Function Test Results

[willsie01]

I do note the high level of magnesium and TPO.

I will be talking to my doctor but how does the forum think I interpret these results?

[SeasideSusie Remembering]

willsie01

Magnesium is an unreliable test. About 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood. So testing what's in the blood isn't giving an accurate picture of our magnesium status.

If you want to read the science, this information is from this article:

ncbi.nlm.nih.gov/pmc/articl...

Cortisol looks to be low, but serum cortisol test is not something I'm good at. Hidden knows about that.

B12 and folate results?????

It's not possible to interpret your thyroid results accurately without knowing what thyroid meds you're taking.

Raised TPO antibodies suggest autoimmune thyroid disease, aka Hashimoto's.

[willsie01 in reply to SeasideSusie]

Separate test

B12 is 416 ng/L (range 211 - 911)

Folate 11.2 ug/L (range 3.4 - 12.2)

Thyroid med is Levothyroxine 100 micrograms

[SeasideSusie Remembering in reply to willsie01]

willsie01

B12 is 416 ng/L (range 211 - 911)

This is low. 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 (pg/ml is the same as ng/L) 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."

The aim of aim of a hypo patient on Levo, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges. Your TSH is fine, your FT4 is 68% through range and your FT3 is only 28.38% through range so your T4 to T3 conversion is rather poor.

[SlowDragon Administrator in reply to SeasideSusie]

Test was done early afternoon...hence low cortisol

[SlowDragon Administrator]

What time of day did you do this test?

[willsie01 in reply to SlowDragon]

1:30pm

[SlowDragon Administrator in reply to willsie01]

So cortisol isn’t very low

ALL Thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Important to regularly retest vitamin D

vitamindtest.org.uk

What vitamin supplements are you currently taking?

[willsie01 in reply to SlowDragon]

Vitamin D test last week 87.4 nmol/L from the link you quote.

I take the vegan societies multivitamin together with Better You Vitamin D spray (the one without K2 because I take blood thinners) & Better You Iron spray.

[SlowDragon Administrator in reply to willsie01]

You might want to look at separate vitamin supplements

This multivitamin contains iodine.....generally not recommended with Hashimoto’s

vegansociety.com/shop/suppl...

(Levothyroxine contains iodine)

Iodine and Hashimoto’s is controversial subject

amymyersmd.com/article/iodi...

drknews.com/iodine-and-hash...

drhedberg.com/iodine-hashim...

[willsie01 in reply to SlowDragon]

Okay, it's been suggested my raised TPO antibodies could indicate Hashimotos's so is there a definitive test to determine whether I do or not?

Is there anything else I should try, as well as not supplement iodine?

[SlowDragon Administrator in reply to willsie01]

If you have high TPO antibodies you definitely have Hashimoto’s...you don’t need any further testing

An ultrasound scan of thyroid can be helpful in seeing extent of damage

healthunlocked.com/thyroidu...

Hashimoto’s frequently affects gut, leading to poor gut function and low vitamin levels as direct result

Conversion of Ft4 to Ft3 is often poor with Hashimoto’s

As explained here...it’s a complex process

drbradshook.com/understandi...

[willsie01 in reply to SlowDragon]

How receptive is a UK GP likely to be to a request for an ultrasound scan?

[willsie01 in reply to SlowDragon]

My GP tells me “raised AT antibodies -this is just an indicator that the cause of your thyroid problems are likely to be autoimmune (due to the presence of antibodies) - it does not change management and thyroid hormones are in the correct range on current treatment...”

[SlowDragon Administrator in reply to willsie01]

So you know you have autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies

It’s true the medics have nothing other than levothyroxine and sometimes in rare cases liothyronine- also called T3 alongside levothyroxine

But with Hashimoto’s it’s essential to regularly retest vitamin D, folate, ferritin and B12 ....frequently we need to supplement to maintain optimal vitamin levels

Hashimoto’s frequently affects gut function and leads to low stomach acid and then low vitamin levels

As a vegetarian or vegan with Hashimoto’s it’s incredibly important to regularly test full iron panel test for anaemia ....low ferritin highly likely as plant based diet only has non-heme iron in it , much harder to absorb than heme iron in meat

List of iron rich foods

dailyiron.net

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.

