Your TSH, FT3 and FT4 look very good. Hopefully that is reflected in how you feel. 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.
Ferritin is good, however these aren't so good:
Vit D 70 ( 30 - 175)
The Vit D Council recommends a level of 125nmol/L [50ng/ml] and the Vit D Society recommends a level between 100-150nmol/L [40-60ng/ml]. For your level, to reach the recommended level, the Vit D Council recommends supplementing with 3,700iu D3 daily (you would need to buy 4,000iu). If you decide to supplement you should retest in 3 months 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 an NHS lab which offers this test to the general public:
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 if taking tablets/capsules/softgels, no necessity if using an oral spray
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 if taking tablets/capsules, no necessity if using topical forms of magnesium.
Check out the other cofactors too (some of which can be obtained from food).
B12 348 (145 - 569)
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Serum B12 is measuring total B12 and doesn't measure what is available to be taken up by the cells, that test is Active B12. You might want to consider testing Active B12 (Medichecks to a fingerprick test) and if that comes back low you should discuss further testing for B12 deficiency with your GP.
This is low, for us Hypos the recommended level is lat least half way through range. Look at including lots of folate rich food in your diet, and a good B Complex such as Thorne Basic B or Igennus Super B will help raise the level. However, don't start taking it before any possible further investigation into your B12 as the folate (folic acid) will skew any results.
hs-CRP 7.11 (<5.0)
This is over range and it would be worth keeping an eye on.
Thank you so much for your reply ! I do feel ok-ish now on my lower dose of 150mcg Levo and I’m happy enough given my RAI history to have a suppressed TSH. When I eventually got my historic bloods from the GP it seems my TSH nosedived over a very short period of time immediately after the RAI which I don’t think should be a surprise to my GP - do you? And it’s obvious to me the GP was stretching the truth when she insisted my TSH was ok once as I Now see that it wasn’t very quickly after RAI. I’ve also discovered from those historic bloods that my T4 was only tested from 2004 onwards and my T3 has NEVER been examined.
Bit worried about the CRP thing but I have been very stressed and I did have a fall a few days before. Maybe that’s it.
CRP is an inflammation marker, so may be temporarily raised when it detects any inflammation (and infection too can cause inflammation). This is why it might be an idea to repeat the test at some point. If it stays raised then GP should maybe look into it.
For some reason doctors don't seem to think testing FT3 is important, I'm not sure how we'll ever educate them
I’ve given up trying to educate my GP as she’s so paternalistic I don’t think she can take anything on board from a patient let alone one with thyroid disease!
Coming back to the vitamins and in particular the B12 I found a converter of pmol to pg and my 348 equates to 471 - do you think I should still investigate this further?
I found a converter of pmol to pg and my 348 equates to 478 - do you think I should still investigate this further?
That has to be your decision and, of course, it depends if you have symptoms, did you check the link I gave?
You are still below the 550pg/ml threshold mentioned where deficiencies begin to appear in the cerebrospinal fluid. And a Serum B12 doesn't tell you what is available to reach the cells, only an Active B12 can tell you that.
I am in the older age group and I make sure my Serum B12 is around 1000pg/ml. I have also just done an Active B12 as I've never had one before, to check that level is as good as the serum level.
Yes I did look at it but I really need to do so again and try a bit harder to absorb all the info.
If my active B12 is as low as only 20-30% of total B12 which I think is what I’ve just read can be the case I guess I’d need loading doses by injections? Is there a ‘normal’ range for active b12 I could aim for?
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