Advice on latest blood tests please : I’d... - Thyroid UK

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Advice on latest blood tests please


I’d appreciate your advice and feedback on my latest blood test results and endocrinologist visit.

I have been taking 3x12.5mcg of T3 for the last 3 months. I upped this from 3x10mcg of T3 to see if any of my symptoms improved. The migraine aura I experience almost daily has virtually disappeared and my ongoing acid reflux has also improved. My problem is when I’ve been on previous higher doses of T3 (42.5mcg) my cortisol levels start to run high.

I spoke with the endocrinologist this morning and I explained the above to him and he suggested trying 3x10mcg of T3 and 25mcg of T4 and retest in 12 weeks. I am to continue to take Vit D 50,000 every two weeks and 1 mcg of folate. I have bought some iron supplements. I do eat 100g of liver every week and I will continue to do this.

TSH 0.69 (0.27-4.2mlU/L)

FT4 1.5 (12-22 pmol/L)

FT3 5.9 (2.8-7.1 pmol/L)

Vit D 51.88 ng/mL

<10 ng/mL Deficient

10-30 ng/mL Insufficient

31-100 ng/mL Normal

> 100ng/mL toxic

Ferritin 86.91 (13-150 ng/mL)

Folate 81.46

Normal >12.19

Deficient <7.63

Vit B12 714.90 (197-866 ng/mL)

Calcium 9.56 (8.5 - 10.5 mg/dL)

I also have the results from a full blood count if they are helpful.

Results from 21.09.19 on T3 3 x 10mcg

TSH 2.01 (0.27-4.2mlU/L)

T4 0.26 (0.89-1.76 ng/dL)

T3 3.29 (2.3-4.2 pg/mL)

Ferritin not tested

Vit B12 613 (211-911 pg/mL)

Vit D 24.73

<20 Deficiency

20-30 insufficient

30-100 sufficient

>100 toxic

Folate 10.16

>12.19 normal

< 7.63 deficient

7.63-12.19 intermediate

Thank you.

20 Replies

sorry just had a quick read of your other posts. So you switch from levothyroxine to T3 because levothyroxine didnt work. You were stable on T3 but it then got altered because it was thought it caused high cortisol? Is that right? And since lowering the T3 dose your cortisol levels have stabalised but you are now how having symptoms of hypothyroidism? Is that correct?

Am just wanting to clarify as it sounds quite complex.

LynLyn in reply to waveylines

I went onto it because I was so run down and very unwell about two years ago. I’m happy to try it now my vitamin levels are keeping better. I can’t take anymore T3 so there’s no alternative as far as I know.

waveylines in reply to LynLyn

Did you ever try a ndt? And did lowering the T3 lower the cortisol? Am only asking as to whether that link has been established as a fact. It is possible to have more than one condition.

You arent doing the circadian rhythm method that Paul Robinsons advocated for low cortisol & its caused high cortisol?

LynLyn in reply to waveylines

I was on NDT 1.5/1.75 grains (I couldn’t take any more) for ten years and I wasn’t too bad for the first five years but the last five years I became very rundown and couldn’t increase my dose although my levels weren’t optimal. I didn’t know about vitamin levels in those days unfortunately. Previous to that I was in 50mcg of thyroxine which I was on for 8 years. I ended up very unwell and fortunately found Dr P who brought me back to life.

LynLyn in reply to waveylines

I did do the circadian rhythm method but only for a short time as being on T3 improves my cortisol levels dramatically and I no longer needed it. Lowering the T3 did lower the cortisol - it took about 4 months to get over how I felt from high cortisol. I don’t know if the high cortisol was just a reaction to beginning treatment on T3. I should test now but I’m not in the UK and tests aren’t available where I live. I am assuming that’s what the headaches are I’m having. It could of course be the low iron. That’s why I’ve posted - to see what people think. Thank you for all your messages.

LynLyn in reply to waveylines

Yes that’s it exactly! I get headaches too and feel very tired when I raise above 35 mcg of T3 although flashing lights and acid reflux improve!

waveylines in reply to LynLyn

Apart from the extra D3 that you are quite rightly on. What vitamins & minerals are you on? I am no expert on these or iron - you really need someone like Seaside-suzie to come along.

Fingers crossed that the new introduction back of levothyroxine will help you.

LynLyn in reply to waveylines

Thank you for replying. It’s good to have someone to chat with about this. Also methyl folate 400ug and iron (not prescribed) 18mg of fortified heme iron. How do I tag Seaside Susie into this thread?

waveylines in reply to LynLyn

Awww happy to not expert but more than willing to share what I know. There are lots of clever people on here who am sure can help you so keep posting.

Am not sure how you do that so sorry..... You could click on her name and send her a message. 😊

Also did you stop b vits folate for one week before blood tests? Most b vits have biotin in them & that interferes with the tests......can give false results.

LynLyn in reply to waveylines

Oh no I didn’t stop folate! Well, perhaps it’s best to ignore that result then! I don’t take b12 - I eat 100g of Liberty every week - since last summer. Hopefully soon I’ll hear from Seaside Susie. I’ll try and message her... Thanks again for taking the time to message

waveylines in reply to LynLyn

I dont think folate is a problem. Its if its taken in a complex b vit tablet which contains biotin. So it might be you are fine as you were only taking folate. Check on the bottle to see if it contains biotin.

