Help with test results. Where to go now? - Thyroid UK

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Help with test results. Where to go now?

WinnieH profile image
10 Replies

I posted here a few weeks ago feeling really desperate and quite poorly. Now feeling even worse. I had my Free T3 checked again and Vitamin D which had been really low and even after 6 months of supplementing is still low.

New results on the 26/9/19:

TSH 3.89 (mlu/L 0.27-4.2)

Free T4 15 (pmol/L 12-22)

Free T3 2.83 (pmol/L 3.1-6.80)

Vit. D3 54.6 (nmol/L 50-175)

Ferritn 49.64 (ug/L 15-150)

Folate and B12 are OK

I have also done a Adrenal saliva test but results are not back.

I really feel very low but so brain dead I don't know what to do next. I am taking T4 x 100mcg at present.

Hope someone can help with these as I feel as I'm in a downward spiral!!

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WinnieH profile image
WinnieH
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SlowDragon profile image
SlowDragonAdministrator

See GP and request 25mcg dose increase in Levothyroxine

FT4 is only 30% through range (should be at least 70%)

FT3 is below range

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

Bloods should be retested 6-8 weeks after each dose increase

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

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

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Vitamin D is too low. GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve 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.

Retesting twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is good as avoids poor gut function.

It's trial and error what dose each person needs. Frequently with Hashimoto's we need higher dose than average

Local CCG guidelines

clinox.info/clinical-suppor...

Government recommends everyone supplement vitamin D October to April

gov.uk/government/news/phe-...

Ferritin is a bit low

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

WinnieH profile image
WinnieH in reply toSlowDragon

Thank you so much for all the information and links.

I contacted my GP and he is prescribing another 25 mcgs.

As for the vitamin D I had this tested at the beginning of the year and it was only 48. I have taken 5000iu's for 6 months now and still only raised to 50. I have ordered the BetterYou oral vitamin D and hopefully that will make a difference.

Thanks again.

SeasideSusie profile image
SeasideSusieRemembering in reply toWinnieH

As for the vitamin D I had this tested at the beginning of the year and it was only 48. I have taken 5000iu's for 6 months now and still only raised to 50.

What form of Vit D have you been taking - tablets, capsules, softgels? Out of those 3 it's softgels that give best absorption, tablets and capsules are poorly absorbed.

Also, when taking D3 there are important cofactors - magnesium and Vit K2-MK7.

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...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

So if you haven't been taking magnesium, this could be why your level hasn't improved much.

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.

Do you take your Vit D supplement 4 hours away from thyroid meds?

WinnieH profile image
WinnieH in reply toSeasideSusie

I have soft gels which I take with my evening meal. Thyroid meds. I take early in the morning at least 30 minute from any food or supplements.

I also take magnesium citrate at the same time as the vitamin D but have not been taking any K2-MK7. what would be an ideal dose of K2?

SeasideSusie profile image
SeasideSusieRemembering in reply toWinnieH

90-100mcg K2-MK7 is enough for up to 10,000iu D3.

Tina_Maria profile image
Tina_Maria

Your test actually suggests that you are seriously under-medicated! Your free T3 is even below the normal range, no wonder you are feeling so low, as this is the hormone that would give you energy.

Your free T4 is also on the low side, usually people feel better when fT3 and fT4 are at least 2/3 through the normal range (as a general note, but not everyone is the same, some even need the fT4 slightly above the normal range).

TSH is definitely too high if you are on replacement, I would go back to the GP and ask for an increase. After 6 weeks you would need to check your thyroid levels again, but by the look of it you may need another increase. Try to get this done quickly, as you need that increase asap, if you want to start to feel better soon. Good luck!

WinnieH profile image
WinnieH in reply toTina_Maria

Thank you for answering my post. I have now been prescribed another 25 mcgs but also he also suggested anti-depressants as I feel so low. I know this is thyroid so don't want to go down that route. Hopefully things will improve in a few weeks.

SlowDragon profile image
SlowDragonAdministrator in reply toWinnieH

Make sure to get blood retested 6-8 weeks after each dose increase

Blood tests as early as possible in morning and no food or drinks apart from water before testing

Last dose levothyroxine 24 hours prior to test

Come back with new post once you get results

Tina_Maria profile image
Tina_Maria in reply toWinnieH

Well, since the fT3 is below the range, this will make you feel very low. Once those levels are up, your mood will improve (low fT3 levels have been linked to depression). The under-medication will mimic depression, but I don't think you are depressed, you are seriously under-medicated - the increase in thyroid medication should resolve this.

Most anti-depressants prescribed are SSRI inhibitors, they increase the amount of serotonin in your brain (feel good hormones). But they cannot address the problem of fT3 being too low. Once you are on your correct dose of thyroid medication, I am sure you will feel heaps better. Take care x

SlowDragon profile image
SlowDragonAdministrator

what brand Levothyroxine are you taking?

Are both 100mcg and 25mcg the same brand?

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

You say here that B12 and folate are "ok"

Can you add actual results

Within range is often not high enough

Low vitamin D and low B vitamins often go together

As explained by Dr Gominack

drgominak.com/sleep/vitamin...

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