Recently diagnosed with Hypothyroidism - six we... - Thyroid UK

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Recently diagnosed with Hypothyroidism - six weeks on Levothyroxine

StrongCoffee
StrongCoffee

Hi all, I've been reading this forum avidly for the last few days following my first blood test after six weeks of Northstar levothyroxine treatment of 50 mcg.

My latest results are below, can anyone please tell me if these are 'normal', 'good' or otherwise? I realise it's a very individual matter.

Also, I have bought high strength Innopure kelp tablets (2000mg) which according to the manufacturer contain iodine of 400mcg/ug per capsule. I had been taking these for only one day when the blood was taken for the results below. Reading about iodine on this forum makes me think I should stop taking them daily and maybe cut down to one every few days, any advice on this would be welcome.

Test Results from (5th June 2019).

'Serum free triiodothyronine level (T3) 4.4 pmol/L [3.5 - 6.5]

Serum free T4 level 13.4 pmol/L [10.0 - 20.0]

Please note change of reference range from 04/02/2019.

TSH (ON T4 RX)

Serum TSH level 3.1 miu/L [0.35 - 5.5]

Please note change of reference range from 04/02/2019.'

Many thanks in advance.

17 Replies
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SeasideSusie
SeasideSusieAdministrator

StrongCoffee

First of all

Also, I have bought high strength Innopure kelp tablets (2000mg) which according to the manufacturer contain iodine of 400mcg/ug per capsule. I had been taking these for only one day when the blood was taken for the results below. Reading about iodine on this forum makes me think I should stop taking them daily and maybe cut down to one every few days,

Stop taking it. Do a non-loading iodine test (Genova Diagnostics do one, details on ThyroidUK's main website under "Private Testing - Genova"). If you are deficient then you can supplement iodine under the guidance of an experienced practioner. If you are not deficient then don't take it. Iodine used to be used to treat hyperthyroidism, so if you aren't deficient then you are very likely going to make your hypothyroidism worse.

Do you know if you have autoimmune thyroid disease, aka Hashimoto's, confirmed by raised antibodies? If so iodine is definitely not recommended.

Current results after 6 weeks on 50mcg Levo:

TSH : 3.1 [0.35 - 5.5]

FT4: 13.4 [10.0 - 20.0]

FT3: 4.4 [3.5 - 6.5]

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well.

Your GP should be following normal protocol for titration of Levo, i.e. after testing 6 weeks following initiation of Levothyroxine, increase dose by 25mcg. Retest every 6-8 weeks with a 25mcg increase in dose each time until levels are where they need to be for you to feel well.

When doing thyroid tests, we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it will give false results (Medichecks definitely use Biotin, they have confirmed this and the amount of time to leave the supplement off).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

Because we Hypos need optimal nutrient levels for thyroid hormone to work properly, and many of us have low levels or are deficient, it would be very useful to test

Vit D

B12

Folate

Ferritin

Thanks so much, I will stop the kelp and go back to my GP about raising the Levo dose.

I don't know whether I have Hashimoto's, I will ask about this too.

SeasideSusie
SeasideSusieAdministrator in reply to StrongCoffee

Doctors in the UK don't tend to call it Hashimoto's, they call it autoimmune thyroid disease (Hashimoto's is the name of the doctor who discovered it). Your GP may be able to get Thyroid Peroxidase (TPO) antibodies tested - if positive this is Hashi's. Sometimes TPO antibodies are negative and Thyroglobulin (Tg) antibodies should be tested because we can have negative TPO but positive Tg antibodies which can suggest Hashi's. Postive Tg antibodies on their own can also suggest other things. Tg antibody testing is generally only done in secondary care when an endo requests it, I don't think it's done at primary level.

Unfortunately, many doctors tend to attach little importance to raised antibodies anyway. The antibodies aren't treated, it's the resulting hypothyroidism from Hashi's destroying the thyroid that's treated.

Ok, lots to learn and digest with this condition! Thanks for your very comprehensive help, I'll take notes when I go back to my GP.

Hi again, my GP has agreed to up my Levo dose to 75 mcg and to test for Hashi's, he also agreed to check my Vitamin D, ferritin and folate (my B12 was checked recently and is fine). Should I fast and have an early morning blood draw as per thyroid tests, or is it not crucial for these ones?

SeasideSusie
SeasideSusieAdministrator in reply to StrongCoffee

For those vitamin tests, this applies

* If taking a B Complex containing Biotin (B7) or a stand alone Biotin supplement, leave off for 7 days for any test.

* If taking an iron supplement, leave off for 7 days for ferritin test. If an iron panel is being done then fast for 8-12 hours and no iron supplement for 7 days. Also, don't eat iron rich food such as liver/liver pate/black pudding in the week before testing ferritin or iron panel.

Other than that, any supplements you do take then take after the blood draw.

Personally, because sometimes they include a test that they haven't mentioned, I always fast and try to get an early appointment.

Thanks loads, much appreciated.

Hello, I have now received the results for the tests mentioned above, they are as follows: (I assume the 'Bone Profile' is the test for TPO antibodies and would indicate whether or not I have Hashi's, I do not know how to interpret these if you could please help?))

Based on these values, can you recommend a good Vitamin D supplement too?

Many thanks as always.

