I have hypothroidisnm treated with 75mg Levothyroxine pd.
My husband kindly bought me this product from PipingRock.com, but I am most unsure about using it. Good vitamins etc I am sure, but contains 'Thyroid Powder (thyroxin-free)', L-Tyrosine, Flax seed, Ashwagandha Root.
Other ingredients are the supplements: Thiamin, roboflavin (B2), niacin, B6, iodine, zinc, selenium, and copper.
I know we have experts on this site and I would appreciate their opinions once more. Thanks, folks.
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The B vitamins are all 25 (mg or mcg) and that's not the best balance. 25mg B6 is too much, recommended is 10mg.
It contains folic acid, methylfolate is the best form.
It contains zinc and copper - best tested to see if you need them.
It contains 150mcg iodine - iodine needs to be tested and only supplemented if found to be deficient - then under the guidance of an experienced practioner.
Ashwaghanda can lower cortisol.
You would be better off testing the vitamins/minerals always suggested here, then supplement where necessary:
Vit D
B12
Folate
Ferritin
I know you posted results for these in this thread 9 months ago
Are you supplementing? If you don't feel optimally medicated, or if you still have symptoms, it would be an idea to do another full thyroid/vitamin test to see if there are any obvious problems.
Brilliant. As expected. And so very thorough. That is greatly appreciated. Lesson learned: get husband to ask first although he had the best of intentions (I think!).
I did Medicheck test last April so I shall ask GP for an annual check when that comes round again.
Same husband (of course) does give me supplements - Vit D, gingko, fish oil, sometimes Q10. He is a supplement enthusiast and thinks these will help me generally. I take a low dose of magnesium which has stopped the painful cramps I got.
I am not fortunately bothered by any palpable symptoms. I suffer badly from sleeplessness but that's been the case for decades and I have other causes for that as well. I find it hard to lose weight. Other than that, I am pretty well.
Or low FT3 (very common if a poor converter of FT4 to FT3)
Suggest you get full Thyroid and vitamin testing
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins
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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
Thank you again. Last April I had the full Medichecks analysis, followed 6 weeks' later, after GP prescribed 50mg Levo, by NHS test following the recommended process you describe, , after which it was then increased to 75. I have not had the vitamin test alone so your recommendation is interesting: thank you. Nor T3. This would be a good next step.
Also 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
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
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.
In answer to your question, my increase to 75mcg was made last April. The April Medichecks whilst on 50mcg showed a TSH of 3, down from pre-treatment of 7.7 . Following the resultant increase to 75mcg, I was tested again 6 weeks later and only for TSH, which was down to 0.32.
The Medichecks test showed Free T3 as 3.72. Their reference range was 3.1-6.8. I see that Thyroid UK has a reference range of 4.0-8.3.
I could get a T3 only test on Medichecks quite cheaply (£29). The vitamins were done at the original test and are all fine, within range. Do you need to know precise figures? Only folate was at the low end of the reference ranges given but stil within it.
A FULL vitamin test is too expensive at well over £300, and I have had B12, ferritin, folate, D.
Thanks for the suggestion about vitamins and sleep. I personally don't think it's a thyroid issue. I have periodic limb movement disorder, which is treated with clonazepam, but any upset, anger or worry destroys my sleep. My sleep can also be very poor quality anyway.
I need to get annual tests done, I gather. I don't know if these are doctor prompted or not, but am acutely aware of the state of the NHS. So many thyroid symptoms are vague and other things can cause them - for instance, feeling very cold, tiredness - but my only real worry is the weight gain. Was it Christmas alone? Don't think so, and I do exercise and don't eat much.
FT3 is far, far too low. Needs to be at least over 5.5
Not surprised you can't sleep with FT3 that low
What was FT4 level including ranges on the same test?
Poor conversion is common with Hashimoto's / low vitamins
Low vitamins tend to cause low TSH
When were vitamins last tested?
