I recently posted here as I've been recently diagnosed with hypothyroidism, and am struggling to conceive. Thanks to all who responded.
As suggested, I had some blood tests done with Medichecks, the results are below. Is there anything I need to be concerned about?
I had an email consultation with my GP prior to getting these results as I was not feeling great, they have increased my medication from 50 to 75mg levothyroxin, which I have been taking for 10 days now. I will send these results to them as well.
Inflammation
CRP HS 2.31 mg/L (Range: < 5)
Iron Status
Ferritin 108 ug/L (Range: 13 - 150)
Vitamins
Folate - Serum ! Sample error
Vitamin B12 - Active 82.000 pmol/L (Range: > 37.5)
Thyroglobulin Antibodies X 132.000 kIU/L (Range: < 115)
Thyroid Peroxidase Antibodies X 50 kIU/L (Range: < 34)
They have recommended supplementing with 20-50 mcg (800 -2000 iu) of vitamin D per day for twelve weeks, reducing to 10 mcg (400 iu) per day after that.
Thanks all for any advice.
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They have recommended supplementing with 20-50 mcg (800 -2000 iu) of vitamin D per day for twelve weeks, reducing to 10 mcg (400 iu) per day after that.
I gave a description of how to dose for low vitamin D in this post earlier today :
Based on the info in my post, you need 3000 iU - 5000 iU vitamin D3 per day if you weigh 140lbs (10 stone).
The very first time I had my vitamin D tested it came out as being borderline deficient. Thinking that I didn't need to improve it much I took a dose of 1000 iU vitamin D3 per day for a few months, going into summer. My level actually dropped quite noticeably.
Nowadays I take 2000 iU per day just to maintain my current level, some people need more than that, a few need less. Doctors rarely prescribe enough vitamin D to raise level and never prescribe enough to maintain it when it is optimal. It is easy enough (under normal circumstances) to buy 5000 iU doses of vitamin D3 online. See SeasideSusie's replies on the subject of co-factors (vitamin K2 and magnesium) required for anyone taking vitamin D3.
The lower the better with CRP as this is an inflammatin marker, yours is mid-range so no cause for concern.
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Ferritin 108 ug/L (Range: 13 - 150)
That's a nice result. Do you supplement?
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Folate - Serum ! Sample error
Are they sending another test out free of charge? This seems to happen a lot with this test.
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Vitamin B12 - Active 82.000 pmol/L (Range: > 37.5)
Not too bad but I'd want mine over 100. The range is actually 37.5-188.0 I think, it will be shown on the bar graph, the green area.
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Vitamin D X 43.5 nmol/L
The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L. To reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 4,000iu D3 daily
As you have Hashi's** (see below), you may want to use an oral spray (eg BetterYou) as this bypasses the gut, some Hashi's patients also do well with an oil based softgel (eg BetterYou).
Retest after 3 months.
Once 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.
The aim of a thyroid patient on Levo, generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges. Your FT4 was 43% through range and FT3 was 29.73% through range so they were low. Your increase from 50mcg to 75mcg Levo will help, retest in 6-8 weeks and see where your levels are then, you may need a further increase.
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Thyroglobulin Antibodies X 132.000 kIU/L (Range: < 115)
Thyroid Peroxidase Antibodies X 50 kIU/L (Range: < 34)
Your raised antibodies suggest that you are positive for autoimmune thyroid disease aka Hashimoto's which is where the thyroid is attacked and gradually destroyed. This is the most common cause of hypothyroidism.
Fluctuations in symptoms and test results are common with Hashi's.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Wow, thanks very much for the detailed advice, I will look into all your suggestions, especially looking into the Hashimotos. I'm surprised the doctors notes with the blood tests didn't spot that.
I'm taking a standard Pregnacare pre conception vitamin.
I'm not getting a retest for the folate due to the current virus situation.
I'm taking a standard Pregnacare pre conception vitamin.
Presumably it contains iron? If so then take it 4 hours away from your Levo as iron affects absorption of medication and supplements so needs to be taken well away..
Hiya, no I didn't. We had a lot going on as we started back on IVF, so it was pushed to the side. I will now start looking into it. Thanks so much for following up.
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
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
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Vitamin D ....important to get higher, at least around 80nmol and around 100nmol may be better
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.
Bloods should be retested 6-8 weeks after each dose increase in levothyroxine
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.
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. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
No other medication or supplements 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)
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
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