Reading Blood test result!

[Rolbo]

I have a TSH blood test reading of 0.5 - is this okay? I am on 75mg of Thyroxine.

[SeasideSusie Remembering]

Rolbo

What is the reference range?

TSH only is not the whole picture. FT4 and FT3 are needed also but rarely done.

How do you feel?

[Rolbo in reply to SeasideSusie]

TSH range 0.3 - 5.6?

Aching muscles, increased heart rate particularly at night.

[SeasideSusie Remembering in reply to Rolbo]

Rolbo

So you are within range so your GP shouldn't insist on a reduction in dose. But as I said, you need FT4 and FT3 testing for a full picture, you can't know if you are on the correct dose, or over or under medicated without seeing the actual hormone levels - FT4 and FT3.

Increased heart rate may possibly be connected with over medication, but may not.

Your aching muscles may possibly be connected with low Vit D, that can give symptoms of muscle and joint aches and pains.

So that thyroid hormone can work properly, optimal levels of vitamins and minerals are advised, so it would be a good idea to test

Vit D

B12

Folate

Ferritin

[Rolbo in reply to SeasideSusie]

Thank you for your prompt reply!

[shaws Administrator in reply to Rolbo]

When I was taking levothyroxine my heart was always taking off with palpitations night, day or anywhere. I had so many t.rips in ambulances and heart monitors etc

Sometimes we can be sensitive to the fillers/binders in the hormones. You can try taking one anti-histamine tablet one hour before your next dose and if you don't have palpitations, ask for a change of make of levothyroxine. Sometimes it is the fillers/binders in them that affect us.

[Rolbo in reply to SeasideSusie]

New Blood Tests now from Thriva - any thoughts please, on 50mg of Thyroxine when these tests were done, no thyroxine taken for 24hrs prior to test and fasting for 12 hours.

B12 (Active)

Active B1292.2 pmol/L25.1 - 165.0 pmol/L

Ferritin

* Ferritin157.0 ug/L13.0 - 150.0 ug/L

Folate

Folate31.9 nmol/L8.83 - 60.8 nmol/L

Thyroid Advanced Profile

* Thyroid Stimulating Hormone (TSH)7.1 mIU/L0.27 - 4.3 mIU/L

Free Thyroxine (FT4)15.0 pmol/L 12.0 - 23.0 pmol/L

Triiodothyronine (FT3)3.17 pmol/L 3.1 - 6.8 pmol/L

Anti-Thyroidperoxidase antibodies15.4 kIU/L0.0 - 34.0 kIU/L

Thyroxine (T4)86.5 nmol/L 66.0 - 181.0 nmol/L

Anti-Thyroglobulin antibodies (TGAB)51.5 kU/L 0.0 - 115.0 kU/L

Vitamin D

25-hydroxy Vitamin D72.7 nmol/L 50.0 - 200.0 nmol/L

[SeasideSusie Remembering in reply to Rolbo]

Rolbo

How long had you been on 50mcg Levo before the test?

[Rolbo in reply to SeasideSusie]

Just over 3 weeks.

[SeasideSusie Remembering in reply to Rolbo]

Rolbo

Why did you reduce your dose? That's too soon to retest, your thyroid levels wont have settled down so there's not much to say about those. It should be 6 weeks after a dose change before retesting, personally I need 8 weeks for everything to stabilise. The only thing that can be said is that the reduction has obviously affected your TSH and you probably didn't need to reduce.

Your ferritin is over range. Are you supplementing with iron? If you're supplementing you should stop for now. If not supplementing it could be infection or inflammation that's caused it to be high, so it's worth repeating in 3 months and if still high look for a cause.

B12 isn't bad

Folate is pretty good, it should be at least half way through range and yours is almost there.

If you want to supplement for these then I would suggest looking at Igennus Super B and take 1 tablet per day, that gives 200mcg methylfolate and 450mcg methylcobalamin and that should be enough to nudge up your levels without taking them too high.

Vit D: 72.7nmol/L

The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L.

If that was my result I would be supplementing the amount the Vit D Council recommends for that level which is:

To achieve 100nmol/L take 2000 IU D3 daily

To achieve 125nmol/L take 3700 IU

To achieve 150nmol/L take 5800 IU

As it's winter and we can't make Vit D naturally from the sun so we draw on our store made during the summer, I'd aim for the top end so I'd take 5000iu daily throughout the winter and retest in March.

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/

there are important cofactors needed when taking D3 as recommended by the Vit D Council -

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.

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. 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 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.

You might find that improving your Vit D level will help with the muscle aches.

[Rolbo in reply to SeasideSusie]

Wow this is great - thank you so much for this reply. Yes, don't think I maybe need to reduce Thyroxine then - my doctor isn't keen for me to but I began to think I needed to do something and since then heart palpatations seem to have reduced and head has been clearer - perhaps just a placebo effect? Vit D will be good to look at and as you say may help with the muscle aches - do you know of any good suppliers? Thank you once again!

