Hi. I have recently had a thyroid blood test and it came back as normal (4.25). However my vitamin D and Folate were depleted. I am 55 years old.
My symptoms include the following:
Dry thickened skin
Dandruff
Tinnitus
Headaches
Painful joints and tendons
Overweight
Fatigue
Trembling episodes / feel shivery/feels like shock
Poor memory / foggy
Muscle loss ( through fatigue)
Dizziness
Depression and anxiety
Should I just take the prescribed vitamins, or should I take a thyroid support supplement?
It is not normal (0.2 up to around 2 is. The normal range) it indicates you are hypothyroid. The uk are rubbish and will not treat until TSH reaches a massive 10 unless you get a decent doctor who knows about thyroid problems (few and far between) all your symptoms indicate it too. It interferes with vitamin absorption hence the deficiencies. take the vitamins of course but I found mine did not resolve until my hypothyroidism was properly medicated. You probably have autoimmune thyroiditis (90% of hypothyroidism is this type) and can get private blood tests if you can afford it to see if there are antibodies. If there are your condition will worsen and you will need medication better to start now if it were not for such bad practice in the uk. Ask admin here for a list of recommended doctors if you can afford to pay to see one.
Totally agree with TSH110. You will probably not feel normal until you have reduced your TSH to around 1.0 or lower. Best to start on Levothyroxene for starters and see how that works out, about 50mcg to 75mcg is a good starter dose. Be prepared for a lot of blood tests and adjustments the first year while you are finding your optimal dose. Sadly it is trial and error usually driven by the patient, most of the doctors are very ignorant regarding the thyroid and endocrine system in general so it is up to us to read, study and learn as much as we can to get back to full health. This is a wonderful place to get information and to ask questions about your own situation. Oh, and btw, if my TSH was 4.0 I would be in a coma! I experimented a couple of times and flaked out at about 1.25!
You need full Thyroid and vitamin tests
Some symptoms sound like low B12. - tinnitus, memory and dizzy
B12 needs testing before starting Folic acid
For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.
Essential to test thyroid antibodies, FT3 and FT4, plus vitamins
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
thyroiduk.org.uk/tuk/testin...
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
All thyroid tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances too, especially gluten. So it's important to get tested.
i agree.....your want to know what your free t3 free t4 is and antibodies and vitamins levels because from experience i know that sometimes...that the thyroid cant function if somethings are not there for it.....and you can have a elevated tsh when you are sick as well......my son had a elevated tsh but ft3 ft4 was great and he was low in iron b12 omega..you name it from a poor diet...he recovered without any thyroid hormone......and he had no anti bodies.....our bodies need the right nutrients, rest, and diet for it to work..just like a car needing gas and oil.....but without all the test...you cant be sure what is going on...
Yes important to get Vit D, B12,folate and ferritin optimal, not just in range as they help the thyroid to work better.
Definitely do not take a so-called 'thyroid support' supplement! They are a huge con. For 'support' read 'stimulant', and the worst thing you can do to a sick gland is stimulate it - you just make it burn out further! These things usually contain iodine, and iodine is actually anti-thyroid, so really not a good idea.
What was your vit D result? And what and how much did your doctor prescribe? I agree with SlowDragon, don't take the folic acid until you've had your B12 tested. In fact, don't take the folic acid at all! If your B12 is low and you need to take B12, you will also need to take a B complex. So, the best thing to do would be to get a B complex with about 400 mcg methylfolate, and take that. That will bring your folate up nicely. Folic acid is synthetic and not well supporte/absorbed by everyone.
Hi gg, can I ask why you say not to take iodine? My gp (I really am going to stop listening to her on anything thyroid related!) said that an iodine supplement would support my natural thyroid production so I have been using an iodised table salt instead of the Himalayan pink salt I usually use.
K x
Yes, most doctors think that, because they don't know the basics! It's that word 'support' again! Iodine doesn't support. It might stimulate, but, as I said, stimulating a sick gland is not a good idea.
Iodine is one of the ingredients for thyroid hormone. Two molecules of L-Thyronine come together and four atoms of iodine are attached to it to make T4. That's what iodine does. But, it's like making a cake. If all you have is flour, but no eggs, you're not going to make much of a cake, are you? And, if, on top of that, the oven doesn't work... So, if you have a sick thyroid that is incapable of making hormone, there's not much point in stocking up on just one of the ingredients, and hoping to produce hormone.
On top of that, iodine acts as an anti-thyroid agent, and actually reduces hormone out-put - they used to treat hyper patients with iodine.
Plus, excess iodine can cause all sorts of problems. It can trigger Hashi's, if you don't have it, and make Hashi's worse if you do have it. And, if you are taking levo, you will be getting 65 mcg iodine with every 100 mcg of levo.
