TSH levels.

[Teddy-Twoshoes]

Hi wonder if anyone can advise me, my 25 year old normally very fit, energetic daughter has become unwell ,the Doctors are looking at a diagnosis of CFS, she is due an MRI in a couple of weeks time,and further hormone tests at the hormone clinic that is not till October.She had her TSH tested recently and it was as follows 2.93 the range is 0.30-4.20 mu/L. Vitamin D 63 range 50.00nmol Serum Ferritin 52 range 28.00-200.00ug/L . B12 758 range 180.00 -640,00ng/L. Many thanks.

[SeasideSusie Remembering]

Teddy-Twoshoes

A TSH of 3 in another country would get a diagnosis of hypothyroidism. Her TSH at 2.93 is on the high side for a normal healthy person. Testing FT4, FT3 and thyroid antibodies will complete the picture, privately if necessary with Medichecks Thyroid Check Plus.

If the test was done in the afternoon her TSH will be lower than normal. Thyroid tests should be done at the first appointment of the morning, no later than 9am, as TSH is highest early morning and lowers throughout the day. Also best to leave breakfast and any drinks other than water until after the blood draw as eating and especially coffee can affect TSH.

Vit D at 63nmol/L is on the low side, the Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L so she could do with supplementing with D3 along with it's important cofactors magnesium and Vit K2-MK7. If that was my result I would be taking 4000-5000iu daily for 3 months then retest.

Ferritin at 52 isn't dire but could be better. For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range. Eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in... can help raise ferritin.

B12 is fine but Folate works with B12 so that should be tested too.

[Teddy-Twoshoes in reply to SeasideSusie]

Thank you Seaside Susie, is currently taking 800ug vitamin D and has done for months now , will buy higher strength ones tomorrow, and some K2 too. Appreciate all the advice ,will keep you updated.

[Crackerjack4u in reply to Teddy-Twoshoes]

Hello Teddy-Twoshoes Hang on before you go shopping please.

I just saw your reply to Seaside Susie above , and want to quickly bring something to your attention to prevent an error, or possible Vit D toxicity from possibly occurring in the future. Vit D toxicity, although rare, is possible at higher dosages over a long period of time, plus this could help partly explain why she is feeling so unwell at the moment.

You said she is currently taking 800ug of Vit D, and Susie had recommended 4000 IU-5000 IU. I just want to make sure you aware these are 2 different units of measurements IU stands for International Units, and ug is the same as micrograms. 1 IU is equal to 0.025mcg or 0.025ug, so according to the ug/IU calculator she is already currently taking the equivalent of 32,000 IU of Vit D, 800ug=32,000 IU, which is actually a much higher dosage already than what Seaside Susie has suggested. After the conversion the 4,000iu -5,000iu recommended dosage by Susie is actually only equal to 100ug for the 4000iu or 125ug for 5, 000iu.

Too much Vit D especially in an excess range can become toxic over time, and even if the labs are currently showing her Vit D levels as slightly lower I'd still recommend a lower dosage than she is currently on-(unless this dosage was for some reason prescribed by her doctor), but if she just bought them over the counter on her own then I'd recommend she go with the 4,000-5,000iu range that Seaside Susie recommend which is 100ug-125ug if purchasing it in the ug measurement.

Do you know if she's had her Calcium, and her Parathyroid hormone levels checked? I'd think if she'd been on 800ug/32000IU of Vit D for months now and her Vit D levels are still running on the lower end she might have something else going on in there. If her calcium levels are rising, or has risen too high from the high amount of Vit D being taken for months, or if her Calcium was already high prior to beginning the high dose of Vit D, and now it has risen even higher since beginning it this could be why she is feeling so poorly.

In addition to the things suggested by the others here, I'd also suggest that she have her Calcium level, and her Parathyroid Hormone level both checked also just to see where they are at the moment. I know you said she has other hormone tests in October which they could be planning on checking her PTH level at that time anyway, but you might want to see if there is anyway they'd be willing to do them sooner because the sooner the cause can be determined the sooner she can receive treatment for it. Hopefully together we all can get that gal of yours feeling better.

