Any Advice please.?: Hi Everyone, This is a re... - Thyroid UK

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Any Advice please.?

DoeStewart profile image
18 Replies

Hi Everyone,

This is a re-post. I have received some help from one member but wondered if there was anyone else with advice as I am confused.

Had my Medichecks results back and don't know what to do next? I wonder if someone would look at them and tell me what they think please.

July 2018

TSH *0.159 ( 0.27 - 4.20)

FREE THYROXINE 16.500 (12.00 - 22.00)

FREE T3 4.27 (3.10 - 6.80)

THYROGLOBIN ANTIBODY <10 (0.00 - 115.00)

THYROID PEROXIDASE ANTIBODIES 10.00 ( 0.00 - 34.00)

ACTIVE B12 58.100 (25.00 - 165.00)

FOLATE(SERUM) 4.84 (2.91 - 50.00)

25 OH VITAMIN D 53.6 (50.00 - 200

00 )

BIOCHEMISTRY

INFLAMATION MARKER CRP, HIGH SENSITIVITY *9.63(0.00 - 5.00)

FERRITIN 64 (13 - 150)

I HAVE HAD 7/8ths thyroid removed 30 years ago. I currently take 100mg Levo daily.

Previous results on 100/75 alternate days - tests through GP

April 2018

TSH 0.43 (0.30 - 5.50)

T4 19.7 (11.5 - 22.7)

RESULTS THROUGH GP AT 100MG LEVO DAILY

JUNE 2018

TSH 0.27 (0.30 - 5.50)

T4 21.1 (11.5 - 22.7)

I am confused that my TSH and T4 have both reduced?

Any help and comments greatly appreciated

Thank you.

Last edited by DoeStewart

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18 Replies
silverfox7 profile image
silverfox7

Did you have both tests at the same time of day as readings can vary depending g on timing.

DoeStewart profile image
DoeStewart in reply tosilverfox7

Hi thanks for reply. Yes tests.under same conditions except June test from GP - I forgot and took my Levo before the test but as you can see my TSH had reduced anyway.

greygoose profile image
greygoose in reply toDoeStewart

Taking your dose before the test would have no effect on the TSH. It doesn't move that fast. But, it would give you a false high FT4.

DoeStewart profile image
DoeStewart in reply togreygoose

Thank you Greygoose. Can I ask your opinion on my results?

SlowDragon profile image
SlowDragonAdministrator

All your vitamin levels are too low. This tends to lower TSH (then GP thinks your over medicated)

Actually you are likely under medicated, but vitamin deficiencies are hiding it. Your TSH is all GP looks at, but FT3 is low.

Getting vitamins optimal is first steps

Only add one supplement at a time and wait at least 10-14 days to assess, before adding another

Vitamin D is too low. Aiming to improve to around 100nmol. Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you supplement 2000iu-3000iu for 2-3 months and retest. It's trial and error what dose each person needs.

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Retesting twice yearly via vitamindtest.org.uk

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

betterbones.com/bone-nutrit...

articles.mercola.com/sites/...

healthy-holistic-living.com...

articles.mercola.com/sites/...

betterbones.com/bone-nutrit...

easy-immune-health.com/magn...

B12 and folate are too low. A good quality daily vitamin B complex may be of benefit. One with folate in not folic acid. Eg Igennus Super B complex or Jarrow B-right

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Ferritin is borderline. Aiming for halfway in range minimum. Eating liver or liver pate once a week should help improve levels

Other supplements that help

Daily vitamin C supports adrenals

Selenium supplements can help improve conversion of FT4 to FT3

TSH should rise and then can get GP to agree dose increase in Levothyroxine

Strictly gluten free diet helps many, suggest you try this too

DoeStewart profile image
DoeStewart in reply toSlowDragon

Thank you so much Slow Dragon- I will start with vitamins as you suggest. Can I ask why it's best to supplement one at a time leaving a week or two between? Also, any other suggestions for FERRITIN as I don't eat liver or pate. I already take selenium. How long should I wait before having a new blood test to see whether things are improving? In the past I have been on 175mg Levo and was stable for about 9 or 10 years, as you can see my dosage has dropped considerably to 100mg daily.

Thank you so much for your Advice, much appreciated.

SlowDragon profile image
SlowDragonAdministrator in reply toDoeStewart

There's a current ridiculous obsession with medics to reduce dose to bring TSH up to within range (which is wrong and virtually impossible)

On Levothyroxine we invariably need TSH suppressed with high FT4 in order to have high enough FT3

Reducing Levothyroxine often results in low vitamin levels and even lower TSH and very ill patient

Repeat testing in say 8 weeks after adding vitamin D, magnesium, vitamin B complex

Perhaps also see if you can push GP for "trial" increase to 100mcg Levothyroxine

You likely need at least 125mcg if not more

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

tukadmin@thyroiduk.org

Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3

rcpe.ac.uk/sites/default/fi...

