You are very under-medicated. TSH should be 1 or under. Frees should be quite a bit higher.
Is this your first antibody test? If not, what were the other results?
Your vit D is catastrophic. You really need to supplement that. Have a look at some of SeasideSusie 's replies to other people, see what she advises taking.
Thank you "grey goose" for your help here. My TSH is low and my "frees" should be higher. As you say my Vitamoin D is catastrophic but I am sure that I can refer to "SeasideSusie's" posts to get her advice. I am only just learning so your advice is much appreciated. Take care,
"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the local guidelines or this summary and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu, which is the typical maintenance dose prescribed by GPs, so post your new result at the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and 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/
If your GP wont prescribe loading doses, you have two choices - report him for negligence, or come here and I will work out what you need.
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 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
How much Levo do you take, you are currently undermedicated. 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. You need an immediate increase of 25mcg, retest in 6 weeks, another increase of 25mcg if necessary followed by retesting 6 weeks later, and repeat until your levels are where they need to be for you to feel well.
TPOAb 34.1 kiU/L 0.0 - 34.0 kiU/L
TGAB 196.0 kU/L 66.0 - 181.0 nmol/L
Your raised antibodies confirm autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
I am overcome by your insight and knowledge about thyroid issues. I am also overcome by your generosity to people like me who really know very little about these problems. I have been trying hard to educate and inform myself; this website is quite remarkable. Enough said.
I will attempt to follow your advice which I regard as a gift. Enough said.
Hi I am a health professional and wanted to ask you what you think of the D1 25-hydroxy. The endocrinologist that I partner with that's all she uses she says the regular vitamin D test that all the doctors use is not the true reading. I had them both done at the same time and the vitamin D 25 was 60 and the vitamin D 125 was 110. She said that is the true reading. She said the vitamin d25 can go up and down daily every other day it's not consistent but the vitamin D 125 is the true reading. please let me know what you think thank you
Hello SeasideSusie - With reference to Adam's post regarding the use of two different Vitamin D tests I have been researching this but thus far have not been able to find a correct (and simple) source to enlighten myself and reply to Adam's question. I will take a wee rest and look further later on. Hope all is well with you - Victoria99 .
•If a patient that is supplemented with vitamin D continues to experience symptoms of vitamin D deficiency.
1,25 dihydroxyvitamin D may be requested if the calcium concentration is high or the patient has a disease that might produce excess amounts of 1,25 dihydroxyvitamin D, such as sarcoidosis or some forms of lymphoma.
Low levels of 1,25-dihydroxyvitamin D can be seen in patients with kidney disease.
High levels of 1,25-dihydroxyvitamin D can be seen in patients with sarcoidosis or some lymphomas, as a result of 1,25 dihydroxyvitamin D being made outside of the kidneys.
It doesn't appear to be a test that can be done privately, like the 25- OH Vit D that we can easily do here in the UK with a fingerprick test.
Personally, it's not something I'm going to be worried about. I discovered I was severely deficient (no thanks to my GP), I supplemented (no thanks to my GP) and brought my level up to that recommended by the Vit D Council and others. I monitor it myself and I know that I don't have high calcium level, sarcoidosis, lymphoma or kidney disease, so I am happy to continue just testing 25 OH Vit D.
For those patients who were tested by their GP and found to be deficient, considering that most GPs wont retest due to cost, then that is worrying. How would the GP know whether the patient continues to experience symptoms of deficiency and might benefit from the 125 Vit D test. Another reason for a patient to become proactive!
I did find a wee bit of information regarding the differerence between these two tests and hope they might be a small help. The second paragraph came from information given with a "do it yourself" text relating to patients who were using a home test.
I think the question Adam posed was a very interesting one and I only wish I was able to give him a reasonable reply. However, I do think that for his partner (as an endocrinologist) it might be crucial to use the 125 Vit test as it is much more relevant to patients with hypothyroid problems because, as Adam says, this test is "consistent and is the true reading" rather than the 25 Vit test which "can go up and down daily every other day!" This pertains to myself as my trusted GP will be checking out my Vitamin D (thanks teacher) soon and I will most definitely provide her with this invaluable information. The problem here is that she might be unable to digress from her NHS guidelines but I will talk about it with her.
