Hi
After fighting with my GP finally got them done
TT in aug and rai in Oct 18
Last TSH in Nov was 5.03 next test Is feb
200 mcg Levothyroxine
GP said all is fine ????
Ferritin 48ug/l (24.0 - 336)
Vit d 60
Folate 5.3ug/l (3.1-19.9)
B12 377ng/l (180 - 914)
Advice please
For someone whose had their thyroid gland removed altogether and one year later their TSH is 5.03 is disgraceful. Besides that, you are on levothyroxine alone and I, who have my gland, could not recover on T4 alone but did on T3. I also tried various NDTs on my journey.
My personal opinion - and am sure many members would agree, is that someone whose gland has been removed should - at the very least - be prescribed a combination of T3/T4 on a 1:3 or 1:4 basis.
As vitamins/minerals aren't my forte, I shall add SeasideSusie due to her knowledge of them.
Hi shaws.
I wish I could have a combination
Not getting looked after very well between GP and urologist
No endo for me
Do I need any vitamins according to the results?
I am in pain with my muscles
Brain fog
Can sleep more than 4-5 hours
Constipated
Extremely tired all day every day
Numb hands during night wakes me up
Yes you need to supplement and Seaside Susie should respond how best to do this.
You can source your own T3 by putting up a new post and ask for a Private Message to be sent to you of where to source (no info is permitted on the forum). You reduce levo and add a portion of T3 which would be the equivalent of the reduced T4. Take note of your symptoms that are being relieved. This is for information re relieving contipation amongst other things:
Hey there Shaws - think you have a typo in the above - should it not read T4 at the end of the 1st paragraph ?
Much obliged pennyannie. Thanks 
and I thought I was the only one who did stuff like that - happy to help !
nothyroid2018
Ferritin 48ug/l (24.0 - 336)
For thyroid hormone to work (that's our own as well as replacement hormone) it's said that ferritin needs to be at least 70, preferably half way through range. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
B12 377ng/l (180 - 914) [ng/L is the same as pg/ml]
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."
So you are quite a long way below the recommended leve of at least 550pg/ml-ng/L, and depending on your age you may wish it to be higher.
Serum B12 tests the total amount of B12, the Active B12 test shows what is available to be taken up by the cells. You can have a decent amount of serum B12 but a poor amount of Active B12.
You could check for signs of B12 deficiency here b12deficiency.info/signs-an... and if you have any you should list them to discuss with your GP and ask for further testing for B12 deficiency/pernicious anaemia.
Folate 5.3ug/l (3.1-19.9)
Folate is recommended to be at least half way through range, that would be 11.5+ with your range so you are rather low. Eating folate rich foods can help, as can a good B Complex containing melthylfolate (not folic acid) such as Thorne Basic B or Igennus Super B. However, if you do have any signs of B12 deficiency then don't start supplementing with B Complex until further testing of B12 has been done and any supplements (or injections) started. This is because the folate (folic acid) masks signs of B12 deficiency.
Vit d 60
- is this nmol/L or ng/ml?
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].
If yours is ng/ml it is fine.
If it is nmol/L then it is too low. The Vit D Council suggests, for your level to reach the recommended level, to supplement with 3,700iu D3 daily (it would have to be 4,000iu). Retest after 3 months. Once 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 an NHS lab which offers this test to the general public:
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 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.
naturalnews.com/046401_magn...
Check out the other cofactors too (some of which can be obtained from food).
Don't start supplements all at the same time, stagger them. Start with one, give it a week or two and if no adverse reaction then add in the second one, give it another week or two and if no reaction add in the next one, etc. By doing it this way, if you do have any reaction you will know what caused it.
Your TSH is far too high
Essential to test FT4 and FT3 as well as TSH
Suggest you get tested via Medichecks or Blue Horizon
Recommended on here that 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
thyroiduk.org.uk/tuk/testin...
How do you take your Levothyroxine?
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, vitamin D or magnesium at least four hours away from Levothyroxine
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
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3
rcpe.ac.uk/sites/default/fi...
Email Thyroid UK for list of recommended thyroid specialists, many of whom will prescribe T3
please email Dionne at
tukadmin@thyroiduk.org
Roughly where in the UK are you?
Getting vitamins optimal, following Seasidesusie advice is first step
Insist on referral to endocrinologist, if there's an NHS one in your area on the Thyroid UK list
New NHS England Liothyronine guidelines November 2018 clearly state on pages 8 & 12 that TSH should be between 0.4-1.5 when treated with just Levothyroxine
sps.nhs.uk/wp-content/uploa...
It's not unusual to need higher dose than 200mcg Levothyroxine, especially as you're male
GP should increase Levothyroxine by 25mcg and retest in 6-8 weeks
Blood test results help
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