I'm not sure what other symptoms she's having other than feeling unwell, and having fatigue. Can you tell us more about any other symptoms she's having? What is her scheduled MRI on?

Here's a Vit D from IU to ug calculator link for you if you need it. nafwa.org/vitamind.php

Sorry this ended up being so long. I just wanted to bring the units of measurement issue to your attention because I was afraid, as you mentioned above, that you were going to go out and buy an even higher dosage of Vit D in the ug measurement not realizing they are not the same unit of measurement and she is already taking much more, not less than what was suggested by Susie.

Susie, shaws and others in this group are much more knowledgeable on this stuff than I am, so they may have other suggestions for her instead.

I hope this helps hun, and I hope your daughter feels much better very soon. Hugs!!!

[Teddy-Twoshoes in reply to Crackerjack4u]

Hi Thanks Crackerjack , have already bought Ultra Vitamin D 2000 Vitabiotics, think I will hold off from giving them to her , dont want her being toxic, she had her calcium levels checked in June it was 2,36 the range is 2,20 to 2,60 so she is within range. October seems a good while off but I guess the hormone clinic must be very busy. The problems she is having are fatigue, cognitive impaired function, not been able to walk for long, balance problems, muscle pain, although that is not there all the time. She has been into work today, but her area manager says she needs to get signed off until she has some kind of diagnosis, she is a Manager for Oxfam, and has had a long period of stress with her former main manager,she has now left thank goodness. The MRI is looking for possibly MS or to eradicate it as a diagnosis as her cousin who is 36 has recently been diagnosed with MS. I have fibromyalgia and there is a history of CFS in the family I also have underactive thyroid and am on Levothyroxine, which I feel is crap, but thats another story, have to get my daughter sorted, she has always had lots of energy and her health was good. Many thanks, take care. x

[SeasideSusie Remembering in reply to Teddy-Twoshoes]

Teddy-twoshoes

Is this what you have bought vitabiotics.com/shop/ultra/...

If so then that is 2000iu = 50ug (mcg)

If your daughter was taking 800ug, then as Crackerjack4u has said, that would be 32,000iu. The Vitabiotics 2000iu is very much less than what your daughter has been taking.

Can clarify that your daughter has actually been taking 800ug (mcg) or was it 800iu (international units).

[Teddy-Twoshoes in reply to SeasideSusie]

Hi Seaside Susie she has been taking 800 IU InvitaD3 colecaloiferol ,and yes can verify they are the Vitabiotics I bought today, Is it still okay to give them to her with her levels of vitamin D as they are ,she was tested in June of this year, dont want to give her extra supplements if they may make her worse. Many thanks.

[Teddy-Twoshoes in reply to Teddy-Twoshoes]

Her Vitamin D levels were 63 taken in June this year.

[Marz in reply to Teddy-Twoshoes]

They need to be at least 100

[Crackerjack4u in reply to Teddy-Twoshoes]

Hello Teddy-Twoshoes if you are 100% sure that she's been actually taking 800IU not the 800ug that was originally written then she should have NO issues with toxicity from taking that dosage of Vit D whatsoever, so she should continue taking Vit D, and it will be fine for her to increase to the new 2000IU dosage that you purchased for her today instead. :).

Also, her levels of Calcium are most like not going to be an issue from the Vit D dosage either now that we know the correct unit of measurement was actually IU and not ug as was originally stated. The range of calcium you posted above looks great so I doubt she has any issues with her parathyroid either.

I didn't mean to scare you, or confuse you, but I felt I needed to post a warning to you in case the 800ug that was listed was in fact correct to avoid an even higher dosage in the ug measurement being given which could have, especially in the long run, caused her more problems. Have a Wonderful Day hun. I hope your daughter feels better very soon.