Dear Teacher
Your last paragraph accords seamlessly with the foregoing. Your penultimate paragraph is overwhelmingly due to the invaluable research you have already concluded. Have you ever thought about offering your life history in this regard to evidence to any interested or needy reader of any status regarding the insights and information you now have?
MANY THANKS TO ADAM AND TO THE TEACHER - MUCH APPRECIATED - victoria!
APOLOGIES FOR THE LENGTH OF THESE SOURCES AND THE ABSENCE OF PROPER SOURCES - i am just a beginner in this study! I could provide the sources if it was needed!
For patients with vitamin D-related disorders, clinicians measure serum concentrations of total 25-hydroxyvitamin D [25(OH)D] or 1,25-dihydroxyvitamin D [1,25(OH)2D]. 25(OH) D serum concentrations have been used as a nutritional marker for assessment of optimum vitamin D supplementation. 25(OH) D and 1,25(OH)2D are converted to inactive metabolites by an enzyme 24 hydroxylase encoded by CYP24A1. 25(OH) D is converted to 24,25(OH)2D and normally the ratio is <25. Inactivating mutations of CYP24A1 (cytochrome P450, family 24, subfamily A, polypeptide 1) cause hypercalcemia (elevated levels of calcium in blood), hypercalciuria (elevated levels of calcium in urine), and increased 1,25(OH)2D concentrations. If CYP24A1 mutations cause reduced or complete loss of 24-hydroxylase function, then the serum concentrations of 24,25(OH)2D may be undetectable.
Vitamin D is a family of compounds that is essential for the proper growth and formation of teeth and bones. This test measures the level of vitamin D in the blood.
Two forms of vitamin D can be measured in the blood, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D. The 25-hydroxyvitamin D is the major form found in the blood and is the relatively inactive precursor to the active hormone, 1,25-dihydroxyvitamin D. Because of its long half-life and higher concentration, 25-hydroxyvitamin D is commonly measured to assess and monitor vitamin D status in individuals.
Vitamin D comes from two sources: endogenous, which is produced in the skin on exposure to sunlight, and exogenous, which is ingested in foods and supplements. The chemical structures of the types of vitamin D are slightly different, and they are named vitamin D2 (ergocalciferol, which comes from plants) and vitamin D3 (cholecalciferol, which comes from animals). The D2 form is found in fortified foods and in most vitamin preparations and supplements. Vitamin D3 is the form produced in the body and is also used in some supplements. Vitamin D2 and D3are equally effective when they are converted by the liver and the kidney into the active form, 1,25-dihydroxyvitamin D.
Some tests do not distinguish D2 and D3 forms of the vitamin and report only the total result. Newer methods, however, may report levels of both D2 and D3 and then add them together for a total level.
Thanks again for all your information about Adam's post regarding the two tests he referred to. I did post some information of my own to you and to Adam. If you have time I would really appreciate it if you would be able to respond to my own searches regarding his question. I know your time is invaluable. Enough said.
Thanks for your post Adam. I am totally unaware of this and appreciate your help in this regard. I spoke with my own trusted GP this morning and will be taking the required dose of Vitamin D as suggested by our own "SeasideSusie." I will let her know about this. Kind regards - Victoria.
Adam: I am suffering brain fog and problems with memory together with symptoms. I sent this to "teacher" but did not do it separately to you. Many apologies. It might be a lot of rubbish! It is the best I could do! Kind regards to you and your partner!
Dear Teacher and Adam
I did find a wee bit of information regarding the differerence between these two tests and hope they might be a small help. The second paragraph came from information given with a "do it yourself" text relating to patients who were using a home test.
I think the question Adam posed was a very interesting one and I only wish I was able to give him a reasonable reply. However, I do think that for his partner (as an endocrinologist) it might be crucial to use the 125 Vit test as it is much more relevant to patients with hypothyroid problems because, as Adam says, this test is "consistent and is the true reading" rather than the 25 Vit test which "can go up and down daily every other day!" This pertains to myself as my trusted GP will be checking out my Vitamin D (thanks teacher) soon and I will most definitely provide her with this invaluable information. The problem here is that she might be unable to digress from her NHS guidelines but I will talk about it with her.
