Hi all, can you have a look at my latest results as I’m wondering if anything needed changing I am taking 100mcg Levothyroxine & 25mcg T3.
I usually have B12 injections but can’t get these at the moment so I’m having tablets.
Many thanks for your time 😊
TSH 0.017 (0.27 - 4.2)
Free T3 4.02 (3.1 - 6.8)
Free thyroxine 12.2 (12.2 - 22)
Ferritin. 33.4 (13 - 150)
Folate 6.5 (3.89 - 19.45)
B12 active 150 (37.5 - 187.5)
Vit D 52.3 (50 - 175)
How do you feel?
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If/when also on T3, make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
Is this how you do your tests?
Your Ft4 and Ft3 are both on low side
What vitamin supplements are you currently taking, apart from B12?
Vitamin D and folate too low
Vitamin D
GP will often only prescribe to bring levels to 50nmol.
Some areas will prescribe to bring levels to 75nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
NHS Guidelines on dose vitamin D required
ouh.nhs.uk/osteoporosis/use...
But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing 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, on levothyroxine 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 vitamin D
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
Importance of vitamin D for fighting Covid
moxafrica.org/post/the-vita...
Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial. Also helps maintain B12 levels between injections
chriskresser.com/folate-vs-...
B vitamins best taken after breakfast
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
You should still be getting B12 injections during Covid crisis
pernicious-anaemia-society....
Ferritin is very low too
Iron and ferritin are complex. Ask GP for full iron panel test for anaemia
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
Links about iron and ferritin
irondisorders.org/Websites/...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
healthunlocked.com/thyroidu...
Thank you for responding.
I did a Medicheck finger prick test at 7am before taking any meds as recommended.
I’m not currently taking any other supplements but now looking at your post I think I need too.
Well looking at your previous posts you have had low vitamin levels for a long time
healthunlocked.com/thyroidu...
With Hashimoto’s we frequently need to supplement virtually continuously to maintain OPTIMAL Vitamin levels
Are you on strictly gluten free diet?
Can see on previous posts you have lots of gut issues
And had negative coeliac blood test
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct 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
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
ncbi.nlm.nih.gov/pubmed/296...
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
ncbi.nlm.nih.gov/pubmed/300...
The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease
nuclmed.gr/wp/wp-content/up...
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
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
I did try a strict gluten free diet a couple of years ago but to be honest it didn’t really make much difference.
I did cut out the rubbish from my diet eg. Processed foods which made a massive difference.
My diet is quite good, I eat lots of veg, fruit and fish. I limit sugary food as this makes me lethargic. I’ve managed to lose some weight and I exercise regularly, during the last year have felt quite well but recently probably the last month I’ve started feeling unwell again.
Obviously you are going to need to supplement regularly to maintain GOOD Vitamin levels
Ideally you would test TPO antibodies before considering starting on strictly gluten free diet
And retest antibodies again in 6 months before considering reintroducing gluten
TPO antibodies frequently drop slowly on strictly gluten free diet
As you have Hashimoto’s are you on strictly gluten free diet?
Or dairy free diet?
Do you feel well? Did you have an early morning blood draw with 24 hours from taking lveo and 8 - 12 from taking lio? I suspect you don't feel tip-top and I'd say you need an increase in levo - and to work on your nutrients
Your free T4 is crawling along at the bottom of the range and your free T3 is slightly better at just less than 25% though range - both need to be much higher, probably in the top third of the range.
Your vit D is really low and ferritin and folate both need to come up a bit - but I defer to SeasideSusie 's expertise on nutrients so hopefully she will pop up in a bit x
Just recently I have started to feel very tired again, unfortunately I don’t sleep very well.
Low vitamin D linked to poor sleep
How do you normally take your T3? As single dose or as 2 or 3 smaller doses through the day
Splitting dose , as 3 doses per day may help
Taking small 1/4 tablet 6.25mcg of T3 before bed can help improve sleep
I usually take a single dose in the morning so will try splitting it.
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