Where do I go from here - Medichecks Blood Test Results?

[janey1234]

My plan to ride off into the sunset have been scuppered by Medichecks and I would be grateful for your advice as to where I go from here.... thank you.

I'm 2 years into my thyroid journey and thought I'd nailed it with my Levo dosage and optimal thyroid and vitamin results. Just to recap (have posted before)...I am 51, I believe perimenopausal (missing periods here and there) and am currently taking 125mcg Levo per day, Jarrows 1000 B12 & Thorne Basic B Complex every other day, Gluten free 15 months (best thing I ever did), 2-3 Brazil nuts per day (selenium on packet). I occasionally use magnesium (drink form or oil) following recommendations on one of my earlier posts, which amazingly worked. Apart from still tripping on my words (which seems to around the time my period arrives), I feel really well. My excess weight is continuing to go, have lost 1.5 stone so far over the past 18 months, my pain has gone. I thought I had reached the light at the end of the tunnel.

I have had a Medichecks blood test this week and the results weren't quite what I was hoping for and left me worrying that although I feel ok, things behind the scene may not be going that well. I have posted the Blue Horizon test from earlier in the year as a comparison.

May 2017 - Blue Horizon - 100 / 125mcg Levo alternate days

TSH 0.23 (0.27 - 4.2)

FT4 16.55 (12 - 22)

FT3 4.29 (3.1 - 6.8)

TOTAL T4 106.7 (64.5 - 142)

CRP 0.5 (<5.0)

FERRITIN 115 (20 - 150)

FOLATE 40.7 (8.83 - 60.8)

B12 SERUM 870

ANTI TYROIDPERI' 211 (<34)

ANTI THYROIDGLOB' 50 (<115)

DECEMBER 2017 - MEDICHECKS - 125 mcg Levo' daily

TSH 0.044 (0.27 - 4.20)

FT4 16.9 (12 - 22)

FT3 4.6 (3.10 - 6.8)

TOTAL T4 101 (59 - 154)

ANTI THYROIDPERI' 209 (0 - 34)

ANTI THYROIDGLOB 76.5 (0 - 115)

CRP 0.5 (<5.0)

FERRITIN 106 (13 - 150)

FOLATE 11.57 (2.91 - 50)

B12 (ACTIVE) 247.6 (25.10 - 165) *Highlighted to reduce supplementing*

VITAMIN D 24.7 (50 - 200) *Highlighted that below 25 is deficient & action to take (see doctors comments below)

Medichecks doctors comments..." Your thyroid stimulating hormone is low whilst you have normal levels of thyroxine and T3. This suggests that your dose of levothyroxine is too high. If you are free of symptoms of an overactive thyroid (I WONDER IF THIS IS A TYPO AS I AM AN UNDERACTIVE HASHI') then you may prefer to repeat the test in three months to assess the trend. If you are experiencing symptoms then you should discuss this result with your GP.Having very low levels of thyroid stimulating hormone for several years has been associated with the development of osteoporosis. If your thyroid stimulating hormone always tends to be substantially below the normal range then it may be worth discussing with your GP whether a bone density scan is advised to monitor for the development of osteoporosis. You do not need to worry about the occasional low reading, only if you get repeated very low levels.Your thyroid peroxidase antibodies are elevated. This antibody is commonly associated with autoimmune thyroid disease. It is frequently seen in conditions such as Hashimoto’s disease (where the thyroid becomes underactive) but confusingly can also be seen in Grave’s disease (where the thyroid becomes overactive).

You have high levels of vitamin B12, if you are taking a B12 supplement then I recommend decreasing your dose..

Your vitamin D levels show that you have vitamin D deficiency.We recommend supplementing with 80 mcg (3200 iu) of vitamin D per day for twelve weeks. It is important to test your vitamin D levels regularly - many people in the UK are insufficient or deficient in this vital vitamin. If you are already taking vitamin D then I recommend that you increase your dose. We suggest that you repeat your vitamin D test in 8 -12 weeks to ensure that your levels have returned to normal.Once your levels have returned to normal then you can decrease your vitamin D supplementation to 10 mcg (400 iu) per day."

So my questions (plural, sorry) are...

