I Fasted and I did not take levothyroxine for over 24 hrs.
How much over 24 hours? Because that FT4 is very, very low. How much levo are you taking? What was it before it was reduced.
You should never accept a reduction in dose based simply on the TSH. You are only over-medicated if they FT3 is over-range. Obviously, your doctor doesn't know anything about thyroid.
Your vit D, B12 and folate are much too low. Possible that you have absorption issues.
OK, so not a lot over 24 hours. So, I think we can safely say that your FT4 is much, much too low, and you need your dose put back to 100 mcg. It should never have been reduced. Can you see a different doctor?
As guided on the forum I had a blood test yesterday.
I Fasted and I did not take levothyroxine for over 24 hrs.
In your previous post, SlowDragon advised as follows:
and last dose levothyroxine 24 hours before blood test
From what you have said above, last dose on Saturday at 6am, test on Monday at 8.45am, you left almost 51 hours which does beg the question "why" when you were given the correct advice.
Free Thyroid 10.8 (12.0-22.0)
Because of your timing you have a false, very low FT4 and there is no way of knowing what it could be.
As your new TSH result is 4.09, what has your GP said about this? It suggests you need a dose increase.
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Vitamin D 46
I have been told I have a slightly reduced Vit D and recommended to take 25mcg ( also labelled 1000iu)
This is more than slightly reduced., it's far too low. The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L. A dose of 1,000iu D3 will not raise your level, it's just about a maintenance dose for some people with a decent level already. To reach the recommended level you will need to take 5,000iu D3 daily along with D3's important cofactors - magnesium and Vit K2-MK7.
Retest after 3 months.
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:
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.
This is low, although your GP wont agree because it falls within it's range.
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Many people with a level in the 300s have been found to need B12 injections. You can check to see if you have any signs/symptoms of B12 deficiency here:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
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Folate 5.3 (3.0-20.0ug/L)
This is low. Folate is recommended to be at least half way through range. Eating folate rich foods and a good bioavailable B Complex (eg Thorne Basic B or Igennus Super B) will help. Don't start taking this before further B12 testing if necessary. If B12 injections are to be given, start the B complex afterwards.
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Your ferritin is high, this can be caused by inflammation or infection but you could discuss this with your GP.
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I can see the forum advises a 4 hr. gap between Levo and vitamins.
This is for iron, calcium, magnesium and Vit D when absorbed through the gut (ie swallowed with water). It doesn't apply to the oral spray Vit D or topical magnesium (gel/cream or Epsom salts baths/foot soaks) as those aren't absorbed through the gut.
Other vitamins can be taken 2 hours after thyroid meds.
You are clearly now under medicated as TSH is far too high
TSH is slow to respond, so won’t have been affected by leaving too long between last dose levothyroxine and blood test
(Next time remember to only delay taking Levothyroxine until immediately after Blood test, so only 24 hours gap
Teva brand of Levothyroxine upsets many many people
See GP ASAP for increase in levothyroxine back to 100mcg
When you get new prescription for 100mcg make sure to have same brand that you had previously
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. (collect paper prescription from GP’s then you have choice of pharmacy )
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.
B vitamins best taken in the morning after breakfast
Igennus Super B complex are nice small tablets. Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks
Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
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