[Teddy-Twoshoes in reply to Crackerjack4u]

Thanks Crackerjack , it was my error, and yes it was 800IU, really appreciate you taking the time to respond to my questions, started her on the new vitamin D today,and myself you have a lovely day too best wishes,

[SeasideSusie Remembering in reply to Teddy-Twoshoes]

Teddy-Twoshoes

Ah, that's cleared that up than

As she has some 2000iu dose, I would double up and take 4000iu for now. Retest in 3 months time to see what her level is then and reassess. When her level has reached 100-150nmol/L the she will 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/

I see she has the tablet form, not the best in my opinion. D3 is fat soluble so I always buy a softgel which contains extra virgin olive oil which aids absorption. What she needs to do is take her D3 with the fattiest meal of the day as it needs the fat to be absorbed.

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 such as hardening of the arteries, kidney stones, etc. Both

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day.

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit best and as it's calming it's probably best taken in the evening.

naturalnews.com/046401_magn...

Check out the other cofactors too.

[Teddy-Twoshoes in reply to SeasideSusie]

Thanks Seaside Susie , was a bit confused for a bit glad it's been clarified , have started her,and myself on the new vitamin D 3 and will make sure its taken with the fattiest meal , she is currently taking magnesium at night ,will try optimise ferritin too, appreciate you taking the time to answer my questions ,really value all the feedback I get from this group, best wishes.

[Marz in reply to Teddy-Twoshoes]

Have been reading your post/thread of a year ago when your T3 was so low. It was suggested you started a new thread asking where you could source T3. T3 is the active hormone and needed in every cell in your body. So if low - then Fibro and CFS will appear. T3 is better towarfs the top of the range so you have enough to go around. 😊

[Teddy-Twoshoes in reply to Marz]

Thanks Marz, the last time my t3 was tested was in March 2017 and it was 4 the range is 3.50 -6.50 pmol/L and T4 was 13.2 range is 11.00 -23.00 pmol /L. and TSH was 0.81. My latest TSH done in June was 0.83 this year. Still have not sourced T3 do you take it and can you get it on prescription where you live, my GP says they dont prescribe it, going to see a different GP next week not happy with the latter.

[Marz in reply to Teddy-Twoshoes]

Yes I do take T3 x 50mcg and 50mcg of T4 - and odd ratio I know - but I was T3 only for a while as it seemed I was still producing T4 that was not converting and then panicked and decided to add in some T4 ... need my annual check but so busy at the moment - running a Guests House and Studio in the midst of the Silly Season.

I live in Crete and until recently could buy T3 OTC - I now have to produce a prescription

I was diagnosed with Fibro back in 2000 by a Consultant Rheumatologist in the UK - and then with Hashimotos here in Crete back in 2005. My health has slowly improved and now as I hurtle towards 72 I am fit and strong - well most days ! Optimal thyroid meds - good levels of B12 and VitD - are vital to our well being. Good Ferritin and folate too - around mid range. These all need to be optimal for our Thyroid hormones to work well and for us to feel well. If the Thyroid is left under-medicated it can stress the adrenals - so make sure you have oodles of VitC several times a day. Adrenals love it

GP's are no longer able to prescribe T3 - due to price - almost 300 GBP's a box as the NHS are being ripped off big time. Same thing here is just over a euro. So you will need to post and ask for Suppliers of T3 and ask for replies by PM as we are not allowed to disclose names of companies connected to T3.

Just a thought - have you and your daughter had your thyroid anti-bodies tested ? - TPO and Tg ? The NHS only do the TPO. If these tests are negative, it rules out Hashimotos ( except in rare cases ! )

There is something odd about your results posted above ! The FT4 would be better around 20 and yet your FT3 is not that bad - would be better around 5. What time of day did you have the test ? Did you take your Levo before ? Was it a fasting test ? Are you taking any other medication that could affect your results ? The FT4 result is low in range - strange ! Others who know more than me may comment later !

