My mum received the blood test results below recently:
Vitamin D - 15 (50-150)
Free T4 - 19.3 (12-22)
TSH - 4.84 (0.27-4.2)
B12 - 602 (197-771)
C-Reactive Protein - 18 (0-5) Raised CRP probably due to recent viral infection
Erythrocyte sedimentation rate 23 (0-15) Within normal limits for age/gender
My mum is on 100mcg Levothyroxine, is very tired and her legs ache badly.
Her GP has prescribed her 40,000iu vitamin D weekly for the next 7 weeks. He hasn’t increased her Levothyroxine but she is going to go back and ask him to and she is fairly confident he will.
I am looking for advice on the dose she is on for vitamin D deficiency please? Is this enough? (I’m on a maintenance dose of 4,000iu daily so it didn’t seem a lot considering her very low reading).
Any advice would be greatly appreciated.
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Tristy
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Her TSH is too high, but her FT4 is right at top of range
She currently very poor converter of FT4 to FT3
Improving her vitamin D may help improve conversion, but she may need dose increase in Levothyroxine
GP should retest vitamin D at end of course
Your mum will almost certainly need to continue to supplement vitamin D at a maintenance dose to maintain at good levels
Ask GP to test folate and ferritin too
Thyroid should be retested after she finishes vitamin D course
For full Thyroid evaluation she needs TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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 or antibodies or all vitamins
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.
So it's important to get TPO and TG thyroid antibodies tested at least once .
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 is in top third of range and FT3 at least half way in range. All four vitamins need to be tested regularly and frequently need supplementing to maintain optimal levels
If autoimmune thyroid disease is confirmed then many people find strictly gluten free diet helps, sometimes very significantly
Her GP has prescribed her 40,000iu vitamin D weekly for the next 7 weeks
That is correct for the loading dose.
She must be retested when it's finished, if GP wont retest and just prescribes 800iu then do a test privately with an NHS lab which offers this test to the general public:
It's essential that she knows her new level because she will have to continue supplementing and the dose will depend on the level after the loading dose. Post the new result when you have it and I will point you in the right direction to find the new dose she will need.
Her GP won't know, because they're not taught much about nutrients, 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.
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Vitamin D test results - advice please
Very low vitamin D
High Ferritin, Low Vitamin D and Hair loss
Low Iron and Vitamin D
Still low on vitamin D
