So I have my results, been to the doctors to discuss and she said basically different clinic's test differently so I just need simply to reduce my thryroxine to 125 and see how we do in 3 months, not interest and said the vitamin levels were fine..:
Inflammation
CRP HS 4.86 mg/L (Range: < 5)
Iron Status
Ferritin 22.3 ug/L (Range: 13 - 150)
Vitamins
Folate - Serum 4.49 ug/L (Range: > 3.89)
Vitamin B12 - Active 38.800 pmol/L (Range: 37.5 - 188)
I wouldn't reduce your thyroxine. You are not overmedicated. Once our thyroid is wonky and we are on medication, tsh is not so important. The important results are ft4 and most of all ft3. Neither of your results for those are near the top of the range. The reason we have symptoms is low ft3. To feel well many need ft3 over half way through the range and more towards the top of range.
been to the doctors to discuss and she said basically different clinic's test differently
Well, they test blood, they may have a different machine with different reference ranges, but the end result is the same - a result within a reference range.
so I just need simply to reduce my thryroxine to 125
TSH X 0.097 mIU/L (Range: 0.27 - 4.2)
Free T3 4.47 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 17.100 pmol/L (Range: 12 - 22)
She's talking rubbish, as usual she is looking at the TSH and not your actual hormone levels. TSH is a pituitary hormone, FT4 and FT3 are the thyroid hormones which tell us what we need to know.
Your FT4 is 51% through it's range and your FT3 is 37% through it's range. The aim of a treated hypo patient generally, when on Levo, 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. You do not need a reduction in Levo, if anything you need to get your FT4 and FT3 higher in range, therefore an increase in dose would be better.
said the vitamin levels were fine..:
Ferritin 22.3 ug/L (Range: 13 - 150)
Folate - Serum 4.49 ug/L (Range: > 3.89)
Vitamin B12 - Active 38.800 pmol/L (Range: 37.5 - 188)
Vitamin D X 44 nmol/L (Range: 50 - 175)
She's saying they're fine because they fall within the range. However, doctors aren't taught about nutrition so as far as they are concerned "within range" means everything is OK. However, this is not so. There is a vast difference to how we feel between when our level is at the bottom of the range to how we feel when it's at the top.
Your ferritin is far too low, it's recommended to be half way through range. With a level of 22.3 this could suggest iron deficiency anaemia so you need a full blood count and an iron panel.
Your folate has barely scraped over the low limit and would be better in double figures.
Your Active B12 is absolutely dire. According to Viapath at St Thomas' Hospital, an Active B12 level below 70 suggests testing for B12 deficiency:
If you do have any, list them to discuss with your GP and ask for further testing for B12 deficiency/pernicious anaemia.
Your Vit D is in the Insufficiency category at 44nmol/L (17.6ng/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)
A good D3 supplement with excellent absorption is an oil based softgel, eg Doctor's Best.
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:
Your 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.
Check out the other cofactors too (some of which can be obtained from food).
Can you see a different GP and ask for an increase in your Levo using the following information in support of your request:
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 also need to ask for further testing of B12 and further investigation to see if you have iron deficiency anaemia.
wow and there's me thinking i'm a hypochondriac, even a little embarrassed that i made the appointment..I don't understand every thing you have said as there is so much information and reference material ... but ill read it and digest..i thank you so much for your time and patience , I so very much appreciate your support and guidance.. be in touch soon S x
No that is thyroid stimulating hormone and the x beside it is to highlight that the result is outwith the reference range. Free t4 ft4 is free thyroxine and is 17.100 for you at the mo.
Hiya hun so Ive been reading and digesting the info you shared and am going to go for another set of bloods in tge attempt to get the doctor to help me increase my vitamins to a healthier level.
Have I understood that the t3 is not available on tge NHS .... not got an issue but where and how do I get t3 And the dosage would be ? I understand if your not able to answer but hope you can help me find my way ... I’ve been pretty ignorant to my health for 25 years and now feel that it’s time to take control ... thank you
Have I understood that the t3 is not available on tge NHS
T3 is not easy to get prescribed on the NHS. It has to be initiated by an endo, endos often refuse referrals when test results are within range.
how do I get t3 And the dosage would be ?
You shouldn't consider adding T3 until your vitamins are optimal so before you do anything else you need:
Ferritin: half way through range. You should ask your GP for that full blood count and iron panel to rule out (or in) iron deficiency anaemia.
B12: as mentioned, your level is dire and you need testing for B12 deficiency/pernicious anaemia.
Folate: although over the low limit this is far too low but you shouldn't supplement anything for this until further testing of b12 has been carried out.
Vit D: you need to get this up to 100-150nmol/L.
These are your first priority. Low levels and deficiencies bring symptoms of their own. Once levels are optimal, then you see where your FT4/FT3 lie and go from there.
Since you need to be tested for Pernicious Anaemia (PA) you must not start supplementing vitamin B12 until after the testing has been completed. You should also not start supplementing folate (or folic acid) before testing because there is a relationship between folate and B12 that could screw up the testing for PA.
Testing for PA has a habit of giving false negatives too often for comfort and taking B12 or folate before testing makes a false negative much, much more likely.
If you want more info on Pernicious Anaemia the PA Society has a forum on HealthUnlocked that you might want to join/follow.
Vitamin B12 - Active 38.800 pmol/L (Range: 37.5 - 188)
Vitamin D X 44 nmol/L (Range: 50 - 175)All dreadful!
And you should not reduce thyroxine as your thyroid hormones are not barely half way through range. Most GPs seem to be a bit mathematically challenged
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