Posting an update from may last post, and now seeking more advice from you clever lot!
latest results for my follow up blood test:
tsh was 16.14 (0.3 - 4.2)
free t4 15.8 (12.00-22.00)
So the doctor has decided to start me on 50mcg Levothyroxine and take it from there. I have a test again in 2 months (they will test for antibodies too then) to see if the dose needs adjusting - what advice do you have for timing the levo etc for the follow up test?
I want to do everything possible to make sure I get into the optimal tsh range... but my doctor is aiming for it be under 4.5. Maybe I will feel better on around 4.5, but to be honest, if I am taking a pill everyday why not aim for optimal results?
I am also on the contraceptive pill containing oestrogen, the advice was to take this pill at night and Levothyroxine in the morning so that the oestrogen doesn't affect absorbency. Does anyone have any thoughts on this? I was considering changing to a progesterone only pill just to be sure.
I also have a thyroid complex supplement containing B-12, Iodine, Magnesium, Zinc, Selenium, Copper, Manganese, Molybdenum, L-Tyrosine, Ashwaghanda Root, Kelp, Bladderwack powder. When is the best time to take this? Will any of it interact negatively with the Levothyroxine?
Any other advice welcome too, feeling grateful to have found this forum with so much great knowledge on here! x
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Iris16257
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I also have a thyroid complex supplement containing B-12, Iodine, Magnesium, Zinc, Selenium, Copper, Manganese, Molybdenum, L-Tyrosine, Ashwaghanda Root, Kelp, Bladderwack powder. When is the best time to take this? Will any of it interact negatively with the Levothyroxine?
There is no best time to take it, it's a terrible thing!
B12, Iodine/kelp/bladderwrack, copper, zinc should all be tested before you even think about taking them. Taking iodine when you don't need it could make things a hell of a lot worse - iodine is anti-thyroid in excess, and not something to play around with.
Hypos usually have high copper levels, so the last thing you want to do is add more.
And, for B12 you need a base-line - you could have Pernicious Anemia but if you start supplementing B12 you'll skew the tests. And, I'm willing to bet that the B12 contained in this supplement is not the right form of B12, it will be the cheaper cyanocobalamin rather than the more easily absorbed methylcobalamin.
Ashwagandha is an adaptogen. In theory, adaptogens level out hormone levels, raising low levels and decreasing high levels. In practice, it's often the other way round. It could lower your cortisol when you don't want it lowered. Adaptogens are unpredictable in their actions. And, when it's in a multi supplement, you won't know if it's that or something else making you feel bad. Multis are always, always a very bad idea. And this one will not help your thyroid, it will probably make it burn out faster, and magnify your symptoms.
So, for starters, you should get your vit D, vit B12, folate and ferritin tested, to see if any of those need supplementing, and work up from there - you'll get all the help you need with that on this forum (because your doctor won't have a clue!).
what advice do you have for timing the levo etc for the follow up test?
Make sure your appointment for the blood draw is early morning - before 9 am - and fast over-night. Leave a 24 hour gap between your last dose of levo and the blood draw.
I want to do everything possible to make sure I get into the optimal tsh range... but my doctor is aiming for it be under 4.5. Maybe I will feel better on around 4.5, but to be honest, if I am taking a pill everyday why not aim for optimal results?
It's not really about the TSH. TSH isn't even a thyroid hormone. It's a pituitary messenger from the pituitary to tell the thyroid to make more hormone. Therefore it rises and falls - or should do - with the rise and fall of thyroid hormones: FT4 and FT3. T4 is basically a storage hormone that has to be converted into the active hormone, T3. It's low T3 that causes hypo symptoms. So, the most important number is the FT3. And, very often, when the FT3 is high enough to make you well, your TSH will become suppressed (which is perfectly normal). And this is something that doctors fail to understand. So, if your doctor thinks that anything under 4.5 is OK, then you might have a future battle on your hands to be optimally medicated. But, cross that bridge when you come to it. You still have quite a long way to go before you get there.
I am also on the contraceptive pill containing oestrogen, the advice was to take this pill at night and Levothyroxine in the morning so that the oestrogen doesn't affect absorbency.
As long as you take your oestrogen four hours away from thyroid hormone, that shouldn't affect absorption.
Most supplements/medication should be taken at least two hours away from thyroid hormone. But, iron, magnesium, vit D, calcium and oestrogen should be at least four hours away. Thyroid hormone should be taken on an empty stomach - two hours after food and any drink other than water, or one hour before.
Definitely chuck that thyroid supplement in the bin
Ask your GP to test vitamin D, folate, ferritin and B12
Come back with new post once you get results
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
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. Teva contains mannitol as a filler, which seems to be possible cause of problems. 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
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
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Latest medichecks results - would welcome your advice as to the next step to take - thank you
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