Created a new post as I posted it as a reply to previous thread but no responses
So my blood results have come back and I'd be grateful if those more knowledgeable than I can help interpret them. As said before I have put on a lot of weight. Currently taking 100mcg Levothyroxine since Jan 2018.
March 2018
TSH 0.95 mu/L ( 0.35 -4.94)
T4 13.3 pmol/L ( 9.0 - 19.0)
June 2018
TSH 2.06 mu/L (0.35 - 4.94)
T4 13.0 pmol/L (9.0 - 19.0)
Vit D 42 nmol/L doctor note: ' needs 1000-2000 u/day'
Ferritin 100 ug/L ( 16- 204)
Vit B12 358 ng/L ( 187 -883)
Folate 4.8 ug/L (3.1 -20.5)
Thyroglobulin ( wasn't done)
Thyroid peroxidase antibody 4.1 U/ml (<5.6)
I noted that that I am Vit D deficient and also my TSH levels has gone up in 3 months. If anyone can make sense of this, I'd be grateful.
I wanted to know whether to get a T3 test done then present results to GP.
Also do I need supplements? Are they free on prescription? Where to buy? How many? When to take dose so they don't interact with thyroxine.
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suzychi7
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You didn't get any replies on your other thread because this type of forum doesn't put new posts at the top of the page, and because you didn't reply directly to any of the members in that thread, or tag them, no-one was notified of your reply
Your new results show that you are undermedicated and need a dose increase. 25mcg immediately, retest in 6 weeks, further increase of 25mcg if necessary, repeat test, etc., until your levels are where they need to be for you to feel well. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well.
Shame the Thyroglobulin antibodies weren't done.
Always useful to have FT3 tested at the same time as FT4 and TSH to see how well you convert T4 to T3. It's no use as an idividual test, it needs to be done with the others. Medichecks and Blue Horizon do a basic thyroid panel - TSH, FT4 and FT3. You could add antibodies and that would include TPO plus TG.
Vit D 42 nmol/L doctor note: ' needs 1000-2000 u/day'
The Vit D Council recommends a level of 100-150nmol/L and your GP's suggestion of 1000-2000iu daily is not enough to raise your level to that extent. I suggest you start with 5000iu D3 daily for 8 weeks, reduce to 5000iu alternate days for 4 weeks then retest. When you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, 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 as recommended by the Vit D Council -
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
You could buy an oral spray, which is best for patients with autoimmune thyroid disease (aka Hashimoto's), or if you don't have that then a D3 softgel will do (they are cheaper). However, you can't rule out Hashi's completely until you've had TG antibodies tested.
Ferritin 100 ug/L ( 16- 204)
This is fine.
Vit B12 358 ng/L ( 187 -883)
On the low side. 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."
As long as you have no signs of B12 deficiency (check that here b12deficiency.info/signs-an... ) then you could supplement with sublingual methylcobalamin lozenges, 1000mcg daily should be fine. When taking B12 we also need a good B Complex to balance all the B vitamins.
Folate 4.8 ug/L (3.1 -20.5)
This is low, it should be at least half way through it's range. The B Complex mentioned will help raise folate (along with lots of leafy greens and other folate rich foods) and good brands are Thorne Basic B and Igennus Super B, both contain the active forms of ingredients.
Sorry, forgot to add that you wont get vitamins on prescription unless you fall into the deficiency category. As long as you are in range that satisfies doctors, but we need optimal levels.
Thank you so very much for taking the time to write such a detailed analysis. I didn't see your reply until now as I think I switched off notifications!
1) It's quite likely that you won't get Vit D on prescription. I doubt you would be prescribed 5000iu daily if she's written 1000-2000 in your medical notes. I don't know what the prescribed Vit D is, if you do manage to get a prescription, but it's unlikely to be softgels.
D3 softgels are cheap, look at Doctor's Best, only 2 ingredients - D3 and extra virgin olive - dolphinfitness.co.uk/en/doc...
If you find that you have Hashi's then you will need a D3 oral spray for best absorption, eg BetterYou.