What about TPO and TG thyroid antibodies. Essential to test these at least once
Vitamin and full thyroid test including both antibodies is only £99 including vitamin D. Often on offer at £79
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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
All four vitamins need to be optimal
Vitamin D at least around 80nmol, but many find around 100nmol better
Ferritin at least half way in range
B12 at least over 500, often thyroid patients have symptoms of low B12 unless levels are near top of range
Same applies to Folate
If you add the actual results and ranges members can comment
Low magnesium is extremely common, also a common cause of restless legs
All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Interim quick reply until I get back. First, restless legs and PLMD are separate conditions fyi. Will dig out those pre-Levo results and let you know all the answers.
One question further: if it is low F3, I don't think NHS will prescribe for it. Am I wrong?
FT4 was 15 (Free Thyroxine); vitamins tested last April with the same test date; TPO was <9; TG was <10; Vit D was 75 nmol/l; Ferritin was 106 in range of 13-150; 25 OH B12 126 nmol/L (range was given as 50-200); Folate serum was 7.61 ug/L in range of 2.91-50.
Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial. B vitamins best taken in the morning after breakfast
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
Are you saying my last test for TSH is now too low at 0.32?
Well, I am knocked out by your analysis and will crack on with what I can do as soon as I can. I do have reservations about possible disagreement with GP as the figures you give are not in agreement with what they have been trained to find acceptable and I find it hard to feel I have a leg to stand on. Other sites which are legitimate say that my FT3 result is within limits - I feel I am about to have an argument with my doctor. I am not actually unwell. Sleep is very hit and miss, it is true, but that's been the case for 40 years and many theories have been propounded and visits to sleep centres etc. So I am very interested in any possibility of improving that situation as I would not wish it on anybody, so I am taking everything you say very seriously, and I would like to thank you deeply for your kind input.
What a complex condition it is.
As for endocrinologists, all I read on here is how useless they are.
Assuming you did test as early as possible in morning and fasting and no Levo in 24 hours prior to test.. ??
How long ago was this test?
Your FT4 is on low side, so you have room to raise dose of Levothyroxine
But GP will only look at TSH and likely refuse to increase dose
This is common problem. On Levothyroxine, which is artificial replacement, TSH does not reflect how hypothyroid we can still be.
FT4 and FT3 are the most important results.
Active B12 at 126 is fine
If this thyroid test was more than 8 weeks ago, Getting new test done is next step. But improve vitamins first, with vitamin D and vitamin B complex and retest 6-8 weeks later.
Remember to stop taking vitamin B complex 3-5 days before test
Getting vitamins optimal helps TSH rise so that we can get dose of Levothyroxine increased
Most Thyroid patients need FT3 in top half of range. Just within bottom of range is too low
There may be a recommended NHS endocrinologists in your area on the list. Certainly in Guildford or Kingston area
I take Vit D anyway, and have added a Vit B12 but need to go and get some folate. Do I not now need B12 from what you said? Just a B Complex?
Yes - my GP would refuse to incease dose. She has done her job as far as she is concerned and the surgeries are on such a tight budget. I have other things to bother her about such as CKD.
Should I get a private FT3 test?
Last thyroid test was June 2018. Sticking to an annual April test would fit in just about with your recommendation for another.
Your link to endocrinologists did not work; it was not complete. It ends with uploa
Well I am really tired today, half awake second half of the night. So it goes on. So hard to move or think.
Just picked up from you CKD is linked to FT3 being low. Very interesting. But without being able to get FT3 it's a bit academic. The first article is excellent: thyroid treatent can help CKD. Thank you for that. But it's also linked across the condition.
I have just bought Vit B Complex (Holland & Barrett). I will have to get the Vits tested again then. I have written extensively to my GP and asked for endocrinologist referral.
I have also got folate. And zinc and selenium.
I have already emailed Dionne, just this morning.
