You said you are taking Vit D supplement, D3 is what you will be taking, unless you are vegan and will then be taking D2.
TSH: 0.83 (0.34-5.60)
Free T4:10.7 (7.9-20.0)
free T3: 4.8 (4.-6.60)
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.
Your FT4 is only 23% through range and your FT3 is 31% through range. You would appear to be undermedicated.
Are you taking your Levo on an empty stomach, one hour before or 2 hours after food, with water only and water only for one hour each side so that absorption isn't affected?
Optimal nutrient levels are needed for thyroid hormone to work properly so you need the following tested:
If you did actually have severe deficiency the level would have been lower than 25nmol/L and your GP should have prescribed loading doses of D3. However, now your level is 40nmol/L you wont be prescribed loading doses and your current dose isn't enough.
Vit D3 x1 per day 25 ug = 1,000iu
Vit D: 40 report says (less than 50 insufficient)
So that will be 40nmol/L = 16ng/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, based on the Vit D Council's suggestions you could supplement with 4,900iu D3 daily (nearest is 5,000iu) based on a current level of 15ng/ml so you aren't taking any where near enough to raise your level, 1,000iu is merely a maintenance dose for someone who has a reasonable level already
What form of D3 are you taking - tablet, capsule, softgel, oral spray, sublingual liquid?
Do you have Hashi's, confirmed by raised thyroid antibodies? If you do then you'd need an oral spray or sublingual liquid for best absorption. If you don't have Hashi's then an oil based softgel, eg Doctor's Best, will give the best absorption out of all the oral supplements that are swallowed.
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).
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B12: 319 ref (120-625 ng/l)
B12 dr says i dont need??
Your doctor is saying that because you are within range; however, it is low. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
pg/ml is the same as ng/L
Your GP wont prescribe at that level but many people with a level in the 300s have been found to need B12 injections so you should check for B12 deficiency here:
and if you have any then list them to discuss with your GP and request further testing for B12 deficiency/pericious anaemia.
If you don't have any signs/symptoms then it would be a good idea to take a good B Complex containing methylcobalamin (B12) and methylfolate. Good quality B Complex recommended here are Thorne Basic B or Igennus Super B which both contain the bioavailable forms of the active ingredients.
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Serum Ferritin: 17 range (11-307 ug)
This is very low in range, although again because it's within range your doctor wont be worried. However, low ferritin can suggest iron deficiency anaemia. You should ask your doctor to do a full blood count and iron panel which will tell you if you have anaemia.
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Because your nutrient levels are so poor, I'm wondering if you do have Hashi's because when Hashi's is present it tends to cause low nutrient levels and deficiencies. Have you had Thyroid Peroxidase (TPO) and Thyroglobulin (Tg) antibodies tested? If not I think it would be a good idea.
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I thoughy i was under medicated Dr disagrees
If I were you I would make an appointment with your doctor to discuss your B12 if necessary and your ferritin. Also I would refer to your recent thyroid results and point out how low in range your FT4 and FT3 are. Your doctor will probably say that because of your current TSH level then you are adequately medicated, this is not so. Use the following information to support your request for an increase, but bear in mind that you need to optimise your nutrient levels for thyroid hormone to work:
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.
Optimal nutrient levels are:
Vit D - 100-150nmol/L
B12 - top of range for Total B12, at least over 70 for Active B12
Folate - at least half way through range
Ferritin - it's said that for thyroid hormone to work properly (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range although I have seen it said that for females a level of 100-130 is good.
Your doctor wont agree with these levels, as far as they are concerned they just need to be in range, but we are patients with hypothyroidism and we need optimal levels not just "in range".
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As for Statins, greygoose knows a lot about why we shouldn't take them. Take a look at her reply here and the links she has put
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
Your blood test results show you are under medicated. FT4 is far too low
All four vitamins need to be optimal
Do you have autoimmune thyroid disease also called Hashimoto's diagnosed by high thyroid antibodies?
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also important to test vitamin D, folate, ferritin and B12
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
Is this how you do your tests?
