Thyroid & Vitamin results for Hypo after RAI treatment

[Koola]

Hello SeasideSusie and SlowDragon,

You were both kind enough to advise me last time and told me to get tested again. Here are my results from yesterday, 30.6.

TSH: -- 1.80 range is 0.20 – 5.00 -- 2 previous tests March & May: 9,27 / 2,63

FT3: – 3.01 range is 1.8 – 4.5 -- 2 previous tests March & May: 4,56 / 3,59

FT4: – 14.09 range is 7.0 – 20.0 -- 2 previous tests March & May: 9,8 / 10,3

Folic Acid: 16.1 range is 5,4 –19,8

Vitamin B12: 418.0 range is 160 - 925

Vitamin D3: 41.0 range is 30 - 100

Iron: 39.60 range is 12 - 290

Cortisone: (because I had taken Ashwaganda and you told me it might have raised my adrenaline level) 17.1 range is 6,0 – 25,0

On paper Thyroid seems to have improved. I’m now on 88 levo, 5 days a week, 75 on others. (100, still knocks me for a loop…) Yet I’m feeling worse all the time! (brain fog, exhaustion and now blurry vision). The heat wave has started, which doesn’t help. Could it be mostly the low iron & Vitamin D?

Thus, again I would be very thankful for your advice.

[Lalatoot]

Koola those thyroid levels and TSH suggest that you could increase your levo dose. this may alleviate your symptoms.

I always found taking my levo in one dose too much so I split the dose. I have taken it twice daily but at the moment I take it 3 times daily to fit in with other medication.

[Koola in reply to Lalatoot]

Thanks Lalafoot. First time I hear of splitting Levo. I sometimes take it later in the morning, after a cup of tea, as opposed to the recommended early, one hour before breakfast and it feels slightly better. But "nothing to write home about".

I will try out splitting!

I'm wondering if I should take T3 again. Have you ever?

[Lalatoot in reply to Koola]

Koola I am on 100mcg T4 and 20mcg T3 which I split into 3 daily doses.

T3 is not a quick fix. It takes time to get into the system and to balance your FT4 and FT3. This has meant looking at FT4 and FT3 results every 2 months and adjusting either the levo or T3 dose. 10 months on I am much better than I was and know that I need both FT4 and FT3 balanced at over 60% through their ranges.

I am lucky to get my T3 on prescription.

[SeasideSusie Remembering]

Koola

There's room to increase your Levo, try 88mcg every day. The aim, generally, for a treated hypo patient is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, so maybe around 16-ish for FT4 and 3.6-ish for FT3.

Folate is fine.

B12 is low. Is that pmol/L or ng/L or pg/m. (the latter two are the same). According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

You might want to consider a good quality, bioavailable B Complex such as Thorne Basic B or Igennus Super B.

Vitamin D3: 41.0 range is 30 - 100

Presumably the unit of measurement is ng/ml, in which case the level recommended by the Vit D Council/Vit D Society is 40-60. You've just scraped in but might benefit from it being higher. Do you make Vit D well enough from the sun? If not I'd consider supplementing with maybe 2,000iu D3 daily, plus D3's important cofactors magnesium and Vit K2-MK7. If you do supplement, check level after 3 months.

Iron: 39.60 range is 12 - 290

I think this may be Ferritin not Serum Iron. This is low, and low ferritin can suggest iron deficiency/anaemia. Before considering taking iron tablets it would be a good idea to do an iron panel (for iron deficiency) and a full blood count (for anaemia), it wouldn't necessarily be a good idea to take iron tablets if your serum iron was already at a good level, supplementing might take it too high.

Cortisone: (because I had taken Ashwaganda and you told me it might have raised my adrenaline level) 17.1 range is 6,0 – 25,0

No, it was pointed out that Ashwagandha is an adaptogenic herb which is meant to be "balancing" but it is know to lower cortisol.

[Koola in reply to SeasideSusie]

Wonderful, SeasideSusie, you’re saving my life again A few questions:

If Folate is fine, do I stop supplementing or reduce?

- Vitamin B is pg/ml. I had an injection of B1 + B6+ B12, “Neurobion” from Merck after blood was taken. This I usually take once a day as a pill (stopped one week before test). I was told injections were stronger. But I’ll switch to the ones you suggested if better.

- I don’t know if I make Vit D well enough from the sun. I certainly don’t sunbathe anymore! I suppose one can’t overdose on Vit D, so I’ll supplement. It is ng/ml.

- You’re right, it was ferritin. I did do an iron test on 26 March:

67 - range: 45 - 155 mg/dl

So, could the tiredness be anemia…?

- Last question is the cortisol okay?

Many thanks again.

[SeasideSusie Remembering in reply to Koola]

Koola

- Vitamin B is pg/ml.