Dear Teacher
Your last paragraph accords seamlessly with the foregoing. Your penultimate paragraph is overwhelmingly due to the invaluable research you have already concluded. Have you ever thought about offering your life history in this regard to evidence to any interested or needy reader of any status regarding the insights and information you now have?
MANY THANKS TO ADAM AND TO THE TEACHER - MUCH APPRECIATED - victoria!
APOLOGIES FOR THE LENGTH OF THESE SOURCES AND THE ABSENCE OF PROPER SOURCES - i am just a beginner in this study! I could provide the sources if it was needed!
For patients with vitamin D-related disorders, clinicians measure serum concentrations of total 25-hydroxyvitamin D [25(OH)D] or 1,25-dihydroxyvitamin D [1,25(OH)2D]. 25(OH) D serum concentrations have been used as a nutritional marker for assessment of optimum vitamin D supplementation. 25(OH) D and 1,25(OH)2D are converted to inactive metabolites by an enzyme 24 hydroxylase encoded by CYP24A1. 25(OH) D is converted to 24,25(OH)2D and normally the ratio is <25. Inactivating mutations of CYP24A1 (cytochrome P450, family 24, subfamily A, polypeptide 1) cause hypercalcemia (elevated levels of calcium in blood), hypercalciuria (elevated levels of calcium in urine), and increased 1,25(OH)2D concentrations. If CYP24A1 mutations cause reduced or complete loss of 24-hydroxylase function, then the serum concentrations of 24,25(OH)2D may be undetectable.
Vitamin D is a family of compounds that is essential for the proper growth and formation of teeth and bones. This test measures the level of vitamin D in the blood.
Two forms of vitamin D can be measured in the blood, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D. The 25-hydroxyvitamin D is the major form found in the blood and is the relatively inactive precursor to the active hormone, 1,25-dihydroxyvitamin D. Because of its long half-life and higher concentration, 25-hydroxyvitamin D is commonly measured to assess and monitor vitamin D status in individuals.
Vitamin D comes from two sources: endogenous, which is produced in the skin on exposure to sunlight, and exogenous, which is ingested in foods and supplements. The chemical structures of the types of vitamin D are slightly different, and they are named vitamin D2 (ergocalciferol, which comes from plants) and vitamin D3 (cholecalciferol, which comes from animals). The D2 form is found in fortified foods and in most vitamin preparations and supplements. Vitamin D3 is the form produced in the body and is also used in some supplements. Vitamin D2 and D3are equally effective when they are converted by the liver and the kidney into the active form, 1,25-dihydroxyvitamin D.
Some tests do not distinguish D2 and D3 forms of the vitamin and report only the total result. Newer methods, however, may report levels of both D2 and D3 and then add them together for a total level.
Reply
victoria99
victoria99in reply to SeasideSusie
17 hours ago
Thanks again for all your information about Adam's post regarding the two tests he referred to. I did post some information of my own to you and to Adam. If you have time I would really appreciate it if you would be able to respond to my own searches regarding his question. I know your time is invaluable. Enough said.
Dear Slow Dragon - I am very fortunate to have not one but two tutors to give support and relevant information which is really a small miracle. The depth of knowledge of both of my tutors is quite amazing and perhaps a wee bit scary! Many thanks - Victoria
Dear Slow Dragon - somehow I seem to have missed or misunderstood your message to me "a month ago" - brain fog, exhaustion, etc. etc. might be culprits! Anyhow, by some miracle it has re-presented itself here. Many apologies for this. Anyhow, I can now take advantage once again of your knowledge. I remember I was struggling significantly to send two different replies. Thanks for everything. My IT results are usually not too bad but not this time round. I hope all is well with you. Victoria x
Hi Victoria. Just enquiried about this Test with Thriva & they have said it doesn't include B12 - although it is listing as included on the web. There are a lot of tests - how many blood vials needed filling ? And it was definitely the 'active' B12 ? Thanks
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