Suggest you see GP and request 25mcg dose increase in Levothyroxine. If they are very reluctant ask for it as 3 months trial
All your vitamins are too low, probably due to being under treated
Ferritin is very poor. Aiming for minimum of halfway in range. Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption
B12 and folate on the low side. Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.
B vitamins best taken in the morning after breakfast
Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).
Or Jarrow B-right is popular choice, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
Vitamin D is far too low. GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve vitamin D by self supplementing to at least 80nmol and around 100nmol may be better .
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
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
Levothyroxine should always be taken on empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and more effective taken at bedtime
All medication at least two hours away from Levo. Some like HRT, PPI's, magnesium, iron or vitamin D, at least four hours away
Many people find Levothyroxine brands are not interchangeable.
Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
Just because your doctor 'put' you on statins, you don't have to take them. There's no law that says you have to take everything you're prescribed. And, if you think your doctor knows what he's doing, you'll be very disappointed. All he knows about cholesterol/statins is what he's been told by Big Pharma reps trying to sell statins. And, as he gets funding points, or whatever, for prescribing them, he's not going to quibble, is he.
So, here's a lot of what you need to know about statins - perhaps not everything, but quite a lot:
Now, it's up to you to learn about your disease and get proactive. Decide what you want to put in your own body, and what you don't. I think you must have had enough proof, by now, that your doctor doesn't know what he's doing, so time to take charge of your own health.
Thank you all for your responses. I wasny happy about the statins as id read that undermedicated underactive thyroid could cause high cholestrol and low Vit D he wasnt having any of it 😪
I will go print of your responses and go properly armed with info. Im also stopping the statins from today.
Yes i am overweight i hate feeling tired all the time. I eat correctly plenty of oily fish plenty of veg less my favs due to thyroid and the proper fats. Ive gone from 5 days of regular cardio exercise to virtually none due to tiredness.
Vit D dr says he believes in the Australian research into insufficient levels believes UK is too high but cant get my Thyroid sorted. If i was brave enough i would start taking the 50mg tabs that i had before being prescribed 75mg =125mg but dont want to over medicate.
I was in a similar position- associating the ongoing tiredness with the hypothyroidism even after I started thyroxine and even after my thyroid
Levels looked fine.
But my doctor did other tests which diagnosed iron deficiency anaemia - which I have since discovered is often associated with hypoT especially if you have Hashimotos Antibodies.
And this ( Hypochlorhydria) in turn can be associated with inadequate
levels of stomach acid which means you don’t digest food properly
Including nutrients such as some
Vitamins ( inc D) and also iron .
I also was positive for H pylori which was contributing to the low levels of stomach acid and the triple Therapy treatment to cure it involving inhibitors of stomach acid ironically made things even worse .
I more or less collapsed on Wednesday and had to have an emergency iron infusion. Still v weak but hopefully on the mend.
So in summary not all Tiredness is due to the thyroid problem
And if your levels are fine inc FT3 then ask your GP to test for other contributory causes to your tiredness including folate, ferritin , vitamin d and low
Armed with all your information i went to see another Dr today (NOT my own who told me via the receptionist under no circumstances was i coming of statins i was on them for life with a level of 3.5!!) and clearly outlined the low Ferritin low Cholestrol, raised liver levels (maybe due to Statins) etc etc. Said that i think im under medicated on Levo that undermedication can cause Cholestrol and i would like to be trialed on a higher dose for 3 months as i appreciate that my TSH level is v good but both ft3 &ft4 are too low in the ref range for good health. She listened and said i had defo been researching 🤣 and agreed to raise my Levo by 25mg for 3 months but has lowered my statins to 20mg to take for 1 month (even though v good levels of C she didnt want me to stop immediatly) with 2 months free of statins with blood tests in 3 months to see what my cholestrol levels are like then. She also put me on iron tablets told me to up my dose on Vit D.
Small victory for me so everything crossed for Nov blood tests so i can come of the dreaded Statins 1🤞🤞🤞
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Borderline results and Vit D deficiency
Medicheck results - advice please?
Back with test results, please advise!
Medichecks results - help in interpreting please
