Thyroid UK

New and need advice please

Hi new to this site and like many others after years of Hashimoto's and feeling poo came here. I have been on 150mcg of Levothyroxine sine last July (previously 0n 125mcg) after reading here about importance of Vit D etc have had bloods done and here are results, Any help to steer me in right direction would be great as it says i am over medicating but my symptoms are terrible especially at the moment I should also add i take 1000mg omega 3 and 12.5ug of Vit dD daily and am looking into a gluton free diet after reading benefits on here, Thanks

Ferritin. H 212.0 Range 13 - 150

Hiscrp. 4.31 Range 13 - 150

TSh L 0.04 Range 0.27 - 4.20

T4 total 128.0 Range 66 - 181

Free T4. H22.10 Range 12 - 22.0

Free T3. 5.22 Range 3.1 - 6.8

Anti thyroidperoxidase abs H.251 < 115

Anti thyroglobulin abs H. 251 <115

Vit D. L22 Def <25

Vit B12. 343 range 8.83 - 60.8

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12.5ug of Vit dD daily

Is that all? That is 500iu. That is a child's dose. Is it prescribed?

Vit D. L22 Def <25

You have Vit D sufficiency and you need to speak to your GP about loading doses - see 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)."

Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the local guidelines or this summary and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu so post your new result at the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and 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/

Your doctor wont know, because they are not taught nutrition, but 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.

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Vit B12. 343 range 8.83 - 60.8

I think you have the range mixed up with Folate.

If it's Serum B12 the range goes up to about 700ish, if it's Active B12 the top of range is 165. I think yours is Serum B12 and I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And 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."

What is your folate level?

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Ferritin. H 212.0 Range 13 - 150

This is high, if not supplementing you might want to discuss with your GP. Raised ferritin can indicate inflammation or infecion.

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Hiscrp. 4.31 Range 13 - 150

What is this please? You have repeated the range for ferritin here.

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TSh L 0.04 Range 0.27 - 4.20

T4 total 128.0 Range 66 - 181

Free T4. H22.10 Range 12 - 22.0

Free T3. 5.22 Range 3.1 - 6.8

Doctor's comments with private tests are generic, not specific. You aren't overmedicated because your FT3 is in range.

From thyroiduk.org/tuk/about_the... > 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. Available 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)."

If you would like a copy of the article then email Dionne at tukadmin@thyroiduk.org

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A strict gluten free diet and 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_...

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Thanks Seaside Susie, No Vit D not prescribed ,To be honest i just picked it up one day last year and have taken it since, Obviously i need to change that :) His crp i believe is C reactive protein and i have got range wrong, it should be <5, Thank you for pointing that out to me, Well a trip to my GP is in order but i'm concerned that he will drop my Levo thyroxine and to be honest i dont feel great now, However it could be Vit D. No i am not on any iron med I do have poly arthritis so that could be why Ferritin is up

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SeasideSusie will not have seen your reply - click Green Reply button when replying 😊 - easily missed 😊

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Thank you But now pressing green button flashes up problems with reply?

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It's only at the time of posting that it works .... ☺

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Thanks Seaside Susie, No Vit D not prescribed ,To be honest i just picked it up one day last year and have taken it since, Obviously i need to change that :) His crp i believe is C reactive protein and i have got range wrong, it should be <5, Thank you for pointing that out to me, Well a trip to my GP is in order but i'm concerned that he will drop my Levo thyroxine and to be honest i dont feel great now, However it could be Vit D. No i am not on any iron med I do have poly arthritis so that could be why Ferritin is up

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