1. What do I do now about my Levo? If I reduce my Levo to raise my TSH, my FT3 & FT4 will go low again and my symptoms will return. If I leave my Levo' at 125mcg, I risk Osteoporosis. I feel like I'm in a lose / lose situation.

2. Re my B12 levels, should I drop the Jarrows B12 and just stick to the Thorne Basic B which contains a tiny dose of B12? Also, I know the ranges are different, but my Folate does appear to have dropped quite a bit. Again, should I stick with the Thorne Basic B?

3. My Vitamin D deficiency is a shocker. I lasted tested in September 2016 and it was 115. As a full time gardener working outside 6-7 hours almost every day in a t-shirt on ALL but the most freezing of days, I didn't ever expect to be deficient. I didn't test in May 2017 as I assumed I would be ok with summer approaching and with my daily exposure to the sun. Is it possible that I was ok this summer but during the autumn / winter I have already become deficient as the sun has dropped or can you NOT drop that quickly? Does anyone have any idea how this has happened and any comments on the doctors recommendations? Quite worried about this result.

I haven't discussed this with my own GP yet.

Thank you everyone

[Clairewalker751]

I'm sure someone more knowledgeable will be along in a minute but with those results I wouldn't reduce my dose as your T3 is well within range, you can get the pulse article that explains this which I took to my GP so she didn't reduce my dose. I believe that everyone in the UK needs to supplement Vit D at least OCT to May as the UV rays are not strong enough for our skin to make Vit D even if we were outside naked all day? Lol as for B12 medichecks recently changed this to Active B12 since they've done this mine has always been over range and I got the same advice as you, so I've bought some folate and take this daily and only taking my B complex twice a week, how long did you leave off B12 and complex supplements before your blood draw?

[janey1234 in reply to Clairewalker751]

Thank you for replying. I left off my B12 & B Complex for a week before the blood test so now I will reduce that to just the B Complex going forward.

I've just dug out Dr Toft's book again and re-read the page about low TSH so will show that to my GP if they try to lower my dose. My FT4 & FT3 are nowhere near the top of the range so not at 'potentially dangerous levels' so hopefully I'll be ok.

I still can't understand why my Vit D though is deficient when I practically live outside, especially as it was in a good place before. If I'm deficient then I dread to think what all my office-based friends and family are ☺

[researcherUK]

Janey,

1/ You are not overmedicated! Your FT4 and FT3 are within the range. If you are symptoms free and happy with the current dose of 125 mcg, then best to stick with it. If it is of any consolation my blood tests on Monday showed the lowest TSH I have ever had 0.005.

2/Your antibodies are a bit high perhaps it is a good idea to add selenium supplements 100 mcg/day. This will help reduce the antibodies.

3/As for your B12, the answer is yes. Stick with the B12 within your B-Complex. You don't need any more for now. Test in 6 months.

4/ Vitamin D is the only thing that needs attention. About 90% of our vitamin D is made in the upper layers of the skins because this is where the light penetrates the skin. But this is not the active form of the vitamin. Vitamin D from the skin and small amounts of vitamin D from the diet pass via the blood to the liver and kidneys where they undergo 2 types of conversion. As we age as much as our cholesterol levels are usually higher but the conversion doesn't take place properly. I am a keen gardener, too, and I take 2000 IU a day all year. I switch to 5000 iu the 4-5 months of winter. I think you could benefit from 5000 iu for 6 months and then take the same dose every other day. Test after 6 months and see where your levels are and adjust accordingly.

Are you on statins?

[janey1234 in reply to researcherUK]

Just dug out my Dr Toft book and you are right about my TSH. I don't have dangerously high FT4 & FT3, so fingers crossed I will ok. More to the point, I hope my GP will agree not to reducing. Will take book if necessary.

Would you recommend selenium supps on top of my brazil nuts or instead of and if so, how long would suggest for? I quite like them as my mid-morning snack.

Do you know if Vitamin D limits can plummet quickly? I still can't believe I'm deficient.

I'm not on statins btw.

Will continue with just B Complex for now.