Table salt is really the worst type of salt. It is stripped of all its nutrients, and has chemicals added to stop it clogging. You'd do much better to go back to the pink Himalayan, and take a pinch of it with everything your GP says! 
Thank you oh wise goose, I would love to take you along to my next gp appointment 😂. Blimmin channel in the way!
Yup. It's a long swim! 
😂 . I forgot to say that is the best way the whole thyroid thing has been explained to me, it now all makes perfect sense! But then I am a baker so anything related to cake gets my attention!
lol Well, it's either that or comparing the thyroid with a car engine. That goes down better with the men!
Hi GG, You mean Radio Active Iodine, the treatment for hyperthyroid patients, which is definitely not nutritional iodine, right? "Radio Active Iodine" (RAI) is completely different than nutritional iodine and has no nutritional benefit. It destroys thyroid tissue and is what is used to reduce excessive thyroid hormone production in hyperthyroid patients. It is so effective that some, if not many (or all?) hyper patients end up becoming hypothyroid at some point and will need supplemental thyroid hormones for the rest of their lives. Some common nutritional iodine types are potassium iodine or elemental iodine.
"Excess" iodine is the problem, not iodine in general. Iodine is a trace element that is required in all bodies for optimal health, development of of a healthy fetus, for proper brain, thyroid, and a fully functioning body. Potassium iodine or elemental iodine are types of dietary iodine that people might see on a nutritional label. Where people get themselves into trouble is when they are taking in more than their body needs. 150 mcg iodine is the recommended dietary allowance for adult women over 19 years of age. Most modern diets include 150 mcg iodine, and extra iodine supplements is not needed. So what is excess iodine? Excess iodine is shown to be 800 - 1,100 mcg for adult women. Anyone with thyroid disease should not be gambling by taking iodine supplements unless they have had iodine tests showing deficiency and they are under a doctors management.
Hypothyroid people are not the only ones who should avoid excess dietary iodine. Both hypothyroid and hyperthyroid patients should not take in excessive amounts of daily dietary iodine, but for opposite reasons. If hyperthyroid patients consumes too much daily iodine, it would have a good chance of making them even more hyperthyroid. Hypothyroid patients have the opposite effect, where excess dietary iodine reduces their thyroid hormone production and makes them even more hypothyroid.
"In conclusion, 78.3% of patients with hypothyroidism due to Hashimoto's thyroiditis regained an euthyroid state iodine restriction alone. Both a low initial serum TSH and a high initial urinary iodine concentration can be predictable factors for a recovery from hypothyroidism due to Hashimoto's thyroiditis after restricting their iodine intake." This quote is from this study: ncbi.nlm.nih.gov/pubmed/127...
Iodine details: ods.od.nih.gov/factsheets/I...
and
ods.od.nih.gov/factsheets/I...
From the British Association of Dietary Physicians, but for some reason they forgot to mention the very important part about excess iodine.
bda.uk.com/foodfacts/Iodine...
Just for the record, and not wishing in any way to get into a long argument, I do know what I'm talking about, and I was not talking about Radio Active Iodine. I do know the difference between RAI and nutritional iodine. End of discussion as far as I'm concerned.
Well, to make thyroid hormones you need iodine and tyrosine (amino acid) and all the other supporting co-factors. But you need exactly the right amount or it just gets shuffled off into other metabolic processes. If you were hypo because you were not getting enough iodine or protein (and that can be tested) then getting the right amount would fix it. But if that is not the case, it won't help at all and will actually make things worse. Iodine was used as treatment for over active thyroid until modern drugs were discovered (and it worked). If your doctor thinks you aren't getting enough iodine, he should get it tested. Without your himalayan salt, you are missing out on all the extra minerals/electrolytes and probably damaging your methylation in return for some (possibly) blood pressure raising sodium chloride - not a good swap. IF it turns out you DO need extra iodine, I'd go for something like liquid Lugol's iodine where you can just take a drop in water.
Thank you, I will go back to my nice “posh” salt as my kids call it. That other stuff can go for de-icing the driveway!
Exactly, Angel_of_the_North. You got it! A 24 hour urine test is the only way to find out full iodine status.
Agreed. For many people, folic acid actually blocks real vitamin B9 (folate) as the can't convert it to the active version. Methylfolate is the best bet for those people. The blood test measures both regardless of whether is it usable or not.
Thank you everyone. If I get a private test, would the NHS pay for medication if my thyroid is slow?
Depends whether your doctor will accept the private test results. They often won't.
Unfortunately you are stuck in this terrible rock and a hard place situation. Doctors often rely on TSH only, they probably won't have a good understanding of the other tests.