I really have no choice but to work with my GP. The surgery has intruduced an email consultation, so this morning I composed a request which will be answered tomorrow about these matters.
You said above to retest after taking the vitamins, and that would fit into my annual schedule of blood tests for thyroid. I would rather do this than get a test done right away.
There was no endo link: just derogatory comments within posts.
Only add one supplement at a time, then wait 10-14 days to assess results
Suggest you start with good vitamin B complex
10-14 days later perhaps add selenium
Wait same time before adding zinc
Otherwise it's impossible to know which may be giving most improvements
Which brand did you get of selenium and zinc?
I didn't add an endo link.
So I am not sure what you refer to
Very many patients have to bypass GP and see a recommended endocrinologist privately, certainly initially. NHS waiting time is months, even if you can get GP to agree to referral
But always get FULL Thyroid and vitamin testing before seeing a private consultant, otherwise it's a waste of time and money
Oh dear. Text confusion. I said I had heard adverse comments about endos. You asked what link was it on. I answered it wasn't on any link but just remarks made by various people posting. I did not say you had sent me a link.
I did not realise that folic acid is contained in the B Complex but I expect I can change it. Thank you for pointing it out.
I will follow your suggestions about phasing. Good idea. Add Folate last?
Adding a good quality daily vitamin B complex is all you need
Igennus Super B is pretty cheap as full dose is two tablets per day, but very likely only need one a day. Certainly on start on one a day. See what levels are like when retest
Too confusing. You gave me a good programme of adding vitamins and now say I only need B Complex.
Why would I need a thyroid test before seeing a private consultant? Surely they would do the test? Anyway, I am on the path to an NHS consultant now. What I would really like is to check out your first remark about FT3 being so low and I will be asking about that. A new test from endo will tell me if I am converting enough from FT4 after being on Levo.
The cheapest way (by far ) on any private testing is to do these first, (making sure to be get done as early as possible in morning and fasting and no Levo in 24 hours before)
If you just see a consultant with no recent blood tests, the first thing they want is blood done, at a higher cost
usually these are immediately after a wasted consultation visit. Unlikely to be correct time of day, or fasting.
If NHS endocrinologist is a Diabetes specialist they may not even do FT3 test
Now just called up your link and certainly don't want either folic acid or folate at all. Am I reading you wrong? I bought folate as a result of you saying I was low on folate. I now instinctively feel I do not want any supplements. Spent a lot on them and seem to have bought wrong Vit B complex, unecessary folate (but selenium and zinc I read somewhere else was good for thyroid issues).
Well I got a B Complex without either! I'll just see how I go. To be honest, if I ever got my sleep back nothing else would worry me. I know I am not living up to your standards but they are always there to try should I feel the need. Got refund on the folate too. So here goes tomorrow, first thing after no Levo night before. I don't suppose I could have a coffee first, SlowDragon?
So both TSH test and renal test. So fascinated that they are linked.
I must say my GP was extremely nice and helpful. Couldn't do enough, and that is a big asset.
Had test done. They include diabetes with all tests now, out of interest. So go that, full bloods, thyroid (and renal). Might get results within 24 hours.
Then I was about to order the £99 test you referred me to. Then a post came up which reported on the fact that the NHS has withdrawn FT3 which was used in combo with Levo if shown to be indicated. So I can't now see any point in seeing what my FT3 is now. Is there?
I am due to be referred (in principle) to an endo, as you know.
Back when results come in. Another poor night's sleep, btw.
It's still possible, (but difficult) to get T3 on NHS. There are approximately 13,000 patients in England prescribed T3. Over 80% are female, so it's gender inequality not to prescribe if have clinical need
It's dirt cheap to make. But NHS is being over charged, which is not the patients' problem. The Government has legal power now to force price reduction. Price has dropped in last year from £258 to £204 for 28 tablets, but EU T3 is about 10 Euro for 28 tablets so price charged to NHS has a lot futher to drop
Well it's done now; she had said it would be only TSH. Only an accepted referral to the endo would amplify that. Whilst looking at my April test online, for which I gave you all the figures, and said it was before I had any meds, well I am sorry but it was not. I had had two months' trial of 50mcg, and this test result recommended it was put up to the present 75.