Thanks for your advice xx

[researcherUK in reply to janey1234]

Your antibodies are not very much elevated so 100 mcg of Selenium supplements for three 3 months while keeping the brazil nuts will hopefully lower them to within the range.

Testing while supplementing with Vit D and other vitamins and minerals can inflate the results a bit and then your body has used whatever it has stored.

The reasons I asked about statins is that depleted the body of several critical nutrients one of which is Vit D. and inhibits the proper absorption while supplementing.

You are very welcome x

[janey1234 in reply to researcherUK]

I'm quite chuffed with my antibody results considering where they once were. Will pop some selenium in my shopping basket once I find out the best Vit D to take. I know it's discussed a lot on TUK, thinks it's D3 and K'something'..lol.

Thank you again. X

[janey1234]

As the vitamin guru SeasideSusie , can I ask if you have any thoughts on my Vitamin D deficiency please and what you would recommend I take?

Can I fix this myself or do I need to go to my GP?

Thank you

[SeasideSusie Remembering in reply to janey1234]

Janey

With a Vit D level of 24.7 you might want to discuss this with your GP as you should be getting loading doses according to NICE treatment summary for Vit D deficiency:

cks.nice.org.uk/vitamin-d-d...

"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

If your GP wont accept the private test result, you could ask him/her to do their own.

If you don't want to go down the GP route, you can do it yourself following the guidance for loading doses above. Doing it yourself might be the better option, you will probably get a better supplement buying your own and you wont be restricted to the lower doses your GP may suggest and you can raise your level more quickly. Almost certainly you will only be prescribed 800iu as a maintenance dose after the loading doses and that generally is inadequate. I keep my level at about 150nmol/L and my year round maintenance dose is 2000iu daily, in fact I sent a test off yesterday and wouldn't be surprised if my level has dropped so I may increase my dose during the winter.

The Vit D Council recommends a level of 100-150nmol/L.

I raised mine very quickly with D3 softgels by Doctor's Best (best value bodykind.com/product/2463-b... ) . My level was 15 and I took 40,000iu daily for 2 weeks then reduced to 5000iu daily. In 2.5 months my level was 202. If you don't like the idea of taking 40,000iu daily, then I suggest 10,000iu daily for 4 weeks then reduce to 5000iu daily. Retest after 3 months.

However, as you have Hashi's then for better absorption you might want to consider using an oral spray (eg BetterYou) but I haven't seen one with a higher dosage than 3000iu and the sprays are considerably more expensive than softgels. If you go with the spray then I would triple dose - 9000iu daily for 4 weeks then reduce to 6000iu daily and retest after 3 months.

Once you've reached the recommend level then you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with 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.

[janey1234]

As always SeasideSusie , thank you. I will go for the self-treat option as I doubt GP will include the co-factors.

May I ask which K2-MK7 you recommend alongside the Vit D and also how much? X

[SeasideSusie Remembering in reply to janey1234]

Janey

As K2-MK7 is a fat soluble vitamin, I think it's best to get a softgel with oil in like the D3 softgels. The normal dose is 90-100mcg. I like this one, no unnecessary ingredients bigvits.co.uk/product.php?p... There is a smaller size pot but this one is better value.

[janey1234 in reply to SeasideSusie]

Thank you...aaaaannnnnnd (lol)...going forward....when at the maintenance dose stage of Vit D, is it still necessary to include the cofactors, like K2, with each daily dose?

At the moment I'm only taking magnesium on a adhoc basis and looking at the other cofactors, magnesium, zinc & Vit A, I'm hoping that I get what I need from my diet.

Think I'm going to go for the spray Vit D triple dose as you suggest.

Please accept this virtual bunch of flowers as a thank you for your guidance on this forum 🌻🌼⚘

[SeasideSusie Remembering in reply to janey1234]

Janey

K2 and magnesium needed when taking D3. The magnesium helps D3 to work, and the K2-MK7 directs the extra uptake of calcium from food to bones and teeth, you don't want it causing problems like calcification of arteries or kidney stones.

Thank you for the flowers

[janey1234 in reply to SeasideSusie]

Brilliant!

Ever thought of becoming a GP (Great Person)?....lol

⛤⛤⛤⛤⛤ 5 star help!!!

Thank you x