Please advise re my latest Results

[weewillywinkie]

Firstly, a huge thank you to all of you kind people there. Back in March you identified for me a serious Vitamin A deficiency. After following your advice, I very soon began to feel better and now have not felt so well since my Graves was diagnosed in 2014 How can you thank someone enough for that?

I think you have done as much for me as anyone can but would be most grateful for your comments on my latest readings, and of course, for any advice you see fit to give.

Ferritin:110 (30 - 400)

Folate: 4.66 (>3.89)

Vitamin B12: 72.200 (>37.5)

Vitamin D:141 (50 - 175)

TSH: 1.16 (0.27 - 4.2)

Free T3:3.7 (3.1 - 6.8)

Free Thyroxine:15.7 (12 - 22.)

Once again thank you so much

[greygoose]

Free T3:3.7 (3.1 - 6.8) 37%

Free Thyroxine:15.7 (12 - 22.) 16.22%

You're still very under-medicated. Neither of your Frees are anywhere near mid-range. How much levo are you taking?

And, your folate and B12 are much lower than I would want mine. Are you supplementing any Bs?

I'm curious to know how the vit A deficiency was identified. I can't find any reference to vit A in your March post.

[humanbean in reply to greygoose]

I think the reference to vitamin A was a typo. Previous posts identified a severe deficiency of vitamin D.

[greygoose in reply to humanbean]

Ah, OK! Now I understand. I'd just never heard of testing for vit A before, nor had any idea what deficiency symptoms might be. Thank you.

[weewillywinkie in reply to humanbean]

Thank you human bean. You're right. Fat finger syndrome!

[weewillywinkie in reply to greygoose]

Thank you! Apologies for the typo. I should, of course, written "Vitamin D"

[greygoose in reply to weewillywinkie]

It happens.

[weewillywinkie in reply to greygoose]

Thank you greygoose. I'll address the folate and B12 issue with Igennus Super B supplement as soon as they arrive. I'm on 150 mcg levo daily. Is that low / medium / or high please?

[greygoose in reply to weewillywinkie]

I'm so sorry, I'm afraid I made a mistake in my first reply to you.

Free T3:3.7 (3.1 - 6.8) 37%

Free Thyroxine:15.7 (12 - 22.) 16.22%

I got them the wrong way round! FT3 should be 16.22% through the range, and FT4 37%.

So, you're taking 150 mcg levo daily. It doesn't really matter if that's a high dose or a low dose, what matters is if it's the right dose for you. And it obviously isn't because your FT4 is only 37% through the range, when it should be more like 75%. I don't think you're absorbing it very well. So, let me just check…

How do you take your levo? Do you take it on an empty stomach and leave at least one hour before eating or drinking anything other than water? Do you take any other medication/supplements at the same time as your levo?

You're also not converting it very well. Your FT3 is very, very low. And, it's low T3 that causes symptoms. But, you might convert better if you had more T4 to convert. You really do need an increase in your dose.

[weewillywinkie in reply to greygoose]

Thank you so much, I'll get on the case with my GP after the weekend. Goodness knows how I'd manage without your guidance!

To answer your questions (no reply expected) I take the Levo (with VitD) first thing in the morning; a good couple of hours before eating. However, a cup of tea, or three, may sometimes pass my lips. I'll stop that straightaway.

[SeasideSusie Remembering in reply to weewillywinkie]

weewillywinkie

Sorry, not Greygoose, but had to respond.

To answer your questions (no reply expected) I take the Levo (with VitD) first thing in the morning; a good couple of hours before eating. However, a cup of tea, or three, may sometimes pass my lips. I'll stop that straightaway.

Vit D needs to be taken 4 hours away from thyroid meds.

Levo needs to be taken on it's own, 2 hours away from most other supplements and medication, but some need 4 hours, i.e. Vit D, iron, calcium, magnesium, oestrogen (and possibly some others).

[weewillywinkie in reply to SeasideSusie]

Thank you SeasideSusie. I'll change my routine right away

[greygoose in reply to weewillywinkie]

OK, so that's cleared that up!

Change your routine before asking for an increase in dose. Because once you're taking your levo correctly, you might not even need and increase.

[AnnaSo]

Do you mean Vitamin D? Don’t think Vitamin A is something people check...

Importantly, how do you feel atm? Looks like you still need more medication as FT3 and FT4 are low.

Did you take vitamins before the test? It can give false results.

[SlowDragon Administrator]

Assuming you meant vitamin D

Looking at vitamin D result now you need to reduce vitamin D supplement to a maintenance dose

[SlowDragon Administrator]

Folate is too low and B12 could be higher

Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

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 ALL blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Ask GP for 25mcg dose increase in levothyroxine and retest in 6-8 weeks