Oh dear, your help with a little more information again, please.
My Free T3 is 3.54 (11% through the range) and my Free Thyroxine is 23.3 (114% through the range) I know this is not good (Slow Dragon kindly calculated and commented) but I’m not sure what optimum figures would be, either for each separately or relative to each other. Can someone advise in simple language please? Thank you so much
You are on T4 only, and the ratio of FT4/FT3 is 6.6/1, That demonstrates your inability to convert the T4 you take to T3 in anything like a satisfactory way. It strongly looks that you are a candidate for T3 supplementation as well as T4. However in the present climate it will be difficult to convince doctors
Thank you diogenes! What ratio should I be looking for please? (agree about doctors, they seem to have other things on their mind currently)
Something less than 4.5/1 would be useful if on combination therapy (but that is only a guide: your own experience must teach you what is best).
weewillywinkie
The aim of a treated Hypo patient on Levo, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges.
Every one is different so we can't say exactly where your level should be but mostly people feel best when FT4 and FT3 are in balance possibly around 70%-ish through range - give or take for indivduality.
You already know that your conversion of T4 to T3 is poor and that your FT4 is high and FT3 is low and that it's been suggested that you test Vit D, B12, Folate and Ferritin. All these need to be at optimal levels for good conversion to take place, so that should be your next step.
Thank you so very much. I have taken your previous advice and tested for Vit D, B12 etc etc and so far my Vit D is very low. I'm taking a supplement and will retest in a few weeks.
How low was vitamin D and how much are you supplementing?
Was this prescribed by GP?
GP will only prescribe to bring levels to 50nmol.
ouh.nhs.uk/osteoporosis/use...
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.
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
It’s trial and error what dose we need, with hashimoto’s or Graves disease we frequently need higher dose than average
Government recommends everyone supplement October to April
gov.uk/government/news/phe-...
Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamins
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Bone pain
easy-immune-health.com/pain...
naturalnews.com/038286_magn...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
If vitamin D is low, B vitamins may be too. As explained by Dr Gominack
drgominak.com/sleep/vitamin...
healthunlocked.com/thyroidu...
What were actual results and ranges of folate, ferritin and B12?
Have you had coeliac blood test yet?
Hello!
Ferritin: 147 (30-400), Folate: 9.42 (3.89 to 19.45) B12: 108 (37.5 to 187.5)
Vitamin D: I only took pharmacist's advice. 5000iu (125ug), Whatever that means. I'll certainly get the mouth spray.
Coeliac blood test: No what is the significance of that please
Thank you
So you haven’t actually had vitamin D tested?
Suggest you get tested after 6 weeks on vitamin D
Changing to a strictly gluten free diet may help reduce symptoms and help gut heal
Incredibly high number of Graves and Hashimoto’s patients find strictly gluten free diet helps or is essential
While still eating high gluten diet buy Coeliac blood test online for under £20, just to rule it out first
It’s easy test to do
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying strictly gluten free diet for 3-6 months
If no noticeable improvement, reintroduce gluten and see if symptoms get worse
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
Thank you! Sorry if I confused you, yes I have been Vit D Tested and it was v low: 14.6 (50 to 175). Just the UK winter maybe?
weewillywinkie
Thank you so very much. I have taken your previous advice and tested for Vit D, B12 etc etc and so far my Vit D is very low.
Looking through your posts, I can't see one where I've replied to you with suggestions about supplementing.
What is your Vit D level?
Hello! Vitamin D level was very low: 14.6 (50:175) Just winter maybe?
weewillywinkie
Vitamin D level was very low: 14.6 (50:175) Just winter maybe?
Absolutely not! That is severe Vit D deficiency. Has your GP seen these results? If not then you need to discuss this result with him and he should follow NICE Clinical Knowledge Summary for Vit D deficiency:
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)."
Once the loading doses are finished then it's essential to retest to check your level so that you know what follow up dose to take. As you have severe deficiency, supplementing will be for life with retesting twice a year to ensure levels stay within the recommended range.
