Hi. I’m after some advice on when I should take various vitamins alongside carbimazole. I was diagnosed with an overactive thyroid and put on carbimazole. My endo suspects Graves’ disease but my latest blood tests show I am underactive. I’ve posted them here for reference. I am waiting for the results of a TSH receptor ab test. I have bought some Vitamin D, vitamin B12 and a good probiotic. Saw my endo last night who said he wasn’t expecting me to go underactive so quickly but he wants me to continue to take 5mg carbimazole for now and wait for the TSH antibodies test to come back, and then have a general thyroid function blood test in 2 weeks. Can someone advise when I should take the vitamins? I take the carbimazole in a morning before food.
When to take vitamins: Hi. I’m after some advice... - Thyroid UK
When to take vitamins
- Blood tests
- TSH test
- Vitamins
- Underactive thyroid
- Vitamin D
- Vitamin B12
- Graves' disease
- Autoimmune diseases
- Carbimazole
- Probiotics
Your endo is an ass! Like so many of them. You are profoundly hypo and he tells you to stay on carbimazole? He should be shot!
You have Hashi's, did he tell you that? And that is more than likely why you had high Frees when you were first tested - or did he just go with a low TSH?
Sorry, I can't tell you about timings for vitamins, but once you get the result for the TRAB, you need to find yourself a new endo. This one will kill you!
Either this forum is seeing an astonishing number of members with the allegedly uncommon combination of hyperthyroidism and Hashi's or there are some interesting/possibly questionable diagnoses being made in response to blood test results without considering the overall context.
Exactly!
I think it is something we have discussed over time - that Docs rarely understand Hashimotos - and prefer to call it something else. Like you I am horrified at the number of mis-diagnosed members that are posting ....
This is an interesting research piece about the occurrence at different times over the lifecycle tho' the direction here is hypothyroidism -> hyperthyroidism: bmcresnotes.biomedcentral.c...
I've seen some clinical papers that effectively argue that because they're both auto-immune conditions, it isn't that unusual for someone to have hyperthyroidism and Hashimoto's *but* they state that they can't be co-morbid (occur at the same time), they transition from state to another. It makes sense of the above paper and case reports.
However, if it's relatively common rather than uncommon - it makes it even more remarkable that this fluidity between the 2 thyroid conditions isn't examined more rigorously in the UK., e.g., by better availability of relevant thyroid antibody tests. Marz greygoose
I haven't read all of this, but can't really see the point, because nowhere do they give ranges for the FT4 and FT3 - and in the first case, they didn't even test the FT3. It would appear they were basing their 'diagnoses' mainly on the TSH, and not taking into account the possibility of Hashi's swings/flares. I don't get the impression that this is very good science at all. But, thank you for the link.
I had to tell my doctor I wanted my FT4 & FT3 tested and she throw in TSH. There was a little resistance from her, but she did agree. Unfortunately Doctors all over the world have a very relaxed view of Thyroidisum. Hypo/Hyper. My Doctor has never mentioned the word Hashimoto’s to me, or autoimmune. Every thyroid suffer needs to investigate and even then you have to fight for change. The normal treatment doesn’t work for everyone and if they treated every patient like a real beings then I think they would realize this and treat people accordingly.
No he didn’t. I asked him and he umm’d and ah’d a Lot and then said if it isn’t graves you’ll have thyroiditis. Agreed to send me for a scan though. He says the TSH antibodies test will tell us everything we need to know. That should be back next week hopefully.
The TRAB test will tell you if you have Grave's or not.
By 'thyroiditis' he meant 'Autoimmune Thyroiditis' which si what they call Hashi's. So, in a way, he did tell you. But, what he won't have told you is that you should try a gluten-free diet and take selenium, to try and decrease antibodies.
Already started on gluten free. Or at least trying to work out what it’s in and what it’s not in, apart from the obvious. But i cook most meals from scratch anyway so it’s easier. I asked about levothyroxine and he said he didn’t think I needed it. That if my levels were still low after reducing my dose to 5mg carbimazole then I would just need to stop taking the carbimazole. I will get some selenium though. What dose of selenium? 200mg?
Selenium dose is 200 mcg (microgram)
going Lactose free might help as well
Oh he also said that the other antibodies were irrelevant. 50% if the population have raised antibodies. The only relevant test is the TSH receptor AB test. And if I don’t have those antibodies then it’s easier to treat .....
He's either lying or he's very ignorant.
It's not true that 50% of the population have raised antibodies. And, if you have raised TPO antibodies, then you have Hashimoto's Thyroiditis, which means that your immune system is slowly destroying your thyroid, and even if you don't need levo now, you are going to need it at some point.
Your TSH is now very high, considering it should be around 1.
Yes, 200 mg selenium. 
Thanks. I will get some ordered. Or nip out tomorrow. Weather is awful today!!!
add L glutamine to your system. It will help.
Help what? Why are you telling me that?