They believe TSH has to be over the top of the range, or even 10 to make you feel ill 
So people in your position are left waiting for your thyroid to deteriorate to the point where your TSH is high enough. It may be that yours is quite close to the top of the range, it's often about 4.5. So you may be able to find a GP who does take it seriously. It's worth shopping around by trying out all the GPs at your own surgery.
If you get private testing and it show high thyroid antibodies then yes they either have to accept your tests or rerun them via NHS (possibly even using the same lab private ones done in)
Low vitamins.....same applies
Hi Maggiv,
I just wanted to say when booking a blood test you need to have it done as early as possible in the day. TSH drops during the day.
I was referred to an Endo after my TSH was repeatedly above 4 on a number of tests. I took a list of signs and symptoms to the consultation and the Endo actually read the list. She did more blood tests but prescribed levothyroxine there and then but only 25mg a day. That was over 5 years ago, while I’m still not well tired etc, I’m now on 150mg a day. I found out at a later test for adrenals that I had autoimmune hypothyroidism as my TPO antibodies were way above range. This was one of the tests the Endo ordered.
I hope you get help, good luck.
If you get an early morning test done, you may find your TSH goes over the top of the range, at which point, you should ask for a trial of levothyoxine.
Ive been told to take selenium 200
Hi Jeppy. There are a few studies on selenium and it's potential to reduce thyroid antibodies, but not a lot. There has been some good results by taking inositol with selenium. Unfortunately, there is no fool-proof way to get antibodies lowered once they are elevated. There are just too many other factors that can be an influence in elevating antibodies. Common and everyday viruses that most people have encountered by the time they are adults sometime trigger autoimmune diseases down the road. Epstein Barr Virus (Mono) and Cytomegalovirus (CMV) are two such common viruses. Chronic stress, infections, injuries, viruses, fungi, parasites, environmental toxins...they can all contribute to elevated antibodies. I've been taking selenium and inositol for years, but they did not prevent me from getting sick multiple times with various things, which is part of why my TPO is in the multiple of thousands right now.
Here is one such study about selenium and inositol:
hindawi.com/journals/ije/20...
Thankyou for that info
Frustrating really, and Iv only had a tiny out of range tPO on one ocassion out of six testing, so yes, I suppose I do find it hard to pick up the Hashi label at this point, although advised I do from this one testing, best wishes
.....I was similar at outset Maggiv, Very low D and B12, tsh At 4.5, And many of those symptoms too, muscles in legs struggling, heavy eyes and fatigue Breathless upstairs etc, please take heart I soon got past those with the vitamins taken, , not brilliant yet but work in progress,
Also checking out adrenals after drip feed long term stress,
lots of good wishes 🌸
Ps depression and anxiety, painful joint, tinnitus, weight gain at top of list too! 😜
It is within normal range, but statistically unlikely to be healthy as the majority of healthy people have a TSH of around 1.2 and very few have a TSH over 2.5. However, the NHS won't treat until TSH >10 or free T4 is under range reagrdless of symptoms. If you have high TPO and TG antibodies, you can ask for treatment when TSH is over range. The NHS would rather try to treat each symptom as a separate illness (usually with anti-depressants which are worth extra funding money to the practice. TUK have a list of doctors (if you can afford private) who may be more clued up). Getting vit D, folate and B12 to optimal (not just "normal") levels will help. Flate needs to be 50% of range, B12 over 500 (top of range is good) and vit D at least high 90s.
Update.... I have just spoken to my doctor on the phone and given him my results. TSH 6.25. All else within normal range. My research indicates sub clinical hypothyroidism. I have also explained nice guidelines state that if TSH is between four and 10 with accompanying symptoms then a trial of LT4 and a follow-up test in 3 to 4 months is recommended. He still seems to think that it isn’t my thyroid, and because I’m currently being treated for depression, that it is more likely that is the reason why I feel so ill. I’ve had depression on and off for 20 years. Never have I felt as bad as this (even when my partner died and I lost my job 10 years ago.) At the last count I had 33 symptoms which are related to hypothyroidism. I have an appointment On the 22nd of May, but I’m going to write a letter detailing everything and handed to him beforehand. Hopefully he will have enough time to digests all of the information, look at the references, and check the sources. Has anyone else been through this and can you give me any more advice?
I just want to say thank you to you all for your good advice and encouragement. It has taken 6 months but my TSH level is now down to 2.49 from 6.25. I am feeling a lot more energised and hope it will continue. I’ve even started a new job because I feel so much better. 👍🏼
normal TSH and T3 but Low T4
High TSH, normal levels
elevated TPO, but normal TSH and T4