Many doctors refuse to retest due to the Vit D test being expensive (so they say), but if GP wont do it then it's essential you do it yourself and this can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public for £29:
The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L so that level should be your aim, although your GP wont agree, they just want to see it over the 50 mark. GP may follow up with 800iu D3 but that wont be enough, so come back with new level when you have it for further guidance.
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...
Gosh. Thank you so much. I've made an appointment with my GP and you have equipped me with so much knowledge
Weewillywinkie
Please come back and let us know what he says. I had severe Vit D deficiency with a level of 15nmol so have been in your position.
Thank you so much for your interest. To update you, because of the lockdown I purchased 5000iu Vitamin D3 tablets and wrote to my doctor asking him to confirm my Vit D levels are deficient and that the dosage is adequate to rectify the deficiency in time for my next blood test in Mid May. He has just done so.
I am already feeling slightly better.
Once again, thank you. You and your colleagues have been vital guides in helping me make sense of what is going on with my thyroid
weewillywinkie
Please make sure that you follow the NICE treatment summary for Vit D deficiency: 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 that's 60 days at 5,000iu. It's essential to retest once the loading doses are completed. Your GP may not be willing to do it, in which case you should do it with the NHS lab which offers this test to the general public:
Please come back with the new level at that time we will work out what your follow on dose should be to get you up to the recommended level of 100-150nmol/L.
Please also remember to take the important cofactors mentioned above - magnesium and Vit K2-MK7.
Can you just confirm which D3 you have bought? If they are tablets then they are the least absorbable form and there are better options out there. I went from 15nmol/L to 202nmol/L in 2.5 months using Doctors Best D3 softgels but I did start at a higher loading dose than you for a couple of weeks.
Thank you. Yes, I've scheduled to retest Vit D3 week commencing 23rd May, (60 days after I commenced). I bought "Natures Aid Maximum strength Vitamin D3 tabs but am happy to hear of anything better. I'm taking the magnesium and K2-MK7 tabs are on order
weewillywinkie
That's not a supplement I would consider. Absorption from tablets is poor and tablets tend to contain quite a few excipients - unnecessary inactive ingredients - to be able to make the tablet. I prefer to avoid excipients as much as possible.
D3 needs fat to be absorbed and tablets can't contain fat.
Oil based softgels contain the fat needed for absorption.
I use Doctors Best which contain just 2 ingredients - D3 and extra virgin olive oil.
Take D3 4 hours away from thyroid meds, same with magnesium.
Vit K2-MK7 is also fat soluble so, like D3, it needs to be taken with some dietary fat, if you have bought oil based K2-MK7 softgels that will be fine.
If your D3 and K2 are not oil based, take them at different times of the day with some dietary fat, otherwise they will compete for the fat for absorption.
Thank you! Both ordered.
That’s extremely deficient
Common side effect of being hypothyroid (on inadequate dose of levothyroxine)
GP MUST prescribe LOADING DOSE of 300,000iu over 6-8 weeks
That’s 5000iu per day over 8 weeks or 7000iu per day over 6 weeks
GP will only prescribe to bring levels to 50nmol.
ouh.nhs.uk/osteoporosis/use...
But improving to a minimum of at least 80nmol and 100nmol may be better
ncbi.nlm.nih.gov/pubmed/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, it’s very likely you 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 very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7
It’s trial and error what dose we need, likely to be at least 2000iu per day every day .... aye more
Government recommends everyone supplement October to April
gov.uk/government/news/phe-...
Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamins
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Bone pain when correcting very low vitamin D
easy-immune-health.com/pain...
naturalnews.com/038286_magn...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
If vitamin D is low, B vitamins may be too. As explained by Dr Gominack
Low vitamin levels frequently suggest gluten intolerance.....
So getting coeliac blood test too
T3 & T4 - What is optimum?
Low Free T3 and Reverse T3
T3 and blood results 
New to T3 (and confused)
Help (request No.2)! Blood results give unexpected drop in % through range of Free T4, Free T3 and quite an increase in TSH