I was at my docs the other day and I asked for the TRAB test and RT3 and she told me that they tell you nothing. I find it frustrating that I have to convince them this is a good idea. instead of them doing a thorough job. I find this lazy, but I may be looking at it too negatively.
No, you're perfectly right, they are lazy. But they're also ignorant, and don't understand the importance of some of these tests. Although, I would agree with her about the rT3 test. That just tells you if there's a problem, but doesn't tell you what the problem is. You'd be better off just doing standard tests to find the problem, because the rT3 is very expensive.
TRAB just tells you if you have Grave's - which is pretty important to know, of course! But, they don't even understand the results of these tests, that's why they don't want to do them.
Do you think you are hyper?
I mentioned RT3 cause if your TSH reads high they cut you back on meds, but if your RT3 is the reason why your TSH is high then they need to find alternative medication regiment, not cut you back. The first diagnosed I was Hyper. I was sporadic, but now I am hypo. I know I have gut issues and this is all related. I just don’t know how to convey this to my doctors. I mean getting them to run tests on you is hard. I have an inner ear infection, a little kids ear infection, puss and inflammation and all the good stuff. I gave in and agreed to go on antibiotic. First round done and I still have infection. On Second round now. Ear infection still going strong. Point to mentioning this is now my gut health is more out of whack and not pleasant. its amazing what can throw your system off.
No, that's not right. If your TSH is low they reduce your dose. If it's high, they should increase. But, rT3 is not the cause of a high TSH. It's incidental. Your TSH will be high if your FT4/FT3 are low. Your rT3 will be high if your FT4 is high and your FT3 is low - poor conversion - but with that, your TSH could be anywhere, not necessarily high. And, if you are a poor converter, the only real solution is to reduce your levo and add in some T3, but doctors are reluctant to do that, because they don't understand T3.
However, there are lots of other reasons for high rT3, including low iron, high/low cortisol, low-calorie diets, infections, etc. etc. etc. Things that have nothing to do with your thyroid hormone replacement. And, just testing your rT3 is not going to tell you which of these things is wrong.
If you started by being diagnosed as hyper, then became hypo, you almost certainly have Hashi's. And, for Hashi's, you need to have your TPO antibodies tested. There are also Tg antibodies, but doctors will rarely test for them. TRAB and TSI are for Grave's antibodies.
I have asked for them to be tested, but got resistance and they seen no need to be tested for this. I have recently found goiters, so this also leads me to autoimmune. again it is a matter of convincing your doctor. When I spoke of rT3 I meant the whole list to be tested for FT3, FT4, TSH, Rt3. I mean would’t all the info give them a more accurate picture of what is going on. I am getting tired of flying blind. Speaking of T3... I got my doctor to put me on it. I am using the both T4 & T3 meds. I do feel better, but as I mentioned still have an ear infection, so I don’t know the total spectrum yet.
They don't like testing for antibodies because they don't understand Hashi's.
Do you mean nodules? One only usually has one goitre, because it's the swollen thyroid, and you only have one of them. But goitres and nodules don't only happen with autoimmune.
No, the rT3 wouldn't give a more accurate picture, it's just a very expensive test that adds nothing to your general knowledge of the problem. If you're FT4 is high then you are going to have high rT3, we know that, why test for it?
I very much doubt your ear infection has anything to do with your thyroid problem. Infections can happen to anyone.
My apologies to Michaeladell for squatting her thread. 
Never meant to steel someones thread. no offence meant.
No, of course not. It happens.
Yes I have nodules, my twin sister has/had a goitre. I start getting this info clear/clearer in my head than I mix it all together. I know I don’t feel healthy and I’m confident that it can be changed for the better. thank you for your time and opinions.
Why don't you post your own question, giving your lab results, and see what people think. You're probably under-medicated, and all you need is an increase in dose.
I have to first get my medical reports. I’m just starting to take a more active roll in my Hypothyroidism.
OK That's good.
Blah blah blah-your not seeing my endo are you-as only in the week he said the same to me and i told him a disagreed about the tsh-well that went down well.ha. im on 5mgs now and feel rubbish and got to wait till next week to test as he wants me to hold on. I havent seen what my bloods are since oct 4th!!! Good luck on 5mgs😕
Haha I don’t know. Where do you live?
Ha. I dont think its the same endo as i live in telford shropshire but mine is equally useless. Mine is nhs.x
Mine does both, as a lot do I think
At least Michaeladell's endo is testing the TRAB! You're has refused to test it.
Well he must be a step up from my registrar not even a consultant but on the 5th Dec when i see him i will be pushing again before i dish out the monies for private. Mine says no definate test but did say he is sure that i have graves too but when i asked how can you make that decision his reply was "well most people have it" theres my diagnosis then!!
Well, that's not true, either! Most people don't have Grave's. lol
But they do, show some respect greygoose to those almighty gods who know. Tut tut. 😆😆x
I would like to say a word that begins with B and ends with ks, but it's naughty, and I can't say it... But, I'm thinking it very loud!