2) B12 should be sublingual methylcobalamin lozenges (or an oral spray) . Some people like Jarrows, I like Cytoplan cytoplan.co.uk/vitamin-b12-...
3) If you use Thorne Basic B you take 1 x capsule, if you use Igennus Super B it's 2 x tablets to give the same dose as the Thorne.
4) K2-mk7 - 90-100mcg is the right amount for up to 10,000iu D3. I like Healthy Origins because it is a softgel containing just 2 ingredients, K2 and olive oil bigvits.co.uk/product.php?p...
Vit D cofactors:
Magnesium is generally low in all of us Hypos, testing is unreliable so just choose the form best for you (link in above post) and take what dose is on the pack.
Zinc you can test for. It should be half way through range. I take a multi mineral supplement that contains boron and zinc. If you consider a multi mineral then make sure it doesn't contain iron, calcium or Iodine.
I don't supplement with Vit A.
You shouldn't take all your supplements together, they can compete with each other.
D3 and K2 are fat soluble so should be taken with dietary fat, eg the fattiest meal of the day. Some people find that taking D3 at night affects their sleep.
B vitamins can be stimulating so are best taken the morning, no later than lunchtime.
Magnesium is calming and best taken in the evening.
So I ordered all the supplements from iherb and then found out they are a bad company as they charge extra customs charges before delivering the goods. I know you didn't recommend them but I thought their prices were too good to overlook. Anyway I've learned my lesson.
So I managed to get the extra 25mcg by going to senior partner at practice and explaining that it is a trial for 2 months.
One question about 5000iu Vit D. GP thought it was a very high amount to take and consulted a book which said that the max per day for someone < 25nmol ( I'm 42 nmol and still within ok range according to her) is 20,000iu per week. Are u sure I should take 5000iu daily? I was thinking 3 times per week?
So I ordered all the supplements from iherb and then found out they are a bad company
No, they're not a bad company. You are importing goods from the US. They make it very clear in the Shipping Information on their website
•You may have to pay import taxes, customs duties, or a brokerage (handling) fee for your order. These charges are separate from your shipping fee, and you will be billed directly from the carrier of your choice.
It is up to the individual to check this out when ordering from overseas.
they charge extra customs charges before delivering the goods
No they don't, it's the UK Government/Customs who charge the VAT and the Carrier who charge the collection fee.
This is why I linked you to suppliers in the UK as anything over £15 attracts these charges.
One question about 5000iu Vit D. GP thought it was a very high amount to take and consulted a book which said that the max per day for someone <25nmol ( I'm 42 nmol and still within ok range according to her) is 20,000iu per week. Are u sure I should take 5000iu daily? I was thinking 3 times per week?
As mentioned, the Vit D Council recommends a level of 100-150nmol/L or 40-60ng/ml. On their website they recommend how much to take when you are a certain level and when you want to reach the recommended level.
Your level of 42nmol/L is the equivalent of 16.8ng/ml and let's say you want to reach the middle of the recommended range, so that would be 125nmol/L or 50ng/ml. You can check the table here
Some people say that you can get selenium from Brazil nuts. However, they need to be grown in selenium rich soil to have any discernable amount of selenium in them, the packaging needs to say "Grown in selenium rich soil" and preferably the area, the richest being Eastern Amazon and Central Brazil.
The easiest way to be sure you get a known amount of selenium is by supplement.
As for the other vitamins and minerals in Brazil nuts, I have not seen any information about the amount contained in nuts, it's unlikely there would be enough to raise a low level.
Thank you once again for answering all my questions. I now feel ready to order my supplements and request 25mcg more of thyroxine. I will retest all privately in 8 weeks and post here.
So it's almost 8 weeks now. Will retest week after next with NHS and private for FT3/antibodies/folate/ferritin. I will fast. Please can you tell me whether/when I should stop taking the supplements: Thorne Basic B, B12, Magnesium, Boron, Vit D, K2, 125mg Levothyroxine
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blood test results 
Desperate for advice
Blood results
Can I get some thoughts on these blood test results?