[SeasideSusie Remembering in reply to Rolbo]

Rolbo

The Vit D that I like, and seems to be vest value at the moment, is

healthmonthly.co.uk/doctors...

It has only 2 ingredients, D3 and extra virgin olive oil to help absorption.

The Vit K2-MK7 I like, again only 2 ingredients, is

bigvits.co.uk/product/vitam...

Where Hashi's is present, which is confirmed by raised antibodies, then an oral spray is best. Your antibodies are within range but not exactly at the low end. You might want to consider the spray.

BetterYou D3 - 3000iu

BetterYou combined D3/K2 - 3000iu

Check the instructions as I think one requires one spray for 3000iu and the other requires 3 sprays for 3000iu.

If you use the spray then I'd start with 6000iu daily for 6 weeks then reduce to 3000iu daily and see how that goes.

[Rolbo in reply to SeasideSusie]

Great thank you - will into this. Again so grateful for your help!

[Rolbo in reply to Rolbo]

Hi, my plan now is - to take my original dose of Thyroxine (75mcg) and then retest in 8+ weeks. Also to take Vitamin D 5000iu (have ordered from healthmonthly) daily throughout the winter and retest in March. Plus Vitamin K2-MK7 (have ordered from BigVits as suggested) - what do you think would be an appropriate dose of this one? Going to order magnesium and wondering how much to take daily of this too? Really appreciate your help!

[Rolbo in reply to SeasideSusie]

Hi, my plan now is - to take my original dose of Thyroxine (75mcg) and then retest in 8+ weeks. Also to take Vitamin D 5000iu (have ordered from healthmonthly) daily throughout the winter and retest in March. Plus Vitamin K2-MK7 (have ordered from BigVits as suggested) - what do you think would be an appropriate dose of this one? Going to order magnesium and wondering how much to take daily of this too? Really appreciate your help!

[SeasideSusie Remembering in reply to Rolbo]

Rolbo

The serving size is 1 softgel, that's what you take. 100mcg is enough for up to 10,000iu D3.

For magnesium, it depends on which form you take, just take what the suggested serving is.

Retest thyroid levels 6-8 weeks after a dose change.

[Rolbo in reply to SeasideSusie]

Many thanks for this - you've been so helpful.

[Angel_of_the_North]

It might be, or it might not. The important tests are free t3 and free t4 - the actual thyroid hormones. TSH on its own can't tell you much.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Low vitamin levels are common, and TSH can be low as result, but we remain hypothyroid

Ask GP to test vitamins k antibodies and FT4 and FT3

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

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. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

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 are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

[Rolbo in reply to SlowDragon]

New Blood Tests from Thriva - any thoughts please, on 50mg of Thyroxine when these tests were done, no thyroxine taken for 24hrs prior to test and fasting for 12 hours.

B12 (Active)

Active B1292.2 pmol/L25.1 - 165.0 pmol/L

Ferritin

* Ferritin157.0 ug/L13.0 - 150.0 ug/L

Folate

Folate31.9 nmol/L8.83 - 60.8 nmol/L

Thyroid Advanced Profile

* Thyroid Stimulating Hormone (TSH)7.1 mIU/L0.27 - 4.3 mIU/L

Free Thyroxine (FT4)15.0 pmol/L 12.0 - 23.0 pmol/L

Triiodothyronine (FT3)3.17 pmol/L 3.1 - 6.8 pmol/L

Anti-Thyroidperoxidase antibodies15.4 kIU/L0.0 - 34.0 kIU/L

Thyroxine (T4)86.5 nmol/L 66.0 - 181.0 nmol/L

Anti-Thyroglobulin antibodies (TGAB)51.5 kU/L 0.0 - 115.0 kU/L

Vitamin D

25-hydroxy Vitamin D72.7 nmol/L 50.0 - 200.0 nmol/L

[SlowDragon Administrator in reply to Rolbo]

SeasideSusie has given you the info on vitamins

Your Thyroid results show you are still hypothyroid.

Testing should only be after 6-8 weeks on a constant dose

Presumably GP will run tests at 6-8 weeks

Dose should be increased slowly in 25mcg steps, retesting bloods 6-8 weeks after each dose increase.

This repeats until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

NHS guidelines saying standard starter dose is 50mcgs

beta.nhs.uk/medicines/levot...

My comments would be what brand of Levothyroxine are you taking?

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.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

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

Other medication at least 2 hours away, some like HRT, iron, calcium (including calcium rich foods) , vitamin D or magnesium at least four hours away from Levothyroxine

See point 8 - any foods to avoid

beta.nhs.uk/medicines/levot...

[Rolbo in reply to SlowDragon]

Huge thanks for your thoughts they are really helpful and a great support.