I made the error of thinking that by posting results on previous post, it would move up and be spotted. Sorry about that.
Results back from Medichecks and according to report all normal. However a few have posted in my previous thread that they believe my TSH is still too high. Endo consultant and GP all think this is normal!
Here's the full results:
Inflammation
CRP HS 0.95 mg/L (Range: < 5)
Iron Status
Ferritin 206 ug/L (Range: 30 - 400)
Vitamins
Folate - Serum >19.8 ug/L (Range: > 3.89)
Vitamin B12 - Active 73.700 pmol/L (Range: 37.5 - 188)
Vitamin D 67.7 nmol/L (Range: 50 - 175)
Thyroid Hormones
TSH 2.34 mIU/L (Range: 0.27 - 4.2)
Free T3 5.16 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 18.300 pmol/L (Range: 12 - 22)
Autoimmunity
Thyroglobulin Antibodies X 498.000 kU/L (Range: < 115)
Thyroid Peroxidase Antibodies X 123 kIU/L (Range: < 34)
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Bluey777
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You're right - professionals wrong but they seem to believe that as soon as the TSH reaches anywhere in the range ( (Range: 0.27 - 4.2) that you're on a sufficient dose. 1 or below is usually when we feel symptom-free.
Maybe both of your professionals should read the following:-
"Dear Thyroid Patients: If you have thyroid gland failure--primary hypothyroidism--your doctor is giving you a dose of levothyroxine that normalizes your thyroid stimulating hormone (TSH) level. Abundant research shows that this practice usually does not restore euthyroidism--sufficient T3 effect in all tissues of the body. It fails particularly badly in persons who have had their thyroid gland removed. TSH is not a thyroid hormone and is not an appropriate guide to thyroid replacement therapy.
The hypothalamic-pituitary secretion of TSH did not evolve to tell physicians what dose of inactive levothyroxine a person should swallow every day. A low or suppressed TSH on replacement therapy is not the same thing as a low TSH in primary hyperthyroidism. IF you continue to suffer from the symptoms of hypothyroidism, you have the right to demand that your physician give you more effective T4/T3 (inactive/active) thyroid replacement therapy. Your physician can either add sufficient T3 (10 to 20mcgs) to your T4 dose, or lower your T4 dose while adding the T3. The most convenient form of T4/T3 therapy, with a 4:1 ratio, is natural desiccated thyroid (NDT-- Armour, NP Thyroid, Nature-Throid). If you have persistent symptoms, ask your physician change you to NDT and adjust the dose to keep the TSH at the bottom of its range-- when you have the
blood drawn in the morning prior to your daily dose. This may be sufficient treatment, but IF you continue to have persisting hypothyroid symptoms, and no hyperthyroid symptoms, ask your physician to increase the dose to see if your symptoms will
improve, even if the TSH becomes low or suppressed. You can prove to your physician that you're not hyperthyroid by the facts that you have no symptoms of hyperthyroidism and your free T4 and free T3 levels are normal in the morning, prior to
your daily dose. They may even be below the middle of their ranges. Your free T3 will be high for several hours after your morning T4/T3 dose, but this is normal with this therapy and produces no problems. You should insist that testing be done prior to your daily dose, as recommended by professional guidelines. If you have central hypothyroidism, the TSH will necessarily be low or completely suppressed on T4/T3 therapy. In all cases, your physician must treat you according to your signs and symptoms first, and the free T4 and free T3 levels second."
Why is it that the patients have to educate the professionals????
Are your blood tests for thyroid hormones always at the earliest possible? Fasting (you can drink water) and allow a gap of 24 hours between last dose of levo and test and take afterwards.
This mirrors my experience of high T3 for several hours after my morning dose, but having absolutely no signs of any overmedication.
It is interesting that it is written on the assumption the NDT is taken daily in the morning, and after any blood draw, which will see the results within range and possibly below the middle of the ranges.
That makes so much sense to me, and puts my mind at ease.
Thanks I did indeed see your reply, just wanted to make sure I maximised comments by reposting on another thread as advised.
Thank you for the advice given. I've now seen two private endos and both say my levels are absolutely fine. GP also thinks they are fine! Both endos also advised multivit supplement.
I really do despair at so called professional clinicians if they are providing such poor advice!
Where can I find a decent endo consultant who understands these issues properly? I have private healthcare through my company so can use whichever consultant I choose. I'm located near Gloucester.
Actually, you get used to their poor advice and in the end, cease to ask for it. You just know you're going to get a load of rubbish. They know next to nothing about hormones and nothing at all about nutrition. It's their education that is at fault, and for that you can thank Big Pharma!
I suppose, if you know nothing about it - and they don't - a multi-vit sounds like a good idea. It's when you break it all down and look at it closely that you see they're a really, really bad idea.
