Blood results help

[Tracyjh71]

Hi these are my blood results taken today I'm on 50mg of levo but still feeling so ill and in a lot of pain I'm also on 8000u of vit d3 for a vit D deficiency any advice on what to do now please would be greatly appreciated thank you x

[Peanut31]

Hi

The experienced members will be along shortly, but looking at your results, You need an increase of Levothyroxine.

Your TSH is still too high, although your GP will argue it’s in range.

For thyroid patients to feel well it’s recommended that our TSH is 1 or below and T3 and T4 in the upper ranges of the lab figures. Your T4 isn’t there yet.

I see you have not had your T3 tested. It’s T3 that makes us feel well and think straight. GP’s don’t understand the importance of T3, and as you have not been tested for T3, I suspect your GP doesn’t thinks it’s important.

Tell your GP you still don’t feel well and ask for a further 25mcg of Levothyroxine = 75mcg.

Your dosage of 50mcg is only a starter dosage. Then make sure you have another blood test 6 weeks later after starting your increased Levothyroxine.

Book the blood test as early as possible in the morning before 9am.

Don’t take your Levothyroxine that morning, no eating and drink water only.

Have you had your iron, and vitamin B12 levels tested as well?

Best Wishes

Peanut31

[Tracyjh71 in reply to Peanut31]

Thank you for your reply, I have an appointment with a doctor next Monday so I will challenge her about my levels. My iron and vitamin b12 was tested in July and came back normal, that's when I was first diagnosed with under active thyroid.

I've asked my doctor and nurses about eating and drinking before tests and the best time of day to have them done and been told a few times that I can eat and drink as normal and the time of tests doesn't matter and that I should take the levothyroxine as normal, so this mornings test was at 10.40 I had a cup of tea at 7.30 ish but didn't take my levothyroxine so my results could be wrong then. Looking back on all my blood results I've never had my t3 tested.

Al my results from being diagnosed if that helps

2/6/18 T4, 12 (11-22) TSH 10.4 (0.27-4.2)

24/6/18 T4, 13.4 TSH 4.7

5/11/18 T4, 12.5 TSH 3.6

Thank you x

[Peanut31 in reply to Tracyjh71]

Hi

There is an article by Dr toft that may help with your increase.

If you put another post up someone may provide you it to take to your GP.

With regards the time of your thyroid blood test. It’s a tip we past onto members on here and we ask that it is not discussed with your GP/Nurse/Endocrinologist. It’s to help us all out.

Your TSH is always higher in the morning, the earlier you have your blood test the better. Don’t eat and only drink water, don’t take your Levothyroxine either.

We offer this advice so that members don’t have to fight with there GP to get that much needed increase in Levothyroxine, the results will speak for themselves.

You need an increase, have you been on 50mcg since your results in June 2018?

If so, your GP knows nothing about thyroid issues and is making you unwell.

You should be having an increase every 6 weeks by 25mcg.

Testing T3 as well as T4 & TSH.

I Always book my blood tests at 8am or 8.30am on my way to work.

Unfortunately you are going to have to be polite but, firm with your GP.

Research as much as you can on your condition, go in there confident and don’t let your GP doubt yourself.

I say this from my own personal experience. I will no longer be fobbed off. It’s your health and you need to take control of it.

Best Wishes & Good luck.

Peanut31

[Tracyjh71 in reply to Peanut31]

Thank you for your advice my doctor started me off on 25mcg then the last time he upped my dosage to 50mcg and said I should have a good level on 75/100mcg but keep having the blood tests and see what happens. I also have what feels like a lump in my throat my doctor put me on 30mg of lansoprazole for 30 days and said it could be acid needles to say 2 weeks down the line and they haven't helped I still feel like I've got a hair ball in my throat.

[Peanut31 in reply to Tracyjh71]

Hi

I suspect it’s thyroid related.

Have you had a blood test for an autoimmune disease (Hashimoto’s). If your GP will not do this below is a link.

medichecks.com/thyroid-func...

I have this as well as an underactive Thyroid.

Before I knew what was going on, it felt like my throat was tight and food stuck in my wind pipe.

A MRI scan also confirmed Hashimoto’s.

Best Wishes

Peanut31

[Tracyjh71 in reply to Peanut31]

Hi

I did have autoimmune disease tests before I had the lump but they come back normal but however inflammatory markers was present but after further tests came back un known and no further action I'm wondering if this is linked to the lump or something else. It just seems to be every time I go to the doctors he says it's all to do with my thyroid and let's get your levels sorted out and doesn't seem really bothered

Once again thank you for your advice x

[SlowDragon Administrator]

On Levothyroxine the aim is to increase the dose slowly in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Is this how you did the test?

