Congenital hypo daughter

[Kmm44]

My daughter recent bloods say tsh 2.4, t4 24,t34.5, vit d 66, b12 299, ferritin 32 .

Really heavy periods and pins and needles together with lethargy .

Discussion welcome . On 175 mcg daily t4 only

[Marz]

VitD - B12 - Ferritin - are all low in range and could well be the cause of her symptoms

Supplementing should help. I see you are new to the forum so reading other posts will help - especially excellent posts by SeasideSusie.

It would help if you are able to pop the ranges in for the results - as labs do vary up and down the country.

If you need help please shout 🥰

[SlowDragon Administrator]

Does she always get same brand of Levothyroxine?

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits, 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.

No other medication at same as Levothyroxine, leave at least 2 hour gap.

Some like calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

Does she always remember to take her Levothyroxine. Getting a weekly pill dispenser highly recommended, makes it much easier to remember daily medication

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

verywellhealth.com/best-tim...

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)

Is this how your daughter does her tests?

Can you add ranges on all results please

FT3 looks low, as does B12 and ferritin

No folate test?

Heavy periods are classic sign of being hypothyroid and still under treated

As her FT4 looks high within range, she may need addition of small doses of T3 alongside Levothyroxine

Getting vitamin levels optimal first by supplementing is essential

Assuming vitamin D is measured in nmol - 66nmol 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 she will need on going maintenance dose to keep it there.

Test 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 when hypothyroid we need higher dose than average

Government recommends everyone supplement October to April

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

Magnesium supplements can be good idea too.,

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Bone pain

easy-immune-health.com/pain...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

intechopen.com/books/cell-s...

[waveylines]

Your daughters symptoms fit b12 deficiency. The link below leads you to an assessment set up by Dr Chandry -well known but now retired uk GP. He also has a book that is free to download that might be of interest.

Although her B12 is in range it is very low. The PA socety reccomends over 500.

b12d.org/admin/healthcheck/...