SeasideSusie SlowDragon

[Teddy-Twoshoes in reply to Marz]

thanks Marz so pleased you have regained your health again, as you probably know it takes years and so many visits to different GP's to get any answers, constantly being fobbed off with "Your TSH is normal" when in fact I feel anything but normal,so many symptoms which defy any logic ,and if you told people they would think you were making it up. I am currently on 50mg levothyroxine have been for nearly two years and does not seem to be doing much at all my levels are more or less the same before I was on any medication, almost afraid to up the dose have no faith in GP's anymore feel I am not been listened to when I say its not working. My main concern at the moment is my daughter Daisy and getting her well ,appreciate all your feedback, have a lovely day.

[Teddy-Twoshoes in reply to Teddy-Twoshoes]

Yes my antibodies were checked a few years ago and appeared to be normal, My daughter will probably have hers checked at the hormone clinic, but that is not till October , hoping she can get the appointment moved forward, thanks again

[Marz in reply to Teddy-Twoshoes]

50 mcg really is only a starter dose and shoukd be increased. It could be that your thyroid is struggling to secrete T4 as result is low and to compensate is throwing out as much T3 as possible. This will not last and then ... If the FT4 is low and does not convert into T3 then your levels will become lower as will your energy/metabolism.

I appreciate you are concerned about your daughter at this time but we need to keep Mum fit and well to do so 😊

Would you consider private testing through thyroid UK - done in the home. Used by 1000's on the Forum in order to get the correct tests done. Information in the link below under the heading - About Testing ... Special Offers on Thursdays.

thyroiduk.org

[shaws Administrator]

Welcome to our forum and am glad you are helping your daughter because you are worried about the change in her.

Unfortunately, doctors and endocinologists in the UK appear to be badly trained nowadays and before the blood tests were introduced in the '60's we were all diagnosed upon our clinical symptoms and given a trial of NDT (natural dessicated thyroid hormones) and if our health improved, we were hypothyroid and stayed on NDT which was increased slowly until all symptoms were relieved.

I would advise your daughter to get a new blood test - a Full Thyroid Function Test - and it has to be at the very earliest, fasting (she can drink water) and make sure she is well-hydrated a couple of days before if you are going to get a private test. these are home pin-prick ones. If she was taking thyroid hormones she'd allow a gap of 24 hours between dose and test and take dose afterwards.

We have three private labs that do home pin-prick tests and a Full Thyroid Function Test is:

TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.

Blue Horizon, Medichecks or Thriva do the home pinprick blood tests.

thyroiduk.org.uk/tuk/testin...

GP should test B12, Vit D, iron, ferritin and folate.

Post the results with the ranges for comments from members. Most doctors seem not to have a clue and in the UK our TSH has to reach 10 before a diagnosis will be considered but if we lived abroad we are diagnosed when TSH is above 3+. Ranges are important as labs differ and enable members to respond.

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/about_...

CFS - ME and fibromyalgia were named about ten years after the introduction of the blood tests and levothyroxine. We were diagnosed upon symptoms alone before this.

[Teddy-Twoshoes in reply to shaws]

Many thanks Shaw for all the information , and agree most Doctors do not know what they are doing regarding thyroid issues, she is due to have some hormone tests through the GP at the hormone clinic but not till October.

[shaws Administrator in reply to Teddy-Twoshoes]

Oh - that all our doctors like the following have retired or lost their licences due to 'treating patients' and not a blood test.

hormonerestoration.com/

hormonerestoration.com/Thyr...

hormonerestoration.com/PCon...

[Teddy-Twoshoes in reply to shaws]

Thanks for all the links will take a good look at them.

[Teddy-Twoshoes]

Thank you Really fed up , I have underactive thyroid , and they should be doing these tests at the hormone clinic in October though I am going to see if they can put the appointment forward. Best wishes.