Thyroid disease is as much about optimising vitamins as thyroid hormones

B12 supplements important too

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

[willsie01 in reply to SlowDragon]

Following your links it seems the Amy Myers one advises supplementing with multivitamin containing iodine. The second advises against it explicitly while the third states that any thyroid issues have to be rectified and then supplementation can be implemented.

This is a pretty muddy situation.

[willsie01 in reply to willsie01]

What's worse with Hashimoto's: too much or too little iodine?

[SlowDragon Administrator in reply to willsie01]

As you are on levothyroxine this has iodine in it

[willsie01 in reply to SlowDragon]

The leaflet with my prescription doesn't list it in the ingredients. Quoting:

"The active substance (the ingredient that makes the tablets work) is anhydrous levothyroxine sodium.

Each tablet contains either

50 micrograms or 100 micrograms of the

active substance.

• The other ingredients are lactose,

magnesium stearate, maize starch, stearic acid and pregelatinised maize starch.:

[SlowDragon Administrator in reply to willsie01]

Suggest you read this old post discussing iodine in levothyroxine

healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to willsie01]

And here

btf-thyroid.org/thyroid-and...

[Kimkat in reply to SlowDragon]

Husband was told by our practice nurse that it costs the nhs £85 for vit D testing!! No winder they’re not keen on giving them out.

[helvella Administrator Thyroid UK in reply to Kimkat]

There has got to be something very wrong with that figure. Though there are several possible interpretations.

We can, as members of the public, send samples to an NHS lab and get results returned for the sum of £29.

vitamindtest.org.uk/

(I get the impression that they set that price to make at least an operating profit.)

If the NHS itself is paying £85 for a test, we need to ask why? They could print out the web address, slip a fifty pound note into your palm, you keep £21 and they'd still save £35!

So, have they got an awful deal? Is a lab in contract to a company which charges them far too much? Is the information woefully out of date? Are they just utterly unaware that they could do it with a blood spot and for so little cost? Or is there some other reason?

[BrynGlas in reply to helvella]

My opinion on what the NHS and other government funded services, nothing to do with Health issues is that they rarely haggle about the cost of things, and anyone going into any sort of a goverment funded service, supply/demand rubbed their hands in glee. I don't wouldn't be surprised if it still goes on to some degree, but £85 does seem a little OTT doesn't it?

[Kimkat in reply to helvella]

I have no idea, I just find it ridiculous that they would accept that charge, when we can order our own for £29! I had mine done a month or so ago and that’s what started the conversation.

[SlowDragon Administrator in reply to Kimkat]

That’s just a guesstimate cost, she was making up

you can buy a vitamin D test done by NHS for £29

vitamindtest.org.uk

Whereas the Ft3 test costs NHS 93pence ....but cheapest we can get it done is £26 (again via NHS private testing )

[Kimkat in reply to SlowDragon]

Maybe, I did say that mine only cost £29 but the way the nhs are tipped off, it wouldn’t surprise me one bit.

[willsie01]

I'm going with Better You Vitamin D, Vitamin B Complex & Iron sprays. This doesn't give me the selenium so I'm eating a couple of brazil nuts every day. Take the tests again in 6 months and see where I am.

[willsie01]

This month’s Levothyroxine brand is Mercury Pharma. Anything said about this brand?

[helvella Administrator Thyroid UK in reply to willsie01]

Strongly recommend that you discuss with pharmacists about getting the same make(s) dispensed each time.

UK Levothyroxine Tablets

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

Last updated 28/08/2020.

This is a list of currently marketed levothyroxine tablets in the UK.

Please note that re-branding (whether by a manufacturer or as an ‘own label supplier’) – which has happened with several products – does not mean any change to formulation.

—————————————————————

🔹 Accord (marketing authorisation holder) – formerly Actavis

🏭 Accord-UK (manufacturer)

🥛 contains lactose

  50  PL 0142/0104

  100  PL 0142/0105

🟢 50 micrograms and 100 micrograms PIL: mhraproducts4853.blob.core....

🟣 100 Micrograms SPC: mhraproducts4853.blob.core....

