Test advice appreciated please, it's the dodgy... - Thyroid UK

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Test advice appreciated please, it's the dodgy D!?

Cup-cake7 profile image
48 Replies

Hi

Quite pleased with results ( I think) I'm now splitting levo dose and it's making a lot of sense to how I feel , I never thought it through before to split my dose

But Vit D.level is low And yet I take the spray with k2 daily & it's the one I never miss, I take 3000 sometimes two sprays of it

Any thoughts or reminders please to get this UP or is it catch 22 when tsh is too high it affects Vit D level?

I feel more confident now to get the tsh down now I'm splitting as couldn't cope with one big dose, may Be adrenal thing, I don't know?

About adrenals, I'm unsure if saliva test is so telling as different days brings different stress levels, I'm not a creature of habit very much. Do you feel the NHS urine test is reliable enough?

Results

Tsh 4.3

Free T3 4.78 out of 3 to 6.8

Free T4 18.5 out of 12 to 22

No antibodies over range

Ferritin 79 out of 13 to 150 so it's halfway

Folate 14.43 out of 3.88 to 19.4

B12 119 Out of 37.5 to 187

Vit D 59.7 out of 50 to 175!!!

Why is this I wonder and may account for feeling dodgy

Appreciate tsh still high, and bio hormones have risen it a bit, but on plus side it's already come down a bit since splitting levo and getting onto Ioomg

Thanks as usual

Jx

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Cup-cake7
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Cup-cake7 profile image
Cup-cake7

Ps

T3 still low but marginally better

I guess il never know about being a bad converter unless tsh is behaving

SeasideSusie profile image
SeasideSusieRemembering

But Vit D.level is low And yet I take the spray with k2 daily & it's the one I never miss, I take 3000 sometimes two sprays of it

Have you tried a different type of D3 supplement?

I remember one member saying he'd tried the spray and I think he tried softgels as well, but it was only an oil based sublingual D3 liquid that worked for him.

I've always done extremely well with Doctor's Best softgels - just 2 ingredients which are D3 and extra virgin olive oil. Got my severely deficient level of 15 up to 202nmol/L in 2.5 months. I obviously started on what would be loading doses, then reduced to 5,000iu daily which, after experimenting, seems to be my maintenance dose.

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Thanks seaside Susie

So, is t the spray classed as sublingual,?

Il certainly try that. Thankyou, I thought I was taking one of the best and it's hard to imagine you don't absorb it well

So I'd better take k2 separately then? What do you take pls?

SeasideSusie profile image
SeasideSusieRemembering in reply toCup-cake7

BetterYou doesn't describe itself as "sublingual", it is absorbed through the mucous membranes in the oral cavity.

It suits some people and not others, we are all individual, so it can be best for some people and they do very well on it, but not everyone does.

I wont take it because of the additives in it, I prefer as pure and clean a supplement as I can get, not always possible to avoid additives but I do wherever possible.

I have taken various brands of K2 supplement including:

Healthy Origins K2-MK7 softgels

Vitabay Organic K2 MK7 liquid drops

Fair & Pure K2 Complex (MK4 and MK7)

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Good info. Thankyou il get into it

Well I just trusted it was a good choice in health shop , I can't read the small print 🙈

Please tell me difference with mk4 and 7

What does mk mean ?

SeasideSusie profile image
SeasideSusieRemembering in reply toCup-cake7

Please tell me difference with mk4 and 7

MK4 and MK7 explained in my reply to this post:

healthunlocked.com/thyroidu...

What does mk mean ?

A sub-type of Vit K.

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

..brilliant Thankyou. I've saved it

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

....is b12 folate and ferritin ok in range at halfway?

What is loading dose of Vit D please? Is it 10000. And for how long ?

SeasideSusie profile image
SeasideSusieRemembering in reply toCup-cake7

B12 and folate are fine.

Ferritin is almost at half way through range (which is 81.5).

Loading doses of D3 are explained in the NICE summary here, there are various ways of doing it:

cks.nice.org.uk/vitamin-d-d...

