Thyroid UK

Seen GP - elevated TPO and TG antibodies

DEC 2017

TSH 33 (0.2 - 4.2)

FT4 10.5 (12 - 22)

FT3 2.0 (3.1 - 6.8)

TPO antibody 1300 (<34)

TG antibody 377.3 (<115)

GP started me on 50mcg Levothyroxine with a retest in 6-8 weeks, also

Vitamin D total 31.2 (25 - 50 deficient) given 800iu D3 on prescription

Ferritin 15 (15 - 150) given ferrous fumarate on prescription

Vitamin B12 250 (190 - 900)

Folate 3.7 (4.6 - 18.7) given folic acid on prescription

Advice please, thank you

8 Replies

800iu of vitamin D is unlikely to bring your levels up to sufficiency and it will take a very long time if at all. Are you in the UK? If so there are guidelines your GP should follow and if your vitamin D was under 30 your GP should prescribe loading doses of vitamin D and then an adequate maintenance dose.

As you are only just above the 30 cut off point for loading doses you will probably need to buy your own extra vitamin D. You could supplement 2,500iu for 3 months and retest then adjust according to results. You may need less in the summer months. You need to aim for a level around 100nmol to ensure sufficiency. The vitamin D Council gives some advice about levels to supplement if your GP cannot prescribe sufficient amounts of vitamin D3.

You may wish to take magnesium and K2-MK7 with vitamin D3 in order to absorb the vitamin D effectively. Magnesium citrate is ok but there are other choices for magnesium.

Have you got symptoms of B12 deficiency because if so, I advise you to post your B12 and folate results along with an outline of your thyroid condition and symptoms, low ferritin etc on the HealthUnlocked Pernicious Anaemia forum and ask their advice about supplements.

B12 symptoms of deficiency

B12 The Guidelines Doctors follow

Ferritin needs to be at least 70 or mid-range for thyroid hormone to function properly.

Iron deficiency anaemia NICE guidelines

The importance of vitamins and thyroid function


Ensure you leave 4 hours between taking levothyrxoine and any other medicines or supplements especially iron.


Hi, my vitamin D deficiency when diagnosed was below 30. I have symptoms of B12 deficiency, mainly neuro symptoms. I only tested negative for intrinsic factor antibodies, have never had MMA or homocysteine checked


Your GP should have treated you with loading doses. I would return and point this out and say you now want the correct treatment, check out NICE guidelines and also local area guidelines for your CCG which will be similar.

For B12 find out what the Pernicious Anaemia society advocate in terms of requesting further tests from GP. If needing further tests I believe you should not take folic acid supplements until after testss as they can obsure vitamin B12 deficiency but check with them as I could be wrong.


I intend to take the Levo in the morning since I take iron at night, also planning to get a B complex, selenium and magnesium and zinc, also vitamin C since I am prone to scurvy?

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You could take 1000mg vit C a day. I take one with my levo as it can aid absorption. Some people like to split it and take some with their iron as it aids absorption of iron too.



The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in Email if you would like a copy of the Pulse article to show your GP.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine as you will almost certainly require a dose increase. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

Vitamin D 800iu is wholly inadequate to correct low vitD. Your GP should have referred to local guidelines or the My sister was prescribed 2 x 20,000iu per week when vitD was 40. Vit D is inexpensive so you might want to buy your own. Softgel capsules are better than tablets. I would take 10,000iu daily x 6 weeks and then reduce to 5,000iu daily for 6 weeks and then reduce further to 5,000iu alternate days for six week and request a followup vitD test. Vitamin D should be taken 4 hours away from Levothyroxine.

If you take 1,000mg vitamin C with each iron tablet it will aid absorption and minimise constipation. Iron should be taken 4 hours away from Levothyroxine.

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Thank you I intend to take Levo in the morning since I take iron at night.

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you need B12 on prescription too

retest and increase from 50mcg should be 6 weeks and then every 4 weeks afterwards until TSH is 1.0 or below

Free t4 is more like 19 and

Freet3 is more like 5.5

but above all the symptoms of hypothyroid are gone


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