I am really hoping that someone can help me and advise me as I am very unwell more than I am well-ish. I do understand that sufferers of Hashimotos will never feel as well as they used to, but my life is so dominated by symptoms that make leading a normal life impossible. I have had an all too common journey since being diagnosed with an underactive thyroid in May 2017. I have been laughed at in the doctors (yes actually laughed at) - told I just have an ear infection - told that I should definitely stop taking iron supplements when I had a result of 20 (range 12-400) - told by the doctor she would be negligent to give me B12 injections when I was below range - and a doctor who sat and read out to me the 5 common symptoms from the NHS website. I have learnt so much from this forum and can’t thank the superstars who help us all enough.
I have done as much as possible to try and help myself (adjusting my diet and lifestyle, reducing hours I work and trying to reduce stress) but I am still at the mercy of gigantic flare ups that are making life just one long struggle. I have had private blood tests with Medicheck 3 times over the past year and I include the latest results below. I am trying to get to the bottom of why I feel so unwell and wonder if my T3 conversion is not good enough (as it sits below half way through range when my free Thyroxine is at the top of its range) and whether or not I should start the process of trying to source T3 medication (which scares me!) to take alongside the Thyroxine.
I am taking Levothyroxine 141mg per day and I follow to the letter when to take my medication in relation to the supplements and food. For the latest test results, I stopped taking B12 supplements (which may explain a lower than usual result) and Ferrous sulphate 7 days before as per recommendations.
I supplement with: Ferrous Sulphate (600mg per day) and (all per the recommended dose) Vitamin D, Calcium and Magnesuim, Zinc, Selenium, Iodine, B12 Complex, Turmeric capsules. I am gluten (and grain) free, dairy free and nightshade free. I eat very healthily and drink plenty of water.
My results are as follows:
Inflammation CRP HS 0.96 mg/L (Range: < 5)
Iron Status Ferritin 67.6 ug/L (Range: 13 - 150)
Vitamins
Folate - Serum 10.87 ug/L (Range: > 3.89)
Vitamin B12 - Active 66.200 pmol/L (Range: 37.5 - 188)
Vitamin D 84.4 nmol/L (Range: 50 - 175)
Thyroid Hormones
TSH 0.272 mIU/L (Range: 0.27 - 4.2)
Free T3 3.83 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine X 22.100 pmol/L (Range: 12 - 22)
Autoimmunity
Thyroglobulin Antibodies X 341.000 kU/L (Range: < 115) (This has gone up from 119 in December 2018)
Thyroid Peroxidase Antibodies X 95.2 kIU/L (Range: < 34)
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bunnycalledpedro
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I supplement with: ... Calcium, Iodine ... B12 Complex
First thing, why supplement Calcium? Have you tested and found to be deficient? If not you shouldn't be taking it.
Next why supplement iodine? Have you tested and found to be deficient? If not then why are you taking it? Iodine deficiency is rare in the UK. Iodine used to be used to treat hypERthyroidism so will make hypOthyroidism worse. And it's particularly recommended not to take it when Hashi's is present.
Next, is this "B12 Complex" a B Complex containing all the B vitamins, and does it contain Biotin (B7). If so did you leave this off for 7 days before testing, it's the Biotin that affects results according to what Medichecks tells us and they should be saying to leave off Biotin not B12.
Assuming you did leave off Biotin:
TSH 0.272 mIU/L (Range: 0.27 - 4.2)
Free T3 3.83 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine X 22.100 pmol/L (Range: 12 - 22)
These results show that conversion of T4 to T3 is poor. FT4 is
100% through range. FT3 is 20% through range. You could do with a bit less Levo and start gradually adding T3.
I supplement with: ....... (all per the recommended dose)
There are no recommended doses. You need to test and supplement according to the result of the test.
Iron Status Ferritin 67.6 ug/L (Range: 13 - 150)
This is getting towards the level needed for thyroid hormone to work properly (which is 70). I would start adding liver to your diet, maximum 200g per week due to it's high Vit A content (but you wont need that much), also liver pate, black pudding, and including lots of iron rich foods in your diet
Do you take your iron tablet with 1000mg Vit C to aid absorption? And do you take it 4 hours away from your Levo and 2 hours away from any other supplements/medication?