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses.

Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total).

But loading doses would only be used if Vit D level is less than 25nmol/L.

Once over that level you'd use the suggestions from the Vit D Council to raise your current level to their recommended level. To reach the recommended level from your current level of 59.7nmol/L (23.88ng/ml), based on the Vit D Council's suggestions you could supplement with 3,700iu D3 daily (nearest is 4,000iu)

vitamindcouncil.org/i-teste...

Retest after 3 months.

Once you reach the recommended dose 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/

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Tres bien. Thanks,,,

My Vit D says

25 OH Vit D 76. nmol/L 50 - 200

How do I know if I need loading dose

SeasideSusie profile image
SeasideSusieRemembering in reply toCup-cake7

My Vit D says 25 OH Vit D 76. nmol/L 50 - 200

Well according to your first post in this thread you said:

Vit D 59.7 out of 50 to 175!!!

So which is it? The amount of D3 you need to take depends on your current level.

How do I know if I need loading dose

I've already explained above:

"But loading doses would only be used if Vit D level is less than 25nmol/L."

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

SORRY. Yes I flicked onto older result

Definitely at 59.7 today

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Please explain what this means....’25 OH’. Thankyou for patience

Then the number of your test result

SeasideSusie profile image
SeasideSusieRemembering in reply toCup-cake7

Please explain what this means....’25 OH’.

It's the name of the test.

Our bodies convert vitamin D to a chemical known as 25-hydroxyvitamin D (calcidiol). Apparently this test is the best way to monitor vitamin D levels.

A lot of these answers can be found by a quick Google.

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Is it recommended to be at very top of range SS?

Il use my spray properly now

Unbelievably its got 3000 on it and you pump it 3 times!!

So i need 4 presses!!

Nhs lab? Is this in a hospital

SeasideSusie profile image
SeasideSusieRemembering in reply toCup-cake7

Is it recommended to be at very top of range SS?

Vit D? No, Vit D has categories - Deficient, Insufficient, Sufficient, etc., and each category has a range. I believe the NHS range, for most labs, say that 50-175nmol/L is the range for the Sufficient category.

The Vit D Council recommends a level of 125nmol/L and the Vit D Society, also Grassroots Health, recommend a level of 100-150nmol/L.

Unbelievably its got 3000 on it and you pump it 3 times!!

Well, that's how they market it but they make it very clear on the packaging that you need 3 sprays to give 3,000iu. It does, however, make it versatile and someone who doesn't need 3,000iu can also use it by using the appropriate amount of sprays for their needs.

So i need 4 presses!!

That's correct for 4,000iu.

Nhs lab? Is this in a hospital

It would be in an NHS hospital, certainly. Major NHS hospitals will have their own phlebotomy department and lab. I live in an area where the main hospital is 50+ miles away. We have a cottage/community hospital which is very small and doesn't have a lab. All blood in my area is taken at the GP surgery and picked up every day and taken to the main hospital for testing.

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Thankyou! Interesting and helpful!

the spray comes in different strengths too....

I will tell the Health shop that sell it to me as it isnt how it was sold to me, they too will be surprised ( print on bottle TINY

Mary-intussuception profile image
Mary-intussuception in reply toCup-cake7

You don't need loading dose. But daily maintenance dose of Colecalciferol (D3) that suits you, as your result dropped a little.

Cup-cake7 profile image
Cup-cake7 in reply toMary-intussuception

👍🏼

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Ps. Does D3 mean it has k2 with it?

helvella profile image
helvellaAdministrator in reply toCup-cake7

No - there were thought to be three, slightly different, forms of vitamin D. They were named D1, D2 and D3. Then research showed D1 didn't really exist. So we actually have two forms available for supplementing. D2 and D3.

Cup-cake7 profile image
Cup-cake7 in reply tohelvella

Thanks helvella, well maybe my Vit D spray doesn't have the right one for me?

Do you recommend k2 separately ?