So the quote above about recommended level of B12 is appropriate.

I had an injection of B1 + B6+ B12, “Neurobion” from Merck after blood was taken. This I usually take once a day as a pill (stopped one week before test). I was told injections were stronger. But I’ll switch to the ones you suggested if better.

B1 + B6+ B12 are not the full range of B vitamins in a B Complex. A B Complex would contain

B1 (Thiamine)

B2 (Riboflavin)

B3 (Niacin)

B5 (Pantothenic acid)

B6 (Pyridoxine)

B7 (Biotin)

B9 (Folate/methylfolate)

B12 (Methylcobalamin)

If Folate is fine, do I stop supplementing or reduce?

What are you taking?

- I don’t know if I make Vit D well enough from the sun. I certainly don’t sunbathe anymore! I suppose one can’t overdose on Vit D, so I’ll supplement. It is ng/ml.

We can overdose on Vit D supplements and it can lead to toxicity (it's fat soluble so doesn't get excreted, it builds up in our bodies) so it's important to take the correct dose and test levels twice a year.

I did do an iron test on 26 March: 67 - range: 45 - 155 mg/dl

Serum iron is recommended to be 55-70% through range (higher end for men), yours is 20% through range.

So, could the tiredness be anemia…?

A full blood count will tell you if you have anaemia. You can have anaemia with or without iron deficiency hence the two tests - an iron panel plus a full blood count.

Your serum iron is on the low side and your ferritin is only 9.93% through range. Article about ferritin and symptoms of low level:

drhedberg.com/ferritin-hypo...

Symptoms of low ferritin include:

◾Weakness

◾Fatigue

◾Difficulty concentrating

◾Poor work productivity

◾Cold hands and feet

◾Poor short-term memory

◾Difficulty remembering names

◾Dizziness

◾Pounding in the ears

◾Shortness of breath

◾Brittle nails

◾Headaches

◾Restless legs

- Last question is the cortisol okay?

Well, it's in range I'm afraid that's all I can say. My understanding is the better test is a 24 hour saliva adrenal test which measures both cortisol plus DHEA.

[Koola in reply to SeasideSusie]

I believe you’ve ”hit the nail on the head” with iron deficiency, SeasideSuzy. Wow! 

Very hot here. Will answer tomorrow. Many, many thanks.

[Koola in reply to SeasideSusie]

Will order Vitamin B Complex

.

- I take Folacin from Solgar – 400 mcg, every 3, 4 days. But I noticed that my daily Feroglobin capsules also contain folacin & Vitamin B12. I will discontinue them as soon as I get another iron supp. Can you recommend a good supplement? There are so many on the market.

I’ll have my blood taken tomorrow for the two tests.

I have all the symptoms, minus two, on the list for anemia, and /or low ferritin. Re the article, I also rarely eat meat and have noticed that, without being a “high performance athlete”, if I swim for an hour I’m even more tired the next day. The usual build up isn’t happening. So I reverted to short swims until 3 days ago, no leaving the house… I used to enjoy the heat but I find it overwhelming right now.

I’ll supplement Vit. D, as well.

Thanks again. Not only for all your knowledge, but as there isn’t even a reliable GP on this island and I’m not fit to travel, it’s also immensely soothing to have you and your great colleagues around! Have a happy Thursday!

[SeasideSusie Remembering in reply to Koola]

Koola

I will discontinue them as soon as I get another iron supp. Can you recommend a good supplement? There are so many on the market.

Iron supplement? Sorry, I don't every recommend iron supplements, iron is too complicated and if there is iron deficiency or anaemia then a GP should be looking after it and monitoring levels. I've said above, your serum iron is only 20% through range and that's low, and you need a full blood count to see if you have anaemia.

I have all the symptoms, minus two, on the list for anemia, and /or low ferritin.

That list I quoted above is for symptoms of low ferritin. The article discusses iron deficiency not anaemia.

I’ll supplement Vit. D, as well.

Remember the cofactors that are also needed.

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...

afibbers.org/magnesium.html

Also remember to retest Vit D after 3 months. You shouldn't go above the top of the recommended range (60ng/ml) but once you reach 50-60 you should adjust your dose to maintain that level (retest twice a year to check), your maintenance dose could be 1,000-2,000iu, it's trial and error.

Please remember that I am a patient, I am not medically qualified, and my responses are based on my own experience and reading/researching, they are not medical advice.

[Koola in reply to SeasideSusie]

Hi again, SeasideSusie,

Results came back. I don't have anemia but low iron. will check with a GP as soon as possible. I do need an iron supplement,though, so I researched here and posted a question.

I know none of you are doctors, but you seem to know much more than most doctors! I just found on this site that iron has to be taken many hours between all but vit. C.

[SlowDragon Administrator]

Would agree you need to try increase levothyroxine to 88mcg everyday