Help please

[masa2333]

Hello everyone.

I would really love to hear your advice if it’s not a problem. I’m relatively new in the world of Hashimoto’s as I’ve been diagnosed when I was 9 years old, so my mother took care of me and my therapy. Now I’m 21 and started to educate and taking care of it myself, but still don’t know much. My latest blood test is:

Serum Calcium 2.56 High (2.10-2.55)

Serum Calcium Ionized 1.29 (1.12-1.32)

Serum Fe 18.9 (8-30)

Serum Ferritin 10 Low (15-260)

Folic acid 16.9 (2.27-54.4)

Prolactin 620 High (109-557)

Cortisol 471 (101-536)

PTH 2.7 (1.3-8.2)

Vitamin D 43 (>50)

Vitamin B12 355.3 (127-517)

Magnesium 0.91 (0.70-0.98)

TSH 0.96 (0.38-3.60)

FT4 14.1 (7,9-20,3)

I drink Levothyroxine 150

My endo told me to take Selenium+Zinc direct powder 2x a week. Vitamin D in spray 1 drop a day everyday. Kelp 2x week. Ferritin during my period only. Recently I’ve been taking complex of B vitamins with some minerals in it and Q 10 (self prescribed). Could you please help me understand how to take those pills, as my endo didn’t mention. Are there any interactions between those, meaning I should take them at separate times? How many hours after Levothyroxine? What time of the day? With meal or no meal? Also, do you think it is safe to take this vitamin and mineral complex alongside these other tablets?

For high calcium she told me to be more physicaly active.

For prolactin she told me it was slightly elevated, it could be due to stress and she doesn’t worry about it.

Thank you on any advice!

[greygoose]

Why are you taking kelp? It's high in iodine and taking iodine is a really bad idea with Hashi's. Did you at least get your iodine tested first, before supplementing?

To know if your vitamin and mineral complex is a good idea or a bad one, we would need to see the ingredients - how much of each and in what form - for example: does it contain cyanocobalamin or methylcobalamin for B12?

The majority of supplements should be taken at least two hours away from thyroid hormone, some need to be left for four hours: iron, calcium, magnesium and vit D.

Iron should be taken two hours away from everything!

Are you taking ferritin or are you taking iron? I would think you would need to take it every day because your ferritin is so very low.

That's the most peculiar range for B12. Is it a serum or an active test?

Magnesium is really not worth testing, because it will always be in-range due to the way the body handles magnesium. But, that doesn't mean you're not deficient. Good idea to take it! It's also a very expensive test, so it would have been better for your doctor to spend the money on an FT3 test, which is the most important number for thyroid.

It doesn't matter when you take your vit D, as it's a spray and doesn't touch your stomach.

[masa2333 in reply to greygoose]

Hello and thank you on your reply. I did not test my iodine levels, my endo just told me to buy Kelp...I had an appointment today and she prescribed me all of the above based on this blood test that I shared with you.

Complex ingredients are: vitamin C 80mg (100%) Niacin 16mg (100%) Vitamin E 12mg (100%) panthotenic acid 6mg (100%) Vitamin B6 1,4mg (100%) Riboflavin 1,4mg (100%) Tiamin 1.1mg (100%) Vitamin A 800 (100%) folic acid 200 (100%) Biotin 50 (100%) Vitamin K 25 (33%) Vitamin D 5 (100%) Vitamin B12 2,5 (100%) it is cyanocobalamin. Minerals are calcium 120mg (15%) magnesium 80mg (21%) Iron 14mg (100%) zinc 10mg (100%) mangan 2mg (100%) Copper 1mg (100%) iodine 150 (100%) selenium 50 (91%) Molibden 50 (100%) and Q10 4,5mg. I took these tablets maybe two times as I didn’t know if I should drink it or not, but I was feeling really low and lethargic and pharmacist told me they were good for raising energy levels.

I just bought FerriMore capsules (Fe+C) - endo prescribed me these. I was also confused why she told me to drink it only during my period as my ferritin levels are extremely low...

B12 test is Serum B12.

My endo actually told me to only take FT4 and TSH as only those parameters are important, cause I have Hashi’s and my antibodies will always be up so it’s not worth testing, and I don’t know why she doesn’t test me on FT3. 🤔 really confused.

Thank you so much for spending time to reply.

[greygoose in reply to masa2333]

You have a pretty rubbish endo there! You should not be taking kelp, no way. Iodine can make Hashi's ten times worse. Plus it is antithyroid.

And that multivit is rubbish, too.

Folic acid and cyanocobalamin are not good, you need methylfolate and mythylcobalamin. But, not worries because the iron will stop you absorbing all the vitamins! And you won't absorb the iron, either, because it will bind with the calcium - nor will you absorb the calcium because it will be bound to the iron. But, that's ok because you don't need that either! And, it's doubtful you need copper because hypos are usually high in copper, low in zinc. So, taking more copper is really not a good idea. It should be tested first.

