Bone problems

[Gillybabe48]

I had full blood tests for thyroid and inflammation markers, vitamin D and B12. All normal except TSH 0.02 range 0.35-5.00 and T4 18.5 in range 7.50 - 20 and T3 5.5 in range 4.20 - 6.90. I have already dropped dose due to my TSH being 0.07 last time. Doctor wants to talk to me about TSH I really feel I do not want to drop again. Any advice would be helpful.

[Marz]

What were your results for VitD and B12 ? I asked you on your thread of two months ago but you did not reply ...

[Gillybabe48 in reply to Marz]

Just getting print out today. Will post as soon as I have them.

[Gillybabe48 in reply to Gillybabe48]

Just got it. Vitamin D is low and I have letter on what to eat and to take vitamin D OTC 800 to 2000. It came back 28 which indicated insufficiency. Where do I get Vitamin D.

[Gillybabe48 in reply to Marz]

Vitamin D was 28 and they did not do B12 as I thought they had.

[Marz in reply to Gillybabe48]

Your GP should be following Guidelines for the treatment of Low VitD in your area- not expensive to treat yourself.

You need a dose of around 5000 iu's. Many people here use a spray by Better You - from Amazon. Re-test at the end of winter to establish a maintenance dose to keep your level around 100. Some contain VitK2- MK7 which is good. Also take magnesium.

B12 - Folate - Ferritin must also be tested.

You do not need to reduce your dose - you are only over- medicated when the FT3 is over range. Yours is not!

[Gillybabe48 in reply to Marz]

Thank you

[msmono]

Hi, I'm having a similar problem with my G.P. But how are you actually feeling? I believe that Dr Toft says it's ok for TSH to be suppressed which yours is mildly and T4/T3 to be in the upper part of the reference range or wherever the patient feels sympton-free? Your TSH has gone up a little so they should be happy with that? My only advice would be to stand firm when you speak to them on how you actually feel - i.e. if you feel ok. It's so easy to crumble when talking to authoritative medical types has been my experience. Good luck!

[greygoose]

Your doctor should not be dosing by the TSH. It's the FT3 that is the most important number, and you are not over-medicated unless your FT3 is well over-range. Yours is only just mid-range, so you cannot possibly be over-medicated. Just refuse. It is supposed to be a partnership between doctor and patient, and the patient is supposed to give informed consent to all treatments and changes in treatment. If you disagree, tell him so. He is not there to dictate to you, but to advise. If you don't chose to take his advice, then that is your privilege.

[SeasideSusie Remembering]

Gillybabe48

Can I ask why your thread title is "Bone problems" yet you haven't mentioned this in your post?

As for your thyroid test results:

TSH 0.02 range 0.35-5.00

T4 18.5 in range 7.50 - 20

T3 5.5 in range 4.20 - 6.90

Your FT4 is 88% through it's range and your FT3 is 48.15% through range.

You need to point out to your GP that TSH is not a thyroid hormone but a signal from the pituitary. The thyroid hormones are FT4 and FT3 and both of these are within range and do not show overmedication. If anything, they show that your T4 to T3 conversion is not particularly good (they would be fairly well balanced if conversion was good).

[Gillybabe48]

Yes I put bone problems as my bottom back is stiff and muscles ache and feel weak on exercise and as soon as I exercise I feel extremely hot.

[Angel_of_the_North in reply to Gillybabe48]

Probably caused by low vit D.

[SeasideSusie Remembering in reply to Gillybabe48]

Gillybabe48

I wasn't notified of your reply. You need to click the blue reply button directly under the post you are responding to in order for that person to be notified that you have replied to their post. Or tag them like I have done and ensure their name turns blue, that also notifies them.

I agree with Angel, muscle and joint aches and pains can be due to low Vit D.

I can see that you have replied to Marz and said that your Vit D level is 28, presumably that is 28 nmol/L in which case it is only just 3 points above Vit D deficiency.

If it definitely is 28 nmol/L then personally I would treat it as deficiency and follow the NICE Clinical Knowledge Summary:

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

(click on Management > Scenario:Management)

"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 25 nmol/L.

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, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.

* 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)."

So if that was me I'd be using Doctor's Best oil based softgels (they are pure and only have 2 ingredients - D3 and extra virgin olive oil) and to achieve 300,000iu over 6 weeks I would take 50,000iu a week made up of whatever is convenient on a daily basis. Probably cheapest to buy 5,000iu dose ones and I find the cheapest place is Dolphin Fitness (easily found on Google).

Retest after the loading doses have finished then come back with your new level so that we can then work out what your follow on dose should be.

Doctors don'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 Vit 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 D3 as 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 magnesium as tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

[SlowDragon Administrator]

Insist GP tests folate, B12 and ferritin

Low vitamin levels lead to low TSH

Your Ft4 is not high

Ft3 too low

You do NOT need dose decrease in levothyroxine

Vitamin levels likely low due to recent (probably inappropriate) dose reduction

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Do you have Hashimoto’s?

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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 you do your tests?

[Gillybabe48]

Thank you. Spoke to doctor today and he wanted me to drop dose. I stood my ground and he agreed with me to stay on present dose. So relieved about this.

[SlowDragon Administrator in reply to Gillybabe48]

Absolutely essential to test folate, ferritin and B12 ....did GP do this?

Did you get LOADING dose vitamin D prescribed ?

That’s 300,000iu vitamin D over 6-8 weeks?

Equivalent to 5000iu per day for 8 weeks or 7000iu per day for 6 weeks

It’s trial and error what dose we need, on levothyroxine we frequently need higher dose than average

ouh.nhs.uk/osteoporosis/use...

Level of vitamin D should be retested at end of course

GP will only prescribe Vitamin D to bring levels to 50nmol.

But improving to around 80nmol or 100nmol may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there. That may need to be as much as 2000iu per day, or sometimes even higher

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7 (for bones)

Government recommends everyone supplement October to April

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

Magnesium important cofactor

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...

If vitamin D is low, B vitamins may be too. As explained by Dr Gominack

drgominak.com/sleep/vitamin...

healthunlocked.com/thyroidu...

low vitamin levels likely due to have had levothyroxine dose reduced

Do you have Ft4 and Ft3 results from when TSH was 0.07?

If Ft3 was not over range you were not over medicated