LynLyn in reply to waveylines

It just says folic acid 1mcg nothing else. I’ve been given methyl folate 400mcg this time as they didn’t have the other!

waveylines in reply to LynLyn

Then thats fine then...... 😊

LynLyn in reply to waveylines

Thank you so much!



Vit D 51.88 ng/mL (was 24.73)

I am to continue to take Vit D 50,000 every two weeks

The Vit D Council/Vit D Society recommend a level of 40-60ng/ml. Your level is good, you might want it at the top of the range but there's nothing wrong with mid-way.

50,000iu D3 every two weeks = 3,571iu daily.

If you continue at this dose then it's essential you retest in 3 months' time. Once you reach 60ng/ml I would reduce to a maintenance dose, 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.

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.

K2-MK7 comes in two forms - All-Trans and Cis form.

All-Trans form v Cis form:

The recommended amount of K2-MK7 is 90-100mcg for up to 10,000iu D3. The best form of K2-MK7 is the All-Trans form rather than the Cis form. The All-Trans form is the bioactive form, the Cis form is inactive (a bit like methylfolate is the bioactive form of folic acid).

There's lots of information available but mainly seems to be on sites selling supplements so I wont link to them, but the message is:

"Since trans-isomer MK-7 are more readily used by our body, they are considered more bioactive. Many K2 ingredients have a mixture of cis and trans isomers, depending on how well they are produced. You’ll want to look for K2 supplements with a high percentage of trans-isomer MK-7, ideally 100%."

The Cis form is cheaper and is what many K2-MK7 supplements use but they don't tell you this.

The All-Trans form can be available as liquid drops, eg Vitabay Organics, or capsule, eg VegaVero. I have used both, they are available from Amazon and maybe other places.

MK7 is fat soluble so should be taken with some dietary fat - traditional English breakfast maybe, or other meal containing fat.

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.

Ferritin 86.91 (13-150 ng/mL)

I have bought some iron supplements. I do eat 100g of liver every week and I will continue to do this.

Your ferritin level is good, it is recommended to be half way through range which is 82-ish with that range.

Have you had a full blood count and iron panel? Do you have iron deficiency (or iron deficiency anaemia)? If not you shouldn't be taking iron tablets. I would continue with the liver as that will maintain your level but if you already have a good serum iron level and saturation percentage then taking iron tablets could raise your levels and that wouldn't be a good thing, too much iron is as bad as too little.

Folate 81.46 (Normal >12.19) (was 10.16)

I am to continue to take .... 1 mcg of folate

It just says folic acid 1mcg nothing else. I’ve been given methyl folate 400mcg this time as they didn’t have the other!

It will be 1 mg (1 milligram) of folate not mcg (microgram).

Your folate is high, far higher than it needs to be. Personally I wouldn't take anything for the moment, I'd let the level fall until it's down to about 20 then 400mcg methylfolate should be more than enough to maintain the level.

Vit B12 714.90 (197-866 ng/mL) (was 613 (211-911 pg/mL)

Your B12 level is good.

You could introduce the Levo at the full 25mcg dose or just start with 12.5mcg initially and see how things go.

If you are in the UK, be aware that Teva brand (and Northstar 25mcg which is made by Teva) does cause adverse reactions in a lot of people. Some members do fine on it, it's lactose free, but many have reacted badly to it.

LynLyn in reply to SeasideSusie

Thank you so much for your very comprehensive reply. I wish I had found this forum years ago and I could have avoided so much ill health. I am so pleased that my iron levels are good enough to begin taking levothyroxine. Thank you again for your wonderful reply.

LynLyn in reply to SeasideSusie

Hello again

I’ve had time to read your reply many times.

Is it dangerous to take Vit D without the co factors? I have looked for sometime for K2 with MK7 and I’ve been unable to find any. There are some on but cheaper ones. Is it better to go with a cheap one than nothing?

I use Epsom salts in the bath. Is this enough to count as a magnesium supplement? I try to avoid supplants due to my absorption problems.

I’ve not taken iron supplements just ate 100g liver once a week for a year! Will keep that going.

I will start on 12.5mcg as I’ve always had problems with T4 and I want to give it the best chance. I understand from my readings here to take it first thing on an empty stomach with water.

I’m in the United Arab Emirates and they’ve given me Euthyrox by Merck. I don’t know anything about brands of thyroxine. Thank you for the warnings about those brands though. I don’t need any complications!

Thanks again for all your help. 🌟

SeasideSusieAdministrator in reply to LynLyn

Epsom salts baths and footsoak seem to be enough for some people.

We need Vit K2 when taking D3 because of the calcium, as explained above. We need the calcium directed to bones and teeth and not settling in arteries and soft tissues.

I've just checked and out of those listed I would choose Jarrow MK7.

LynLyn in reply to SeasideSusie

Thank you so much for looking on there - I’ll get some ordered!

Thank you again for helping me so much! I’m hoping I’m on the road to a lasting recovery!

Hi Seaside Susie. Thank you for all the information you gave me about K2 MK7. I wanted to ask about the dose with 50,000 of Vit D. You mention about 90-100mcg of K2 MK7 for 10,000 Vit D. Does that mean taking 5 K2 MK7 pills when I take a 50,000 Vit D? Thank you

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