I know about the legal test result permission. That's how I traced it all back eventually, in the case of CKD it being back 10 years before I ever knew on asking what it meant! It sure pays to be on the ball.
Interesting. Well, I'll get the vitamin check you encouraged me to do. The other question is about FT3 availability and relates to today's post: healthunlocked.com/thyroidu...
TSH is 3 (last June it was 2). Creatinine and GFR are about the same up and downs as during the last 10 years. That's all I can tell you as I am waiting to see if my surgery will do the Mediichecks venous blood sample or I may have to go some distance to a clinic.
Suggest you print out pages 12 and 13 on these New NHS England Liothyronine guidelines November 2018. clearly states on pages 8 & 12 that TSH should be between 0.4-1.5 when on just Levothyroxine to be adequately treated
on page 13 in Box 1, column 4 it lists vitamins that should be tested. Vitamin D, folate, ferritin and B12
highlight these and request GP gives 25mcg increase in Levothyroxine dose and tests vitamins (and antibodies too if never been tested)
I will look at that. I have just got an appointment on Friday for the Ultravit thyroid bloods to be taken.
It's at 10.am. To confirm, I do not take any vitamins before then; I do not take Levothyroxine at my usual time the night before. One question though: can I have a cup of coffee at 8am that day? I will not have taken Levo for 36 hours.
Once I get the full private test results back, I shall go with them to see my GP, armed with the printouts you have brought to my attention.
Would undermedicating account for weight gain and/or insomnia? I have learnt that CKD also causes insomnia.
Yes - got that! Re TSA - June 2018 it was 0.32. April 2018 it was 3. In between the two the dose was raised. So 3 went down to 0.32. Now it's back to 2. Bit bizarre. But will see what next test says.
I have these now. Bottom of p.13 says 'the aim of the treatment is to maintain TSH of 0.4-2.5 with the T3 and T4 in the normal range'. Does that not conflict with the lower figure on p.8 of 1.5? And under 'Indications' on its own page? Also, it's Liothyronine instructions, so seems as if I would be asking my GP for this. I will have to make myself clear about that.
Serum TSH was 3 in April 2018, after which the dose was increased from 50 to 75, retested only back in June and was was down to 0.32. . . Now it's up to 2. This puzzles me.
Serum folate was done last week and is 8.6, within their reference range of 4-20. Last April it was 7.61.
Last April Vit D was 75 (ref 50-200)
Last April Ferritin was 75 (13-150)
Last April Active B12 was 126 (25-165).
My test to come will cover TSH FT4 FT3 TGAb TPOAb Vitamin B12 (active) Folate Vitamin D CRP-hs Ferritin
When I have these results next week I will hope they recommend extra 25mcg as you do and will post up new results.
And I realise now I can't have the coffee before the 10am test.
Interesting. I shall leave it to the Medichecks report I think before deciding to ask for increase dose as the TSH references in that NHS paper are apparently ok.
TSH is 3 (last June it was 2). Creatinine and GFR are about the same up and downs as during the last 10 years. That's all I can tell you as I am waiting to see if my surgery will do the Mediichecks venous blood sample or I may have to go some distance to a clinic.
TSH is 2 as of 14 Jan; it was 0.32 as of June 2018 and 3 as of April 2018. Sorry about any errors. My papers are piling up and the questions came fast. 16 hours ago I wrote:
Serum TSH was 3 in April 2018, after which the dose was increased from 50 to 75, retested only back in June and was was down to 0.32.
14 hours ago I wrote:
Re TSA - June 2018 it was 0.32. April 2018 it was 3. In between the two the dose was raised. So 3 went down to 0.32. Now it's back to 2.
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