Hypothyroid and vitamins/minerals

[holabola]

Hi I'm just amazed at the information on here and the knowledge. I get annual bloods done at doctors but am ignorant of levels and such. Only told to maintain dosage or change if told necessary. It appears I should be asking lots more questions and become much more aware of my condition. On the whole I never feel 100% and always put that down to the hypothyroid, but I would like to know what vitamins/minerals might help me feel better? I am currently on 75mg Levothyroxine daily. thank you.

[fuchsia-pink]

Hi there

I'll bet they just test TSH and tell you you're "in range" ....

If you don't feel tip-tip you really need full testing to see exactly where you are ... so TSH, free T4, free T3, thyroid antibodies and key nutrients - ferritn, folate, vit D and B12.

You need to have your bloods done early in the morning, fasting, and with a 24 gap from your previous dose of levo.

You need free T3 and free T4 to see what your thyroid is doing (TSH comes from the pituitary). Many of us need these to be in the top quartile of the range to feel our best. You need the key nutrients testing because your levo works best when these are nice and high

In the meantime, to get the most from your levo, you need to take it on an empty stomach, just with water - 2 hours after food / one hour before food and 4 hours from certain supplements.

Post all the results, and the ranges here (ranges vary from lab to lab) and the lovely people will tell you what might need improving. Don't let your GP get away with saying things are "in range" - you are legally entitled to your blood results, with no need to give a reason. The lab ranges are very wide and it's where you are in range that matters...

And if the GP won't do the testing you need, go for private tests if you can - you will see lots of posts about these and eg Medichecks usually has a discount on a Thursday.

Good luck x

[holabola in reply to fuchsia-pink]

Thank you fuschsia-pink I will arrange this as soon as coronavirus lockdowns are lifted.

[Lalatoot]

Hypo patients are often low on vitamins and need to supplement. However we only need to supplement with the ones that are lacking. If we just supplemented then we would knock the system out of balance.

The first step is to get vitamin D, B12, folate and ferritin tested. The results need to be over half way through the ranges otherwise the levels are too low for us.

If you do then supplement a multi-vitamin is not recommended as these don't target what we need and do give us things we don't need. They also tend to be of poorer quality.

[holabola in reply to Lalatoot]

thank you Lalatoot

[SeasideSusie Remembering]

holabola

As fuchsia-pink has said, to get a full picture you need a full thyroid/vitamin panel - unlikely to get all done with your GP. If you wish to do a private test, only fingerprick version or "arrange your own blood draw" are available at the moment, and the most popular tests here are:

Medichecks Thyroid Check ULTRAVIT medichecks.com/thyroid-func...

You can use code THYROIDUK for a 10% discount on any test not on special offer, but check on Thursday to see if they have a special price for it

or

Blue Horizon Thyroid PREMIUM GOLD bluehorizonbloodtests.co.uk...

Both tests include the full thyroid and vitamin panel. They are basically the same test but with the following small differences:

For the fingerprick test:

Blue Horizon requires 1 x microtainer of blood (0.8ml), Medichecks requires 2 x microtainers (total 1.6ml)

Blue Horizon includes Total T4 (can be useful but not essential). Medichecks doesn't include this test.

B12 - Blue Horizon does Total B12 which measures bound and unbound (active) B12 but doesn't give a separate result for each. Medichecks does Active B12.

Total B12 shows the total B12 in the blood. Active B12 shows what's available to be taken up by the cells. You can have a reasonable level of Total B12 but a poor level of Active B12. (Personally, I would go for the Active B12 test.)

Blue Horizon include magnesium but this is an unreliable test so don't let this sway your decision, it also tests cortisol but that's a random cortisol test and to make any sense of it you'd need to do it fasting before 9am I believe.

**

TIPS FOR DOING FINGERPRICK TEST

* Be well hydrated, drink plenty of water the day before, and before you do the test.

* Some people take a shower before hand, some run up and down the stairs to get blood flowing. Personally, as I can't run up and down the stairs, I circle my arm round, windmill style.

* Have a bowl full of hot water, dip hand in and out, swish around, hand needs to go red. If blood flow stops, you can always swish round in the hot water again.

* Stand up to do the test. Make sure your arm is straight down when collecting the blood. Either use a small step stool to raise yourself well above the work surface, or put the collection tube on a lowish shelf. One member uses an ironing board so she can get the perfect height.

* Prick finger on the side, not the tip. I find that half way between the nail bed and tip is about right, or maybe slightly nearer the nail bed rather than the tip. I use my ring finger, but middle finger is next best for me.

* Do not squeeze your finger to get the blood out, it can damage the blood and it may not be usable

I've recently done 2 tests. The first one there was very little blood coming out which was unusual for me so I used a second finger and between the two I gradually filled the tube. However, when I checked the prick site for the first finger the actual cut was very small and as I've had some of these lancets fail before I put it down to that. When I did the second test this is what I did

* Prick my finger as usual, make a very slight twist with the lancet whilst blade is still in the finger. I'm not talking 90 degrees or anything, just a very slight twist to make the cut just slightly bigger, it doesn't hurt or cause a blood bath! This made a big difference, 11 generous drops of blood filled the tube in less 2 minutes.

If you supplement with Biotin, or a B complex containing it (B7), leave it off for 7 days before doing any blood tests as it can give false results when biotin is used in the testing procedure, and most labs do use it.