DoeStewart profile image
DoeStewart in reply toSlowDragon

I have since April taken 100mg levo a day, previously was taking 100mg/75mg alternate days and felt very unwell. When I had bloods done via GP in June, my TSH had dropped below range and my T4 was right at top of range, GP said recommendation on lab form was to reduce dose. I persuaded her to leave me on 100mg a day. However, as you can see from private testing, both TSH and T4 have dropped? I thought they would have remained stable but obviously not. I am trying to understand why this would be?. If my GP saw these results she would certainly drop my dosage. I keep having to remind her that I have had 7/8ths thyroid removed 30 years ago but I feel they treat me as if I still had all the gland.

SlowDragon profile image
SlowDragonAdministrator in reply toDoeStewart

TSH drops when vitamins are low

Vitamins drop when not on enough Levothyroxine

FT4 drops when not on enough Levothyroxine

FT3 drops when not on high enough dose of Levothyroxine

Just testing TSH and FT4 or just TSH is completely inadequate

One of the main reasons there are over 85,000 members on here. Current thyroid testing and treatment is extremely poor

DoeStewart profile image
DoeStewart in reply toSlowDragon

Gosh Slow Dragon it's an education being on this site, I'm amazed at how much information there is and yet Drs seem to know very little if anything at all ??. I have only now started to gather information to help myself as I feel very let down by medical profession, don't listen to symptoms just look at TSH. I am about to order the Dlux + Vitamin D+K2 spray from Better You - is that suitable? I will also order the B complex vitamins you have suggested. What about Magnesium? What dose of this should I be looking for please?.

Sorry to bombard you with questions but I need to get this right so I can start to improve my health.

Many thanks again.

SeasideSusie profile image
SeasideSusieRemembering in reply toDoeStewart

DoeStewart

Can I ask why it's best to supplement one at a time leaving a week or two between?

If you start all supplements at the same time and you have an adverse reaction, you wont know which one caused it. Staggering supplements with a week or two inbetween, if you do have a reaction you can pinpoint the culprit.

What about Magnesium? What dose of this should I be looking for please?.

As there are different forms of magnesium, you should take what is suggested on the pack for the form you are using. There are lots of articles you can find but as a general rule, it's roughly about 300-400mg daily.

DoeStewart profile image
DoeStewart in reply toSeasideSusie

Thank you Seaside susie, now understand the one at a time vitamins. Thank you so much for your help.

SlowDragon profile image
SlowDragonAdministrator in reply toDoeStewart

Personally I just buy the plain Better You vitamin D and take separate vitamin K2 (by Healthy origins). But I still take fairly high dose vitamin D. (More on my profile)

Magnesium. There's loads of different options. Lots of us use Calm Vitality Magnesium powder. It's cheap and easy to use. Starting with small dose eg 1/4 teaspoon. Taking too much can cause diarrhoea. So best start slow! Ideally taken afternoon or evening (it's relaxing and good for sleep) Must be four hours minimum away from Levothyroxine

So time of magnesium is depending when you take Levo.

Many of us find taking Levothyroxine at bedtime is good. Needs to be 2-3 hours after meal. Longer if you have a feast. Can take in middle of night, if eating out late

verywell.com/should-i-take-...

Vitamin B complex, I like Igennus as its small tablets. Doesn't turn your pee bright yellow, unlike many others. Full dose is two per day, but would recommend just one per day initially, (after breakfast) see how you get on.

Medics just want one simple test. They also don't learn about vitamins or nutrition. They just don't understand the thyroid and gut connection

Being hypothyroid very often lowers stomach acid. No easy test for this. So it's often misdiagnosed as high acid. We get many turn up here incorrectly put on PPI's (omeprazole, Lansoprazole etc) when actually they need more acid not less

Low stomach acid leads to low vitamins

thyroidpharmacist.com/artic...

drmyhill.co.uk/wiki/hypochl...

scdlifestyle.com/2012/03/3-...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

pulsetoday.co.uk/clinical/m...

gov.uk/drug-safety-update/p...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription

DoeStewart profile image
DoeStewart in reply toSlowDragon

Hi SlowDragon- yes I have just been looking at seperate vitamin D spray and K2 vitamins and I will order those. Thank you for the information regarding Magnesium, not something I know anything about, I saw Gel, Lotion, cream etc... but powder sounds ideal. I have ordered the vitamin B from Amazon. I have also ordered vitamin C and I already take Selenium, my husband said I would be rattling when I walk 😊. Your help and advice has been invaluable and I just want to thank you very much for taking the time.

silverfox7 profile image
silverfox7 in reply toDoeStewart

Many of us rattle!

DoeStewart profile image
DoeStewart in reply tosilverfox7

Good way to recognise a fellow sufferer?

Tile profile image
Tile in reply toSlowDragon

What? TSH drops when vitamin s low?????.Sorry that sounds.like misinformation. TSH is suppressed when on hypo meds and the pituitary has no problem using the T4 T3 from meds. I'm.far.from vitamin deficient and have a suppressed TSH. Which may be how I got rid of my Hashi antibodies.

SlowDragon profile image
SlowDragonAdministrator in reply toTile

Yes that's true when we are on high enough meds.

Many people on here are stuck on 25mcg, 50mcg or 75mcg Levothyroxine and never get an increase because TSH is low.....but by testing and improving low vitamin levels by taking supplements, TSH very often rises so that they can then get prescribed higher dose of Levothyroxine

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