I did write the message below on my previous post unfortunately I think that it had been too long since I last posted on it -
I am sorry it has taken me so long to post. I have been very unwell - depressed, suicidal - ended up in hospital. Feel as if I am getting nowhere with my doctor. I saw her today and she said that all my bloods were perfect and just where she would want them. Nothing there that could be causing my current health issues. I have just had a look and I don’t know if I am worrying unnecessarily. Can anyone help?
TSH - 0.02 (0.27 - 4.2)
T3 - 5.7 (3.2 - 6.8)
T4 - 18.2 (12 -22)
Vit D 71.2 - no range on this one
B12 - 420 (180 - 700)
I think they look okay apart from TSH could that be contributing to how ill I feel or is it as the the doctor thinks all in my head? I take a Vit D and B12 supplement every day. My doctor has suggested that I attend a menopause clinic. I feel as if it has been so long since I have felt well - I am desperately looking for some cause but doctor says mental health problem only.
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marshmallow1
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TSH - 0.02 (0.27 - 4.2)
T3 - 5.7 (3.2 - 6.8)
T4 - 18.2 (12 -22)
Your current results seem pretty good. What thyroid meds are you taking?
Vit D 71.2 - no range on this one
This is most likely nmol/L - the unit of measurement usually used in the UK. This is on the low side. 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]
What dose D3 are you taking, and are you taking D3's important cofactors magnesium and Vit K2-MK7?
B12 - 420 (180 - 700)
Again, no unit of measurement. Is it pmol/L or ng/L (or pg/ml which is the same as ng/L)?
Do you have, or before supplementing have you had any signs of B12 deficiency - check here:
I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:
"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."
And 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."
Why are you taking a B12 supplement? Was it suggested by your GP?
What is your Folate level? B12 and folate work together.
As you take B12, do you also take a good B Complex to balance all the B vitamins?
Do you have a result for Ferritin - this is also very important for thyroid hormone to work properly.
Yes Vitamin D is 71.2 nmol/L and I take 25ug daily.
Vitamin B12 is 420 ng/L. I started taking a supplement when my last test was 281 ng/L [which I thought was quite low even though GP said normal.] I have been taking Feroglobin liquid - it says B12 10 ug. I will have a look at the links posted.
25mcg D3 = 1000iu. This is just about a maintenance dose for some people who have a decent level already. To achieve the dose recommended by the Vit D Council - 125nmol/L (50ng/ml) - they suggest that with your current level of 71.2nmol/L (28.48ng/ml) to take 3,700iu daily (nearest equivalent is 4,000iu).
You may want to consider increasing your dose of D3. If you do then retest after 3 months and when 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:
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).
Do you have Hashimoto's - raised antibodies? If so then an oral spray gives best absorption, eg BetterYou. They do D3 spray, also a combined D3/K2 spray.
If you don't have Hashi's, are you taking a D3 softgel or tablet/capsule? Softgels are best because they tend to be based in oil to help absorption. Look at Doctor's Best, just 2 ingredients - D3 and extra virgin olive oil.
With B12 at 420ng/ml it is under the level recommended in Sally Pacholok's book. Have you checked the signs of B12 deficiency?
Feroglobin liquid isn't the best thing to take. It's a multivitamin and these tend to contain the wrong form of ingredients and things we shouldn't take without first testing to see if we're deficient.
The form of B12 it contains is cyanocobalamin and methylcobalamin is the recommended form, and 10mcg isn't that helpful anyway. It does contain other B vitamins but mostly very small amounts.
It also contains Folic Acid and methylfolate is the best form.
These ingredients should be tested for deficiencies before supplementing:
calcium
iron
iodine - and iodine should only supplemented under the guidance of an experienced practioner because it has important cofactors.
Iodine used to be used to treat hyperthyroidism, it can be damaging to your thyroid and make things worse. If you drink milk, use other dairy products such as yogurt, and eat white fish and scampi then you probably get enough iodine in your diet. Levothyroxine also contains iodine.
The iron will affect absorption of the other ingredients.
Because it contains iron, do you take it 4 hours away from your thyroid meds?
You really need to know your ferritin level, and if it is below 70 then eating liver regularly (or liver pate or black pudding) is the best way to raise ferritin. If it is very low then you need a full blood count and an iron panel.
I take 15 liothyronine and 125 thyroxine.
Those doses appear to be giving you pretty good thyroid results with FT4 - 18.2 (12 -22) and FT3 - 5.7 (3.2 - 6.8). Your FT4 is about 62% through range and FT3 about 70% through range.
Optimising Vit D, B12 (after checking for deficiency), Folate and Ferritin may help.
Looking at adrenals (cortisol and DHEA with a 24 hour saliva test) may throw up some clues. And you can, of course, consider what HughH has mentioned.
TSH is not a thyroid hormone. It is produced by the pituitary gland and travels in the blood to the thyroid gland where it signals to the thyroid gland to produce more thyroid hormones.
Thyroxine (T4) is a thyroid hormone but is not an active hormone, it needs to be converted to T3 to become active. .
T3 is the active thyroid hormone which controls the metabolism and therefore the symptoms. Your Free T3 is in the top part of the normal range - higher that almost 75% of people. This is good, so you should not have hypothyroid symptoms.
If you are still having hypothyroid symptoms, one possible cause is a genetic condition: Impaired Sensitivity to Thyroid Hormone (more often known as Thyroid Hormone Resistance). It causes hypothyroid symptoms and requires very high T3 levels (often above the top of the normal range) in the body to overcome the resistance.
As it is genetic if there are other family members with thyroid problems, fibromyalgia, CFS, ME, Coeliac Disease, MS, Heart Disease or depression this would further support this possibility. Even if you cannot identify any family history of this it is still possible that you have this condition.
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)
If/when also on T3, make sure to take last dose 8-12 hours prior to test
Is this how you do your tests?
How and when do you take your Levothyroxine and T3?
Do you take T3 all in one go, or as two or three split doses?
Do you take your Levothyroxine at night or in the morning?
Adjusting time can make quite a difference for some people
Also do you always take same brand of Levothyroxine and same brand of T3?
Many people find different brands are not interchangeable
I was careful this time not to take Thyroxine for 24 hours before blood test - the same with T3. I fasted for approx 12 hours before the test.
I take my T3 in one go in the morning - I found trying to take it 3 times a day led to me forgetting. I take my Thyroxine before I go to bed.
I supposed I was more concerned that I could be over medicating and so hyperthyroid - I have anxiety alongside the depression and mood swings. I don't even look at brand - I had no idea this could be an issue.
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Help needed with how I am feeling.
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