But, I don't know of any good endos in the UK, because I don't live there. Email Dionne
tukadmin@thyroiduk.org
for her list of the best patient-recommended doctors in the UK.
If I were you, I would tell these so-called specialists that they wouldn't think those levels were fine if they were theirs! Walk a mile in my shoes, etc.
There seems to be some disagreement about your B12 level. Personally, I wouldn't be happy with it that low. So, what I'm suggesting is a booster dose, followed by a maintenance dose. I'm not suggesting you stay on the 1000 mcg long-term.
Sorry how do I test and supplement only those I need? My B12 is low so I've been advised to get B12 1000mg along with Vit B Complex. I'm trying to choose a suitable product from the vast range out there.
Your B12 test result was the Active Test and your result was fine. The Active test indicates the B12 available to be transferred to the cells where it is needed. A B Complex should be fine to maintain B12 and balance with the other B Vitamins. I take Thorne Research ...
Please note that the staff of Thyroid UK don't respond at weekends because the office is shut. So if you haven't heard anything by now the chances are you'll have to wait for Monday.
I don't have any links to hand, but this is a resumé I wrote myself based on all I've read:
You shouldn't be taking a multivitamin anyway for all sorts of reasons.
* If your multi contains iron, it will block the absorption of all the vitamins - you won't absorb a single one! Iron should be taken at least two hours away from any other supplement except vit C, which is necessary to aid absorption of iron, and protect the stomach.
* If your multi also contains calcium, the iron and calcium will bind together and you won't be able to absorb either of them.
* Multi's often contain things you shouldn't take or don't need : calcium, iodine, copper. These things should be tested before supplementing.
* Multi's often contain the cheapest, least absorbable form of the supplement : magnesium oxide, instead of magnesium citrate or one of the other good forms; cyanocobalamin instead of methylcobalamin; folic acid instead of methylfolate; etc. etc. etc.
* Multi's do not contain enough of anything to help a true deficiency, even if you could absorb them.
* When taking several supplements, you should start them individually at two weekly intervals, not all at once as you would with a multi. Because, if you start them all at once, and something doesn't agree with you, you won't know which one it is and you'll be back to square one.
With a multivitamin, you are just throwing your money down the drain, at best, and doing actual harm at worst. Far better to get tested for vit D, vit B12, folate and ferritin, and build up your supplementation program based on the results.
Not only that, many members seem to be unaware that they can see the forum any other way and mention that posts have dropped off the first page (so can't be seen) or they say that people can't see old posts which have been recently replied to. But this is not true.
If people look at Recently Active posts it doesn't matter how long ago the original post was written - if someone has replied to it it will show up on the Recently Active link :
Edit : I'm not having a go at you in this post. I am just genuinely baffled about the way that people use the forum in ways that seem to be counter-intuitive to me.
Yes, this is what puzzles me. By always looking at Latest Posts (which is the default) people miss a lot. My bookmarked link to the forum is the one for "Recently Active" which lists the newest created threads AND the older posts with new replies. I very rarely look at Latest Posts at all.
I use a full-sized desktop PC and what I see isn't scrunched up and hidden behind little symbols or requires a special key-stroke. Instead it is all on display and easy to see. I don't have a smart phone and the idea of using the web on such a tiny screen fills me with horror. I have a small tablet which I rarely use but the way that more info has been squeezed onto the page on such a small screen explains everything to me about how people miss so much that is available on websites. I imagine that people using small screens have to be very dedicated to find all the bells and whistles. Whereas for me they are on full display.
Well, I'm on a PC with an extra large screen, but I can't see all that. And, it might be that I'm a bit O/C or something, but I like my posts in chronological order. Anything else would perturb me enormously. lol
My interpretation of your results (my opinion only, I'm not medically trained)
CRP HS 0.95 mg/L (Range: < 5)
This is fine.
**
Ferritin 206 ug/L (Range: 30 - 400)
This is fine. Half way through range is said to be recommended, I've also seen it said that 150 is a good level for males.
**
Folate - Serum >19.8 ug/L (Range: > 3.89)
This is fine.
**
Vitamin B12 - Active 73.700 pmol/L (Range: 37.5 - 188)
I would say this could be a little bit borderline. According to Viapath at St Thomas' Hospital, below 70 suggests testing for B12 deficiency, so although you are over that level, for me I would want it over 100.
When supplementing with B12, we need a B Complex to balance all the B vitamins. Your B12 isn't dire so not really low enough for a separate B12 (in my opinion) so a good B Complex containing a decent amount of B12 could be better. And your folate is good so you don't need very much folate as you're not looking to raise that, just maintain it.
I wouldn't take any of the Nature's Best B Complex supplements that you linked to because the ones that are B50 or B100 aren't that well balanced.
The best supplements say "Bioavailable" or "Bioactive", this means they contain the already converted forms of the active ingredients, so look for methylcobalamin not cyanocobalamin, methylfolate not folic acid.