I was wondering if you can overdose, I eat Gouda which I believe is a source

helvella profile image
helvellaAdministrator in reply toCup-cake7

I wouldn't make any assumptions about how much is in Gouda. This recent paper (Februry 2019) may be of some interest:

Vitamin K: Double Bonds beyond Coagulation Insights into Differences between Vitamin K1 and K2 in Health and Disease

ncbi.nlm.nih.gov/pmc/articl...

Cup-cake7 profile image
Cup-cake7 in reply tohelvella

Thankyou

SeasideSusie profile image
SeasideSusieRemembering in reply toCup-cake7

Does D3 mean it has k2 with it?

No. If it says D3 then it's D3 only. If it says D3 + K2 then it has both in the supplement.

D3 and Vit K2 are completely different supplements.

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

👍

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

TY

The doc gives me D and calcium so I'm concerned as to how much k2 I should take for balance if you know pls?

SeasideSusie profile image
SeasideSusieRemembering in reply toCup-cake7

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

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

👍TY

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Why do they put D with calcium, does D help it along?🤷‍♀️ You would think there would be more Instruction to add k2. Wouldn't you!

Also Clients of mine have their levo in blister packs and I'm tired of telling my manager and pharmacist that it would be helpful to instruct them to be taken away from breakfast which is when they are mostly given

It just doesn't work in practice but very frustrating the person isn't getting full benefit

But then I suppose you could say they are getting the dose that the tsh shows up, breakfast or not!

Although again, they don't seem to get annual check ups for this

SeasideSusie profile image
SeasideSusieRemembering in reply toCup-cake7

Why do they put D with calcium, does D help it along?🤷‍♀️ You would think there would be more Instruction to add k2. Wouldn't you!

Because they think it sells supplements to people who don't know any better. It's all about making money. Vit D aids uptake of calcium from food, so we shouldn't take a calcium supplement in any form unless we have been tested and found to be deficient.

Even doctors tend not to know about K2 as they're not taught much about nutrition.

Also Clients of mine have their levo in blister packs and I'm tired of telling my manager and pharmacist that it would be helpful to instruct them to be taken away from breakfast which is when they are mostly given .... But then I suppose you could say they are getting the dose that the tsh shows up, breakfast or not!

All UK Levo tends to come in blister packs inside a box, and the box should contain a Patient Information Leaflet, and it's the responsibility of the patient to read that leaflet to ensure that it's OK for them to take the medication prescribed and follow the advice regarding how to take it and to check for side effects. If a patient is not capable of doing this for themselves, then hopefully they have someone who can take this responsibility for them. If they do take their Levo too close to eating and absorption is affected, then their test results would show this and the dose they are prescribed would reflect what is needed according to their symptoms and test results.

Although again, they don't seem to get annual check ups for this

Hypo patients should be checked annually. If they are missed, and the patient wants to be tested then they should contact the surgery to arrange it. I didn't get called for 3 years but it didn't bother me because I do private tests to monitor my levels myself. I prefer not to have NHS tests because my GP is TSH obsessed and refuses to acknowledge that FT4 and FT3 are important.

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Yes in novice world i guess its all about the tsh which at least gives good indication - so really even taken with a meal, it gives a marker as such ( you would prob just need higher dose)”

Well re my clients getting annual results goes through a net

I tell care mgr but its not her role, and i dont see family to prompt and would seem interphering 🤷‍♀️

Pls refresh me, is t3 good at two thirds? And am i right thinking t4 can be over top as long as t3 ok?

Although doc & endo wont like!

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

...the client doesnt see leaflets when they have their blister pack set up so the pharmacy should list the instruction then?

But it would mean having to identify the tablet amongst others ( lady today had a 75 & 25 in her blister with three other tabs! I couldnt have picked the levo out . All were round & white

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Yes exactly but clients & fams arent informed to have annual review🤷‍♀️ Frustrating

Yes maybe its a bit unnecessarily a bit too rigid to have empty stomach etc

Cup-cake7 profile image
Cup-cake7 in reply toSeasideSusie

Ps

I haven't used the doctors as don't get a good feel about it

hjh88 profile image
hjh88

Hello Jeppy,

It sounds like you’re using the BetterYou D3 + K2-MK7. Is that right?

