Thanks for the quick reply seaside susie... I’m on 100mcg Levothyroxine, last dose was 24 hours beforehand and test was done at 8am. I stupidly had a cup of tea when I woke (would this make a difference to my test?)
I used to take the spray VitD - DLux and B12 Boost but haven’t had it for a few months as I wasn’t feeling any benefits.
Coffee can affect TSH, so presumably any caffeine containing drink can, which is why water only is suggested.
TSH - 1.02mIU/L – Range 0.27 - 4.2
Free T4 - 17pmol/L – Range 12 - 22
Free T3 -4.52pmol/L – Range 3.1 - 6.8
Your TSH is good, recommended is 1 or below for a treated hypo patient, but it may or may not be accurate because of the cup of tea.
Your FT4 is 50% through range and your FT3 is 38% through range, most hypo patients feel best when these are in the upper part of their ranges. There is room for an increase in your Levo dose and I would ask for 25mcg now and retest 6-8 weeks later.
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Thyroglobulin Antibody -20kU/L - Range < 115
Thyroid Peroxidase Antibodies - 23.1kIU/L Range < 34
These don't show signs of autoimmune thyroid disease (aka Hashimoto's) but you can have Hashi's without raised antibodies, and your TPO antibodies are nearer the higher end of range rather than the lower end.
Even though your antibodies aren't raised, there is a chance you could have Hashi's and this could be why your nutrient levels are so poor. It may be worth trialling a strict gluten free diet for a while, which has helped many members here although there's no guarantee. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
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Ferritin - 58.7ug/L – Range 13 - 150
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
I would point this out to your GP and ask for further testing.
Check for signs of B12 deficiency here and if you have any list them to support your request for further testing. Doctors are supposed to go by symptoms rather than numbers.
You are folate deficient. You should really speak to your GP rather than self treat, you may be prescribed folic acid, some people find this isn't effective and are better with methylfolate.
Folic acid shouldn't be started before further investigation into your B12 level, as it will mask signs of B12 deficiency.
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25 OH Vitamin D - 25.4nmol/L – Range 50 - 175
This is Vit D deficiency. See NICE treatment summary for Vit D deficiency:
"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the local guidelines or this summary and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu, which is what most GPs prescribe, so post your new result at the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and 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:
Your doctor wont know, because they are not taught nutrition, but 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
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).
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I used to take the spray VitD - DLux and B12 Boost but haven’t had it for a few months as I wasn’t feeling any benefits.
This may be because if your levels were as bad as they are now, then whatever dose you were taking wasn't enough for your deficiency, and you may need B12 injections rather than just a spray.
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Optimising all your nutrient levels may see an improvement in your thyroid results.
Hi Susie, will definitely get an appointment with my GP and see what can be done, symptoms have been ongoing for a very long time. Thanks you so much for taking the time to help decider the results, it’s people like you who do a great deal to help us who feel like we are a burden on doctor’s. So Thanks again and I will give you an update on how things progress. Your an absolute ⭐️
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