See GP and request 25mcg dose increase in Levothyroxine and for thyroid antibodies, folate, ferritin and B12 testing too

How low was vitamin D?

Has it been retested since started supplementing

800iu is a low dose

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

Local CCG guidelines

clinox.info/clinical-suppor...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...


Bloods will need retesting 6-8 weeks after each dose increase

NICE guidelines saying how to initiate and increase. Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

cks.nice.org.uk/hypothyroid...

[SeasideSusie Remembering]

Tracyjh71

I'm also on 8000u of vit d3 for a vit D deficiency

I doubt that you are on 8000 (8 thousand) iu Vit D. Your picture above shows 800iu.

However, what was your result, because if you do have a deficiency (less than 30nmol/L) then you should be given loading doses of D3 totalling 300,000iu over a few weeks - see NICE treatment summary for Vit D deficiency:

cks.nice.org.uk/vitamin-d-d...

"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)."

If your level was less than 30 and you have only been prescribed 800iu daily, you should go back to your GP and ask him/her to check the local guidelines and prescribe you the proper loading doses. 800iu D3 daily is just a small maintenance dose for someone who already has a decent level.

If your GP wont increase your prescription, come back and I will work out what you need based on your current Vit D level when tested.

Once you've reached the level recommended by the Vit D Council - which is 125nmol/L (50ng/ml) vitamindcouncil.org/for-hea...

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 -

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.

[Tracyjh71 in reply to SeasideSusie]

Hi thank you, your right I am only on 800u D3 my results for vitamin D was serum total 25- hydroxy vit D

Serum total 25 hydroxy vit D levle 31.

I did ask my doctor if that was OK and if I needed testing again and he said it was OK and don't need testing again

Thank you for all your advice I really do appreciate it x

[SeasideSusie Remembering in reply to Tracyjh71]

If your GP doesn't increase your dose to the loading doses, personally I think for 1 point over the limit he should, then come back and I will let you know what to buy.

It's possible GPs wont retest Vit D, but once supplementing it's important to keep an eye on levels. Excess Vit D is stored and can reach toxicity level, so we need to retest once or twice a year to ensure we don't go too far over the recommended level.

[Hidden in reply to Tracyjh71]

My Vitamin D was around the same as your two years ago. I have now been taking 2000 every day and it has risen up to a good level. You can buy your own always take it with K2 which helps the calcium to be directed in the bones instead of the soft tissue. Take both together with the fattest meal of the day.

[SlowDragon Administrator]

Gettin Levothyroxine dose increased and vitamin levels optimal should help improve gut function

Do you have Hashimoto's? Have you had thyroid antibodies tested? If not bee tested ask GP to do so

Lansoprazole is likely to be making vitamins worse not better

Most hypothyroid patients have LOW stomach acid, not high stomach acid

Virtually identical symptoms, very different treatment. But GP unlikely to be aware of gut issues linked to thyroid

However you can NOT just stop Lansoprazole, or any PPI. They must be weened off very very slowly

Low stomach acid can be common an issue

thyroidpharmacist.com/artic...

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

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

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Low vitamins linked to PPI

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

Ask GP to retest B12 and folate now you taking a PPI

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

As you supplement vitamin D adding magnesium supplements likely to be beneficial

Vitamin D mouth spray by Better You is good as avoids poor gut function.

Suggest you supplement 2000iu 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

Local CCG guidelines

clinox.info/clinical-suppor...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...




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...

Do NOT supplement any vitamin K if you take any blood thinning medication

drsinatra.com/vitamin-k2-su...

[Tracyjh71]

Thank you all for you replies, I went back to my doctor yesterday and she as upped my levothyroxine and as for the lump feeling in my throat she as referd me to a cancer e n t as an emergency because I've had it longer then 2 month, this is worrying me as to why a cancer ent and not a normal one could anyone throw some light on this please advice is greatly appreciated thank you

Last thyroid antibodies test was on 24th August Serum thyroid peroxidase antibody concentration < 15 kU/L

[SlowDragon Administrator in reply to Tracyjh71]

So 6-8 weeks after this increase to 75mcg you will need FULL Thyroid and vitamin testing

Ask GP to test vitamin D, folate, B12 and ferritin as well

800iu vitamin D is jot enough for a mouse

75mcg Levothyroxine is still a low dose. Likely to need further increases

Most patients eventually need somewhere between 100mcg and 200mcg

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

If GP can't or won't test all vitamins, FT3 or TG antibodies then recommended to get private testing