I take this too and it’s worth clarifying the dose. The recommended dose of 3000IU is made up of 3 sprays. If you are only taking 1 spray, you are only getting a dose of 1000IU so, if I’ve understood correctly, you’re only getting 1/3 of the dose you think you are.

The bellow is taken from the BetterYou site for the product, also linked below:

“3 sprays deliver 3000IU (75μg) of vitamin D plus 75μg of vitamin K2”

betteryou.com/vitamin-d-k2

I have to re-read this occasionally because it’s not the most clear on the product info and, unhelpfully, it’s not on the bottle itself so once this has been binned it needs to be looked up. Hope that answers some questions!

hjh88 profile image
hjh88 in reply tohjh88

Just to clarify, I’ve had chance to have a look at my bottle and the bottle itself says that the daily recommended dose is 3 sprays. What’s missing is the specific numbers this refers to.

All very confusing really! But the long and short is recommended dose = 3 sprays daily = 3000IU

Cup-cake7 profile image
Cup-cake7 in reply tohjh88

Well it's misleading, really grateful. TY

Cup-cake7 profile image
Cup-cake7 in reply tohjh88

....I like the product as long as it does what it is supposed to do 🙈🤣

hjh88 profile image
hjh88 in reply toCup-cake7

It’s a bit confusing not having all the info on the bottle. There are a good few supplements that require multiple sprays/tablets to get the recommended dose though. And the recommended dose isn’t always the right dose for everyone! Always worth a good read of the leaflet or jar.

Cup-cake7 profile image
Cup-cake7 in reply tohjh88

👍🏼 Il get new reading specs too lol

Cup-cake7 profile image
Cup-cake7 in reply tohjh88

Thankyou

I know! I can't read the bottle🤷‍♀️ Mine is the red bottle 3000

Great link thanks a lot

Cup-cake7 profile image
Cup-cake7 in reply tohjh88

Omg. How confusing is this, It says 3000 on the spray! Thankyou. No wonder !!!

Gingernut44 profile image
Gingernut44

I agree with hjh88 - you have to take 3 sprays of Better You to get 3000 so, if you've only been taking 1 spray, sometimes 2, you haven't been taking enough. Try that first before you ditch it 😊

Cup-cake7 profile image
Cup-cake7 in reply toGingernut44

Ah thanks ginger nuts, I buy the 3000 though

Cup-cake7 profile image
Cup-cake7 in reply toGingernut44

Omg I'm really shocked. Thankyou!!!!

asidist profile image
asidist

Prob best to take vitamin d and k a few hours apart per below.

Consumerlab: “Large doses of vitamin E may antagonize vitamin K, making it less effective (Traber, Nutr Rev 2008), and there is potential concern about other fat-soluble vitamins. A laboratory experiment using intestinal cells from mice found that uptake of vitamin K was reduced by approximately half by vitamins A, D, and E — likely due to competition for absorption among these fat-soluble vitamins (Goncalves, Food Chem 2015). Interestingly, vitamin K did not significantly reduce uptake of the other fat-soluble vitamins. While there do not appear to be studies demonstrating reduced vitamin K absorption in people due to vitamin D, it may be best to take vitamin K at least 3 hours apart from vitamin D and not from "bone health" formulas (such as many in this review) which include vitamin D. Keep in mind that such formulas are rarely clinically tested in people for ingredient absorption, let alone for efficacy and safety.”

The Gonclaves article cited above: Fat-soluble vitamin intestinal absorption: absorption sites in the intestine and interactions for absorption -

ncbi.nlm.nih.gov/pubmed/254...

Cup-cake7 profile image
Cup-cake7

Thankyou very much asidist quite comprehensive and interesting. Il read again later to absorb, Nothing straight forward, I'd love to take a multimineral and be done with it 🙃

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