One that might be worth considering is Igennus Super B. At the recommended dose of 2 tablets it gives 900mcg methylcobalamin and 400mcg methylfolate. As you don't really need that amount of methylfolate you could start with 1 tablet and see how that goes. You could retest in 3 months to check your levels and if necessary look at a different supplement.
Without doing a lot of Googling I don't know of any others off the top of my head that gives a lower amount of methylfolate (many are 400mcg) and a decent amount of methylcobalamin.
**
Vitamin D 67.7 nmol/L (Range: 50 - 175) = 27.08ng/ml
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 of 100-150nmol/L (40-60ng/ml).
To raise your current level to the recommended level, the Vit D Council suggests supplementing with 3,700iu D3 daily (nearest is 4,000iu).
Retest after 3 months.
When you've reached the recommended level then you'll need a maintenance dose to keep it there, 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).
As you have Hashi's (see below) then for best absorption an oral spray is recommended (eg BetterYou) or you could use a sublingual liquid such as Vitabay Organics.
**
Don't start all supplements at the same time. Start with one, leave it 1-2 weeks and if no adverse reaction then add the second one. Continue like this. If you have any reaction then you will know what caused it.
**
Thyroglobulin Antibodies X 498.000 kU/L (Range: < 115)
Thyroid Peroxidase Antibodies X 123 kIU/L (Range: < 34)
Your raised antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where the thyroid is attacked and gradually destroyed. Fluctuations in symptoms and test results are common with Hashi's.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can possibly 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.
**
TSH 2.34 mIU/L (Range: 0.27 - 4.2)
Free T3 5.16 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 18.300 pmol/L (Range: 12 - 22)
When on Levo only, the aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well. So your TSH is indicating you are currently undermedicated. Your FT4 is 3% through it's range and your FT3 is 56% through it's range. Your FT4 and FT3 are reasonably well balanced. There is room with your FT4 and FT3 for an increase in Levo.
If your doctor is reluctant to increase your dose, use the following information:
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3. You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
You can also refer to NHS Leeds Teaching Hospitals who say
Thyroxine Replacement Therapy in Primary Hypothyroidism
TSH Level .......... This Indicates
0.2 - 2.0 miu/L .......... Sufficient Replacement
> 2.0 miu/L ............ Likely under Replacement
I see from your previous post that you were taking a multivitamin. Are you still taking it? If so can you list the ingredients. If not, did it contain Biotin (B7) and did you take it in the week before this Medichecks test?
Thank you so much for that detailed reply. Very much appreciated and very educational. It's not a straight forward subject and reflects the poor levels of knowledge amongst some healthcare professionals.
I am still taking the multivit. I was taking it up to the test and yes it appears to contain Biotin. Here's some details:
OK, well because it contains Biotin, then there's a chance that some of your results aren't reliable. Medichecks have advised us that they use Biotin in their assay, and that if taking Biotin as a supplement then it can give false results, and to leave Biotin off for 7 days before a test. They don't tell us how much is a problem, just to leave any Biotin supplement off.
As for multivitamins, in general they are not a good idea, they tend to contain too little of anything to help improve low levels, often contain the least absorbable and the wrong form of active ingredients, and can contain things we need to be tested for and only take if we're deficient in that vitamin.
So taking yours:
There is 5mcg Vit D which wont have any effect at all, 5mcg = 200iu and the amount recommended for your current level is 3,700iu.
There is 75mcg Vit K, but it doesn't tell us which form. There is K2 which is the blood clotting form, and K2 which is the form needed when taking D3.
The B vitamins are generally very small dosoes - B12 is 2.5mcg which is miniscule and as it doesn't say that it's methylcobalamin then it will be the cheap cyanocobalamin which we are advised not the form to take.
Folic acid is the cheap synthetic form, methylfolate is better.
And the big problem here is iron - this affects the absorption of everything else because iron has to be taken 2 hours away from other supplements.
Best thing to do is ditch it. Just take what you need in the correct forms.
Ok SeasideSusie, think I'll order the B Complex you kindly linked to. I was also looking at ordering this D3 supplement. Wou this be a good starting point?
For the D3, as you have Hashi's, you would be better off with the oral spray or sublingual liquid I mentioned above. These bypass the stomach for best absorption.
The Vitabay Organics D3 liquid is available on Amazon, BetterYou spray is available in lots of outlets.
Don't forget the K2-MK7 and the magnesium. Vitabay Organics do a sublingual liquid K2-MK7, or there are Healthy Origins K2-MK7 softgels (oil based, K2 is a fat soluble vitamin).
Yes, leave a 2 week gap between adding any new supplement.
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Medichecks: "Contradictory Results"
Help with Medicheck results please
Update to my test results
My latest test results, still not well
Results in from medichecks. I'd love some input on them please.