Oh i cant stop laughing as i knew you would bite back.😅😅😅😅😅xx
lol
Mine said it must be Grave’s because I’m 50 🤣
What utter tripe!!!
Excellent clinical diagnosis haha
Doesn’t it kinda boil your blood..... I mean they can be so dismissive. Like you have no idea what your feeling and theres no way for you to become informed. I mean theres the internet and there are thousands of books written about thyroid disorders. You have the Knowledge you are gaining, Plus you have how you feel now compared with how you use to feel. I find Doctors frustrating! Unfortunately you have to push harder or as to be referred to another doctor. It’s our right to be healthy.......
Lol endos and docs are a complete utter disgrace-they just do not comprehend that all our illnesses are connected to the thyroid, i do not ask to be referred i tell them what I WANT-lol its not a question its a order!! As you said -"we have a right to be healthy".😊😊😊
SeasideSusie always advises that vitamin D should be taken with the fattiest meal of the day to help absorption (what dosage are you taking)? ETA: I've linked one of her replies to someone with a vitamin D level approx. like yours (you might need to scroll down): healthunlocked.com/thyroidu...
I don't think B12 has especial conflicts - are you opting for sublingual lozenges?
It's iron and calcium that are problematic with various supplements/medications. Are you taking either of those?
Some VitD capsules contain Olive Oil - so that should help with the fatty element Healthy Origins is one brand ....
No I’m not taking either of those and I got a vitamin D spray. The B12 is a liquid
OK, the vitamin D spray should be grand. I am going to say that sometimes the absorption can be affected if taken at the same time that the pH of the mouth abruptly changes because people have taken Milk of Magnesia or various other items.
B12 should be fine when it's most convenient for you.
Thank you. Just waiting for the vitamin D to arrive but have taken the others
Again someone like me- my endo was the same - hyper readings but i have hashis and told me not to get techical its irrelevant. Im on carbi still as apparently its the correct treatment and i am now on 5mgs and feel like runnish. Again he reduced my dose with the help of tsh as hospital lost ft3 and 4. Good luck.
I feel rubbish also. It’s difficult to describe it to people x
I was initally on 20mgs back in july then 10mgs in oct then i reduced myself to 7.5mgs 1 week and then had a fone call to say reduce to 5mgs and this has hit me hard again, feeling breathless, heart palps and inner trembling, i think dose changes hapoen quickly with me. Have no idea at the moment how dire my bloods are because of endos advice of holding on. Idiot him. What do you feel like?
Exhausted, very achy, today I feel like I’ve got vertigo, heart racing and palpitations have thankfully stopped!!
When did you notice the change and how long did it last for? Sorry im nagging you abit here.😊
I can’t pin point it to anything I don’t think. I started to feel like this almost as soon as I started taking carbimazole. My palpitations got a lot worse for a while but I reduced my dose of propranolol and they got better. Went away on holiday and I was in so much pain I had to take 30mg cocodamol just to be able to walk anywhere. My heart rate was dropping to 30 so I stopped taking propranolol. At the moment I can’t even stand to clean my teeth without my back killing me and I’ve also liked weight on. Endo says I must be very sensitive to carbimazole 🤔
Let me know how you get on, we all have it in different ways, i dont really have the pain but i do have the occassional twinge in my thyroid area but that is probably from the hashis and also nodules. Take care and good luck.😊
You too. Let me know how you get on. I now have lumps on my neck I never had before and feel like I’m being choked. And I get very odd sensations in my neck but the back of my neck
Ha yes i get that in my neck and one stage was even choking on drinking water and the tightness in the neck, it lessened and was virtually non exsistent on 10mgs of carbi but can feel it coming back abit, feels like you cant even swallow saliva properly aswell.x
Forgot to say my neck is slightly lumpy and mine are nodules and thickening of the isthmus been told in keeping with hashis but not sure what endo will suggest if anything really!😕
Yeah I constantly feel like I haven’t swallowed something properly too. At least he agreed to send me for a scan
Good i should think so, i had mine done early november, good luck with that. X
I can't believe the Endo let the hospital get away with losing the FT3 and FT4 and based his decision on TSH. He should have ordered an urgent retest!
Sad but true nanaedake, i have my blood forms ready to be done again 10 days ago but then out of the blue endo rang as he had been sent through a tsh only which was 3.77 and said reduce to 5mgs and dont get new bloods done until you are due to see me- well ive got to go this weds have done so tbey are ready for him to view on following week.x
Often they say not to take vitamins Within 30 minutes before or two hours after taking other medicine. I did recently read an article though in a medical journal that you should not take vitamins unless your doctor says to and only take the ones that they say you were low on because taking multivitamins are causing people to be too high and different levels which can be very dangerous actually so I just recommend making sure with your doctor that it's okay that you take those ones and even ask your doctor when they recommend you take them
After lunch I take mine.
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A new Endo with attitude