Vitamin B12 - Active 66.200 pmol/L (Range: 37.5 - 188)
This suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital
I am supplementing with all these vitamins and minerals I guess in a bid to feel well. I read an article and think that might be the next miracle cure..... I hope you don't think I'm stupid! Just desperate!
- These results show that conversion of T4 to T3 is poor. FT4 is
100% through range. FT3 is 20% through range. You could do with a bit less Levo and start gradually adding T3.
This is what I have suspected. Could you please advise me how to source T3 and what would be a starting dose?? My GPs are utterly useless (and I have seen all of them)
The B complex contains this:
Two caplets contain: %NRV*
Thiamin (Vitamin B1)10mg 909%
Riboflavin (Vitamin B2)15mg 1,071%
Niacin25mg NE 156%
Pantothenic Acid100mg 1,667%
Vitamin B610mg 714%
Vitamin B1225µg 1,000%
Folic Acid400µg 200%
Biotin100µg 200%
Choline Bitartrate250mg **
Inositol250mg **
PABA50mg *
And as it contains Biotin, as per your previous advice on the forum, I had not taken it for 7 days before the blood test. I only take one of these a day and the above amounts are for 2 tablets per day - so I will be taking half these amounts.
I take 25ug per day of Vitamin D, I will increase to your recommended dose.
I do take my iron in 3 doses spread well away from my levo and supplements and with Vit C.
Calcium (500mg per day) I started taking when I had a restricted diet and was concerned I wasn't getting enough and the tablet I buy contains magnesium (250mg per day) so I thought that I was killing two birds with one stone - not so!
Iodine, I had read that this was beneficial, so thank you for telling me otherwise. I had dropped this to every other day but will now drop completely.
I will get some Vit K2-MK7, what dose would you recommend?
Could you please advise me how to source T3 and what would be a starting dose??
You'll need to make a new thread asking for recommendations by private message. Feel free to check any out with myself or any other member of the Admin team, we do know of some unscrupulous suppliers so we can steer you away from them.
First of all I would reduce your Levo by 25mcg to bring your FT4 down a bit. Then a week or two later start adding T3.
Starting dose is 1/4 of a tablet, so you will probably get 25mcg tablets so that will be 6.25mcg. Stay on that dose for 2 weeks then if all is OK (no adverse reaction) add a second 1/4 of a tablet, stay on that for 2 weeks.
I took it very slowly when I added mine. Personally, I'd see how you feel on 1/2 a tablet, maybe actually give it 6 weeks and retest. Or if you feel the need to add a third 1/4 of a tablet then give that 6 weeks and retest. There's a lot of tweaking of both Levo and T3 involved, it's not quick and easy, you need time for levels to stabilise after each dose change and to check your levels and see how you feel.
As for Vit K2-MK7 (this is needed to direct the extra calcium uptake, which D3 encourages from food, to be directed to bones and teeth and away from arteries and soft tissues), the dose suggested is 90-100mcg for up to 10,000iu D3.
Thank you so much, this is another huge learning curve for me!! I have emailed Dionne at Thyroid Uk and will heed all your advice. Many thanks and best wishes
Gives D3 and K2-MK7 in one capsule along with coconut oil to help absorption. It has definitely increased vitD levels for both me and my daughter. They can be clear or cloudy or a mix inside the capsule without issue. And when you make a purchase from them, you can go to their website with your Amazon order number and they will send a free bottle. There is a little flyer in the box with the bottle with the details.
Hi! I also take Levothyroxine (Hypothyroid) and although I really have nothing to add to this very detailed response from these other helpful lovelies, I want you to know you're in great company! We are all here to learn and help ourselves (and each other) become healthier. This has been a very uplifting community for me, and I think you're noticing the same. I hope you have the speediest recovery in balancing everything you need!
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