidase Antibodies 19.5 IU/mL 0 - 34

Method used for Anti-TPO: Roche Modular

Doctor’s Comments

________________________________________

The Thyroid Stimulating Hormone (TSH) is elevated. If you are already taking a form of thyroxine, it is possible that that your dose is too low or that you have forgotten to take it on occasion. It may be that an increase in dose is in order - if adjusted it would be sensible to repeat thyroid function (TFT) testing in around 2 months’ time. If you are not taking thyroxine, and this is the first time TSH has been noted to be high, it is possible that 'non-thyroidal illness' or other medication effects are the cause of the elevation. It may be that hypothyroidism (underactive thyroid gland) is about to develop. In these scenarios, it would be advisable to repeat thyroid function tests in 3 months’ time. I would suggest undertaking this repeat test sooner if symptoms develop. The positive thyroid antibody result, however, increases the possibility of your having or ultimately developing autoimmune thyroid disease, such as Hashimoto's thyroiditis or Grave's disease.

The Vitamin B12 level is elevated. This is not likely to represent significant overdose, as B12 is well tolerated by the great majority of people even in very high concentrations (as indeed are most water soluble vitamins). Excess levels are usually a result of supplementation or from following a diet rich in the vitamin. A few exceptions to this rule include those who suffer from a rare hereditary eye complaint known as Leber’s disease. Too much vitamin B12 in these individuals can lead to damage of the optic nerve, which might lead to blindness. Anyone who is allergic to cobalt should also avoid taking vitamin B12 - as the vitamin contains a significant amount of this element. Rarely, high dose supplements or injections of Vitamin B12 cause diarrhoea, itching, blood clotting and allergic reactions. Liver disease and myeloproliferative disease (disorder of the bone marrow) can lead to elevated levels of B12. Some practitioners advocate high doses of Vitamin B12 to help sufferers from Chronic Fatigue Syndrome (CFS) and to combat the development of Alzheimer's disease, amongst other conditions.

I am currently taking:-

Levothyroxine 100m a day taken at night

Folic Acid 5mg x 1 a day (should be 2 but I forget to take the other one regularly)

Adcal-D3 x 1 a day

Vit B12 1000 ug x 1 a day

Turmeric 10,000 mg as 500 mg of extract x 1 a day

Cod Liver Oil 1000 my x 1 a day

Fluoxetine 20mg X 1 a day

Omeprazole 20 mg x 1 a day

Regarding the latter 2, I was on Fluoxetine for years until I weaned myself off early this year. When I went to the Dr because I was not feeling well recently she said it was because I was not taking any and put me back on one tablet a day. They have certainly calmed me down, but whether that was because I needed them or because of my Thyroid I don't know.

As for the Omeprazole well I have had cronic heartburn for the last couple of weeks and they seem to do nothing for it. Maybe I should increase the dose?

I was also taking Natures Best Multi-Max until I ran out a few days ago. I can post the make up of these if needed, they did include 50ug B12

Main symptoms at the moment are swelling and pain in hands, feet and ankles, muscle tenderness, hearing problems, sleeping problems, inability to lose weight and burning feet. A lot of the other symptoms, but these are the worst.

Sorry this is so long but wanted to give as much information as possible.

How much of it can be put down to being 80?

5 Replies
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I don't know how much can be attributed to being 80 but if it were my results I would increase my Levothyroxine to bring TSH lower. Omeprozole interferes with absorption of Levothyroxine and check whether fluoxetine does too. You sound like you might be undermedicated. Vitamin D is better mid range which in UK is around 100.

Reply

Your TSH is much too high, it should be around one. You need 25mcg dose increase in Levo and retest in 6-8 weeks

FT4 should be at top of range, around 20 and FT3 around 5.0 or higher.

Your vitamin D is far too low, but not low enough for GP to recognise. Aim for around 100nmol.

You could try some vitamin D mouth spray by Better You perhaps 3000iu daily and retest in 2-3 months. Vitamindtest.org.uk if just looking to test vitamin D

See SeasideSusie detailed vitamin supplements advice on ferritin, also magnesium and vitamin K2, both cofactors of vitamin D

Omeprazole is for treatment of high stomach acid. When hypo we most likely have low stomach acid

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

thyroidpharmacist.com/artic...

drmyhill.co.uk/wiki/hypochl...

scdlifestyle.com/2012/03/3-...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

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Hi Margaretindevon

The first thing I would say is don't bother buying any more Natures Best Multi Max. I've looked at the ingredients, and the Multi Max Complete contains 50mcg B12 so I assume it's that one. A few things wrong with it:

Iodine

150µg - we shouldn't take iodine unless tested and found to be deficient, iodine used to be used for treatment of overactive thyroid.