And, it contains yet more iodine! Do realise quite how much iodine you will be getting if you follow her instructions? I bet she doesn't even realise herself. High iodine in the kelp; 150 (what? you don't say if it's mcg, mg or kilos) a day from the multi-vit; you don't say how much levo or whatever you're taking but you should know that 100 mcg levo contains 65 mcg iodine; plus whatever you get from your food. That's enormous! And the RDA is only 150 mcg! Which you probably get from just your food.

This multi-vit, like most multi-vits is a waste of money, if not down-right dangerous. It belongs in the bin.

Q10 is good for lethargy if the lethargy is caused by low Q10. You're not taking statins, are you?

OK, so you've bought iron supplements, with vit C, which is good. But, I really think you need it every day. Can you eat liver? Eating that once a week is a good way to raise your ferritin. As long as you eat it with some source of vit C, which helps with absorption.

So, if your B12 test was serum, your B12 is low. But, you should supplement it with sublingual methylcobalamine, 1000 mcg daily, plus a B complex, with just B vitamins, containing methylfolate.

I think your endo is pretty confused herself. Whether you have Hashi's or not, the FT3 remains the most important number. It is low T3 that causes symptoms. The TSH is of no value on its own, FT4 is necessary, but should be considered in conjunction with the FT3.

I would be very worried about this endo, if it were me. I don't think she knows what she's doing. Is she a diabetes specialist? She certainly knows nothing about nutrition.

[masa2333 in reply to greygoose]

I just read online that kelps makes Hashimoto’s even worse! Oh my. Definitely not going to take it.

Thanks for helping me understand this vits+minerals complex better. I should stop that also.

Levo I take is 150mcg. Not taking any statins.

I will definitely drink those iron supplements more often than prescribed. I feel like I need it more than just on my period! I’m dizzy and lightheaded all the time! I was working out really hard in past months and I would always feel like I was going to faint. And I find that when I get more iron, I feel more energy overall. Yes I can eat liver and I am now trying to get more slow-cooked red meat in my diet to up my iron levels.

This was only my 2nd visit to her as I’ve been stuck with pediatric endo untill recently. But she wasn’t helpful either. I will definitely demand FT3 to be tested on my next blood tests, alongside antibodies just to see how it stands.

I feel like a lot of doctors can’t help you much with nutrition exept for some general rules (eat more fruits and vegetables ect) at least in my case. So I’m doing a lot of self-education on that!

[greygoose in reply to masa2333]

Doctors can't help you with nutrition because they've never studied it - they don't do it in med school. As a general rule, never, ever take nutritional advice from a doctor! Some of the rubbish I've been told in my time!

You really should not be working out hard if you don't even know what your FT3 level is. A hard work out can cause your FT3 to lower. Just gentle walking or swimming until it's optimal, or you're going to make yourself more hypo.

Yes, iodine can make Hashi's worse.

greenmedinfo.com/blog/iodin...

And if you're taking 150 mcg levo, you're getting 97.5 mcg iodine from that alone - almost two thirds of your daily needs. And, as you're hypo and not making much thyroid hormone, you need less iodine, not more. Can you change your endo before this one makes you worse?

[masa2333 in reply to greygoose]

I am taking a break from all that stress now, and trying to just adapt to everything slowly again. I will not work out so hard for now, only brisk walks when weather allows it. I am trying to get more sleep and eat better and consume less coffee.

I will try to be reffered to another endo! And to make those tests again including FT3!

[greygoose in reply to masa2333]

That all sounds very good!

[masa2333 in reply to greygoose]

I don’t know if it’s worth mentioning that I also take Xanax and Paroxetine for my panic disorder, but endo told me they have no effects on Levo, so it’s safe to take them.

[greygoose in reply to masa2333]

It's safe to take them if you take them at least two hours away from your levo. But, your panic 'disorder' is probably due to your hypo. So, if your hypo is properly treated, you probably won't need them. But, we can't know how well it's being treated without testing the FT3. Your FT4 is mid-range, and that would be too low for a lot of people. And, if you can't convert it to T3 - which lots of Hashi's people can't - your FT3 will be very low. Comparing FT4 and FT3 tested at the same time, will tell you how well you convert. You could do that privately.

[masa2333 in reply to greygoose]

I also tought of that. That maybe my trigger was working out too much with vitamin deficiencies in my body (that I haven’t known about at the time) and studying a lot, less sleep and more coffee and red bulls...so my body went through a lot of stress. And stress also affects thyroid. But I won’t know for sure untill I raise my vitamins to normal levels. 😕 thanks for telling me about FT3 importance

[greygoose in reply to masa2333]

More likely to be the low T3. Working out too much will affect your conversion of T4 to T3, making you more hypo. Nutrient levels affect how your body uses thyroid hormone - both exogenous and endogenous.