Do your test on Monday or Tuesday and send back the same day so that it arrives before the weekend where it could be hanging around waiting for the lab to reopen and the blood may by then have spoiled.

**

When doing thyroid tests, we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

[holabola in reply to SeasideSusie]

Thanks SeasideSusie I have to lot to think about

[Gingernut44 in reply to SeasideSusie]

SeasideSusie Hi SS, just thought I’d let you know, Medichecks are now only sending one phial for the Ultravit test, I rang them to check if this was a mistake but was told that the decision had been made that one phial was enough. Will see if this correct as will be doing it in a few days time

[SeasideSusie Remembering in reply to Gingernut44]

Thanks Gingernut. Do let me know how you get on, also whether they are able to complete all tests from just one vial. We often see with the UltraVit test that Folate couldn't be done and I've always wondered if it was because there isn't enough blood.

If you wouldn't mind, can you also check the microtainter to see if the numbers on it are 400 and 600, or whether they use a slightly larger tube which says 800 which is what Blue Horizon use for their equivalent test.

[Gingernut44 in reply to SeasideSusie]

Hi SS, it is the 400 and 600 size which is why I rang them. If it had been a larger size I wouldn’t have worried as I’ve seen quite a few posts where folate hadn’t been tested. It’s bad enough having to do it once but doing the whole thing again just for the folate is no joke ☹️

I will keep you posted as to the outcome once I’ve got my results. If this is a cost saving exercise by Medichecks, it seems to be rebounding on them if they have to send out new tests just for folate.

[SeasideSusie Remembering in reply to Gingernut44]

Sorry, yes I'd forgotten that you've already got the kit.

I would have thought the tubes cost just pence so if it is cost cutting then it's penny pinching!

Anyway, looking forward to hearing how you get on

[Gingernut44 in reply to SeasideSusie]

SeasideSusie I have now received my results from Medichecks Ultravit test and am pleased to say that all tests were complete with the one 400 and 600 phial, although I did fill it just above the 600 line. One thing I will say is that although I took it to the PO and paid extra for the guaranteed next day delivery, it took 2 days - something to remember if, like me, you purchased the test before they included the tracking label.

[SeasideSusie Remembering in reply to Gingernut44]

Gingernut44

One thing I will say is that although I took it to the PO and paid extra for the guaranteed next day delivery, it took 2 days -

Was that the Guaranteed by 1pm service?

I know they are currently saying they've extended the time to 9pm so it would be dependent upon anyone being there at the time of the delivery if it is later in the day.

However, did you keep the receipt with the tracking number on? If so check on RM's track and trace page and see the details of the journey and times. If they didn't attempt to deliver before the new extended time of 9pm next day then you can claim the cost of the service back. I've had this happen quite a few times in the past, you just claim online with a scan of your receipt and they refund with no question if they failed to try and deliver next day.

The Tracked24 envelope Medichecks are currently using took 3 days to arrive when I sent mine back about 3 weeks ago.

[Gingernut44 in reply to SeasideSusie]

Thanks for the info- just like me, this afternoon I thought I didn’t need the receipt any more and tore it into shreds and threw it into the paper recycling. I suppose I’d better get the sellotape out of the drawer 😩😄

[SlowDragon Administrator]

Do you always get same brand of levothyroxine at each prescription?

75mcg levothyroxine is only one step up from starter dose, so unless you are very tiny and under 8 stone you are likely under medicated

Small selection of posts that include Medichecks’s test results

healthunlocked.com/search/p...

[holabola in reply to SlowDragon]

Sadly not under 8 stone nearer 10 but had lost a little weight last year and felt shaky so was reduced from 100mg but I do feel I might need a bit more as I've regained any weight I'd lost. Definitely time for another blood check. Thank you for your informative reply.

[SlowDragon Administrator in reply to holabola]

Common to need to find tune dose

Important all four vitamins are optimal too

Also ....guidelines by weight might help push for dose increase

Even if we frequently don’t start on full replacement dose, most people need to increase dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

gp-update.co.uk/Latest-Upda...

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

[SlowDragon Administrator]

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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

Almost always the only test GP does is TSH or TSH plus Ft4 which is completely inadequate

[holabola in reply to SlowDragon]

Thank you SlowDragon, I now have so much more to say and ask when I next go for my test which I will do soonest.

[BrendaSmith in reply to SlowDragon]

Does taking beef liver capsules help get B12, folate, ferritin and vitamin D levels up? Thanks

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

[SlowDragon Administrator in reply to BrendaSmith]

ods.od.nih.gov/factsheets/V...

....Small amounts of vitamin D are found in beef liver, cheese, and egg yolks.

[BrendaSmith in reply to SlowDragon]

So would you say beef liver capsules are helpful as long as I get my Vitamin D from sun or other sources?

[FancyPants54]

Yes. You should get up to speed on your condition. The levels required for health and how to get yours to that point. Your GP's will not bother provided you are in the reference range. You could be crawling along the bottom of it, but they won't bother.

Start by asking for print outs of all your blood tests over the past year and see where you can go from there. You need a print out and it must give the test result and the reference range.

I doubt you are even close to optimally restored.

[holabola]

You know I could cry for having been so ignorant. Thank you all so much.

[fuchsia-pink in reply to holabola]

Don't beat yourself up - we've ALL been there too!

This forum is a lifeline for so many xx