Serum ferritin level 76 ug/L [15.0 - 300.0]

Serum folate level 7.8 ug/L [2.0 - 17.0]

TOTAL VITAMIN D

Serum total 25-hydroxy vitamin D level 57 nmol/L [75.0 - 200.0]

Below low reference limit

Vitamin D status may be adequate or borderline

insufficient. Advise supplement only if clinically

indicated. If follow up of vitamin D level

required, allow 3 months before re-testing

BONE PROFILE

Serum calcium level 2.37 mmol/L

Serum adjusted calcium concentration 2.42 mmol/L [2.2 - 2.6]

Serum inorganic phosphate level 1.05 mmol/L [0.8 - 1.5]

Serum alkaline phosphatase level 48 u/L [30.0 - 130.0]

Serum albumin level 41 g/L [35.0 - 50.0]

SeasideSusie
SeasideSusieAdministrator in reply to StrongCoffee

StrongCoffee

I assume the 'Bone Profile' is the test for TPO antibodies and would indicate whether or not I have Hashi's, I do not know how to interpret these if you could please help?

No, the bone profile is nothing to do with thyroid, it's testing things connected with your bones - calcium, etc. Your levels are all in range so appear fine.

You haven't had any thyroid antibody tests carried out.

Serum ferritin level 76 ug/L [15.0 - 300.0]

Ferritin is OK, it needs to be 70 for thyroid hormone to work (our own or replacement hormone) although I've seen it said that for females 100-130 is a good level and for males 150.

Serum folate level 7.8 ug/L [2.0 - 17.0]

This is in range but alittle bit low, recommended is at least half way through range so that would be 9.5+ with that range.

No B12 test? B12 and folate work together.

TOTAL VITAMIN D: 57 nmol/L = 22.8ng/ml

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 reach the recommended level from your current level the Vit D Council suggests supplementing with 3,700iu D3 daily

vitamindcouncil.org/i-teste...

Retest after 3 months.

An oil based softgel gives excellent absorption, eg Doctors Best, tablets and capsules aren't recommended.

If Hashi's is present than an oral spray or sublingual oil based liquid would give best absorption as they bypass the gut.

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:

vitamindtest.org.uk/

There are important cofactors needed when taking D3 as recommended by the Vit D Council -

vitamindcouncil.org/about-v...

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.

naturalnews.com/046401_magn...

thefamilythathealstogether....

drjockers.com/best-magnesiu...

Check out the other cofactors too (some of which can be obtained from food).

Did you get an increase in your dose of Levo following those results on 5th June?

Thanks again for your comprehensive reply, yes, I'm up to 75 mcg Levo and have been taking it for five days.

B12 was only tested recently and was ok.

I'm puzzled as to why I've got bone results though as the form I gave to the nurse prior to my blood draw definitely had a request for the antibodies test on it. I will have to follow this up on Monday.

Hello once again, I have now had my TPO antibody blood test results and the reading was 35kU/L. The surgery told me that the range is 0 - 50 and that my result is 'normal'. I do not know what this means and won't be able to speak to my doctor until Monday 8th. Does this show that I have Hashi's?

On the supplement front, I am now taking B12 late morning, (I take my Levo around 7.00 am) and take oral spray Vitamin D with Vitamin K and Magnesium with my evening meal which is my largest and fattiest. Is this a sensible schedule?

Many thanks again for your invaluable help and advice, I hope you're enjoying the fine weather whichever seaside you're by!

SeasideSusie
SeasideSusieAdministrator in reply to StrongCoffee

I have now had my TPO antibody blood test results and the reading was 35kU/L. The surgery told me that the range is 0 - 50 and that my result is 'normal'

We tend to see two ranges for TPO antibodies here, <34 and <50. So if your range is <50 you are within range and technically your antibodies are negative for autoimmune thyroid disease (Hashi's). However, antibodies fluctuate and you'd need a few negative results to discount Hashi's. Also, even though within range, they're not exactly low. I wouldn't be surprised if they came back higher or even over range if tested at other times.

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and even if you do have it then it's not going to change your treatment. It's the resulting hypothyroidism that is treated. You could, if you wish, try a gluten free diet which many members have found helps, also supplementing with selenium l-selenomethionine 200mcg daily can help reduce the antibodies, as can keeping TSH suppressed.

On the supplement front, I am now taking B12 late morning, (I take my Levo around 7.00 am) and take oral spray Vitamin D with Vitamin K and Magnesium with my evening meal which is my largest and fattiest. Is this a sensible schedule?

B12 timing is fine. Oral spray Vit D can be taken any time as it bypasses the stomach and is absorbed through the mucous membrances in the oral cavity, and if it's a combined D3/K2 spray then that's fine. Magnesium with evening meal is fine.

Ok, thanks for the prompt reply and useful extra information.

SlowDragon
SlowDragonAdministrator

NHS rarely tests FT3 or TG antibodies.

TG antibodies are only tested if TPO antibodies are high. It is possible to have high TG antibodies and low TPO antibodies. It's less common, but not rare

Often people struggle to get diagnosed is only TG antibodies are high

Private testing available

Iodine is definitely not recommended for anyone with Hashimoto's

Most primary hypothyroidism is due to autoimmune thyroid disease (Hashimoto's)

Thanks for your insight.

By the way, I have seen a list of 'foods to avoid' which includes peanuts; I eat peanut butter on half a slice of toast fairly regularly for breakfast and also have a handful of peanuts with a sandwich for lunch, should I stop doing this?

No

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