I have just received blood test results. Background, total thyroidectomy just over a year ago, commenced on 125mcs Levothyroxine, end of November 2018 reduced to 100mcgs. Gradually began to feel unwell, feeling like I’m walking in treacle, muscles feel tired, very fatigued and muzzy headed. Since my surgery have put on 6 - 7 kegs and unable to shift. Results are as follows.
Hs-CRP 1.05 normal range <5.0 mg/L
Ferritin 88.2 normal range 13 - 150 ug/L
TSH 0.74 normal range 0.27 - 4.20 ml/L
T4 Total 81.7 normal range 66 - 181 nmol/L
Free T4 17.60 normal range 12.0 -22.0 pmol/L
Free T3 3.95 normal range 3.1 - 6.8 pmol/L
Anti-thyroidperoxidase abs <9 normal range <34 klU/L
FT4 is 56% through range, FT3 is 23% through range, T4:T3 conversion is poor.
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Vitamin D (25 OH): 43nmol/L (17.2ng/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]. For your current level they suggest, to bring it up to the recommended level, supplementing with 4,900iu daily (nearest is 5,000iu).
Retest after 3 months. When you've reache 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:
A good quality supplement will be a softgel with extra virgin olive oil to aid absorption, e.g. Doctor's Best. An oral spray such as BetterYou gives best absorption for people with Hashi's (your antibody levels don't suggest Hashi's but you could consider the spray if you wish).
There are important cofactors needed when taking D3 as recommended by the Vit D Council -
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.
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Vitamin B12 334pmol/L (453pg/ml)
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 Folate 9.65. Normal range 9.65 - 60.8 nmol/L
You are right on the bottom of the range. Your GP may not do anything about it until you are below range. You can include lots of folate rich foods in your diet and could take a good quality B Complex to help raise this level, one containing methylfolate not folic acid. Consider Thorne Basic B or Igennus Super B, both contain 400mcg methylfolate at the suggested dose. They also contain methylcobalamin which should help push your B12 up.
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Optimising nutrient levels may help conversion, if not consider adding T3 to your Levo.
Just for reference a healthy working thyroid would be producing, on a daily basis, approximately 100 T4 + 10 T3.
I simple believe that if one has had a medical intervention and had the thyroid removed or ablated, it makes common sense to have both these vital hormones on one's prescription.
Some people are fine on T4 alone, some people simply stop being able to convert the T4 to T3 and some people need both these hormones independently dosed and monitored to achieve a level of wellness acceptable to them, the patient.
I hope this helps you with your doctor - good luck.
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Blood test results - please advise.
Blood Test Results
Interpreting thyroid test results