Iron

7mg - iron will stop everything else working, iron affects absorption of all the other ingredients and should be taken at least two hours away from them.

Calcium

800mg - calcium will stop even the iron working, and that's a pretty large dose of calcium.

On top of the large amount of Calcium in the Multi Max, your Adcal contains Calcium carbonate (750 mg) and vitamin D3 (200 I.U.) so as you are taking 3 x Adcal daily you are getting 2250mg calcium but only 600iu D3.

Why are you on Adcal? Have you had calcium tested? We shouldn't take if unless we are tested and found to be deficient. If not tested I would ask for it to be done because you are getting over 3000mg calcium daily with the Adcal plus the Multi Max.

25 OH Vitamin D 62 nmol/L 50 - 200

The Vit D Council recommends a level of 100-150nmol/L. I would do as SlowDragon suggests and get some BetterYou spray 3000iu daily and retest after 3 months City Assays vitamindtest.org.uk/

There are important cofactors needed when taking D3

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, D3 four hours away from thyroid meds.

Magnesium helps D3 to work and 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...

Check out the other cofactors too.

BetterYou do a D3/K2-MK7 combined spray which would save you buying two separate supplements there, just leaving the magnesium to get separately.

Vitamin B12 * 832 pg/ml 197 - 771 Vit B12 1000 ug x 1 a day

Personally, I would continue with this. An extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

And I would take a good B Complex to balance all the B vitamins and ditch the Multi Max. I like Thorne Basic B.

FERRITIN 26 ug/L 13 - 150

This is poor but I doubt your GP will do anything as it's within range. For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range. The easiest thing to do to help raise your level is eat liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

Thyroglobulin Antibody * >4000.0 IU/mL 0-115

Thyroid Peroxidase Antibodies 19.5 IU/mL 0 - 34

Your high Thyroglobulin antibodies indicate autoimmune thyroid disease. You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

TOTAL THYROXINE(T4) 99 nmol/L 59 - 154

THYROID STIMULATING HORMONE * 4.85 mIU/L 0.27 - 4.2

FREE THYROXINE 15.2 pmol/l 12.0 - 22.0

FREE T3 3.5 pmol/L 3.1 - 6.8

I agree with the others than you need an increase in your Levo. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo. If your GP isn't happy to have your TSH that low due to age, then she should be guided by your symptoms.

Burning feet can by a symptom of hypothyroidism, I used to get it quite a lot (particularly in bed) but since I optimised my vitamins and minerals I don't get it now.

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SeasideSusie

Thank you for the advice, I was hoping you would reply.

I only take one Ad-cal a day, it should be 2 but I forget to take the other one quite often.....more often than not. I was put on them because a bone scan showed I was osteoporotic, and have 2 crumbling vertebrae in my back. Saw a back specialist when I was 70 and was told "at your age we would not operate, and there is a 50% chance you could end in a wheelchair". No thank you, then.

I will get some Selenium, Magnesium, the B Complex you suggest and the D3/K2 spray as suggested both by you and SlowDragon.

I will also be seeing my GP about an increase in Levo. At present I am amassing evidence to show her that my TSH should be around 1.

I will also look into a gluten free diet, but have to say I tried gluten free bread and it was awful!

Is there any benefit to be gained from taking Co- enzime Q10 please?

Thank you Nanaedake, and SlowDragon for your replies, and thank you SS for yours also.

Reply

I only take one Ad-cal a day

Sorry Margaret, I read Adcal-D3 x 1 a day as Adcal 3 x 1 a day

Should've gone to Specsavers :D

I will also look into a gluten free diet, but have to say I tried gluten free bread and it was awful!

I think the secret is to avoid anything that comes prepackaged and prepare your food from scratch. However, I remember a couple of people saying they'd found a decent gluten free bread, so you could make a new thread asking about that and I'm sure they'll reply.

Is there any benefit to be gained from taking Co- enzyme Q10 please?

Here's an article about it (by someone not selling it!) everydayhealth.com/diet-nut...

and Dr Myhill's articles are always worth a read drmyhill.co.uk/wiki/Co-enzy...

I take it in the Ubiquinol form.

I will also be seeing my GP about an increase in Levo. At present I am amassing evidence to show her that my TSH should be around 1.

Do you have a copy of the article in Pulse magazine written by Dr Toft? From thyroiduk.org.uk/tuk/about_... > Treatment Options:

According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

The booklet is written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist. It's published by the British Medical Association for patients. Avalable on Amazon and from pharmacies for £4.95 and might be worth buying to highlight the appropriate part and show your doctor. However, I don't know if this is in the current edition as it has been reprinted a few times.

Also -

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the article by emailing louise.roberts@thyroiduk.org print it and highlight question 6 to show your doctor but as there is nothing age-related in the article I suppose it's possible your GP may actually play on your age.

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