🟣 50 Micrograms SPC: mhraproducts4853.blob.core....

—————————————————————

🔹 Advanz (marketing authorisation holder) – branded both “Mercury Pharma Levothyroxine” and “Mercury Pharma Eltroxin” which are identical

🏭 Custom Pharmaceuticals Ltd. (manufacturer)

🥛 contains lactose

  25  PL 12762/0016 5.5mm diameter

  50  PL 10972/0031

  100  PL 10972/0032

🟢 Eltroxin 25 PIL: mhraproducts4853.blob.core....

🟢 Eltroxin 50 & 100 PIL: mhraproducts4853.blob.core....

🟢 Levothyroxine 25 PIL: mhraproducts4853.blob.core....

🟢 Levothyroxine 50 & 100 PIL: mhraproducts4853.blob.core....

🟣 Eltroxin and Levothyroxine 25 SPC: mhraproducts4853.blob.core....

🟣 Eltroxin and Levothyroxine 50 SPC: mhraproducts4853.blob.core....

🟣 Eltroxin and Levothyroxine 100 SPC: mhraproducts4853.blob.core....

—————————————————————

🔸 Almus ‘own label supplier’ – (a brand owned by Walgreen Boots Alliance – Boots pharmacies and Alliance distributor)

  50 – This is repackaged Accord – formerly Actavis.

  100 – This is repackaged Accord – formerly Actavis.

—————————————————————

🔹 Aristo (marketing authorisation holder)

🏭 Aristo Pharma GmbH (manufacturer)

No lactose ingredient

  100  PL 40546-0159

🟢 PIL: mhraproducts4853.blob.core....

🟣 SPC: mhraproducts4853.blob.core....

—————————————————————

🔸 Northstar ‘own label supplier’ – (a brand owned by McKesson – Lloyds pharmacies and AAH distributor)

  25 – This is repackaged Teva. ❗

  50 – This is repackaged Accord – formerly Actavis. ❗

  100 – This is repackaged Accord – formerly Actavis. ❗

—————————————————————

🔹 Teva (marketing authorisation holder)

🏭 PLIVA Croatia Ltd (manufacturer)

No lactose ingredient

  12.5  PL 00289/1971

  25  PL 00289/1972

  50  PL 00289/0038

  75  PL 00289/1973

  100  PL 00289/0039

🟢 12.5 and 50 microgram PIL: mhraproducts4853.blob.core....

🟢 25, 75 and 100 microgram PIL: mhraproducts4853.blob.core....

🟣 12.5 microgram SPC: mhraproducts4853.blob.core....

🟣 25 microgram SPC: mhraproducts4853.blob.core....

🟣 50 microgram SPC: mhraproducts4853.blob.core....

🟣 75 microgram SPC: mhraproducts4853.blob.core....

🟣 100 microgram SPC: mhraproducts4853.blob.core....

—————————————————————

🔹 Wockhardt (marketing authorisation holder)

🏭 CP Pharmaceuticals Ltd (manufacturer)

🥛 contains lactose

  25  PL 29831/0130

🟢 PIL: mhraproducts4853.blob.core....

🟣 SPC: mhraproducts4853.blob.core....

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

🔹 – identifies marketing authorisation holder

🔸 – identifies ‘own label supplier’ products

🏭 – identifies manufacturers (where known)

🥛 – contains lactose

❗ – Take particular note of the actual product which varies by dosage.

🟢 PIL – Patient Information Leaflet

🟣 SPC – Summary of Product Characteristics document

🟢🟣 Single document combining typical PIL and SPC information

—————————————————————

Numbers refer to tablet dosages in micrograms.

Only products which definitely contain lactose are identified (🥛 contains lactose). Please always check other products. Where products are ‘own label supplier’, check the marketing authorisation holder for the specific product.

There are links to product information on the MHRA (Medicines and Healthcare products Regulatory Agency) website. products.mhra.gov.uk/ These are the latest versions known.

If there is anything inaccurate in this information, please let me know by Private Message, or on the forum:

healthunlocked.com/user/hel...

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

This document is updated whenever I am aware of any changes or enhancements are needed. Please check the Last updated date. The current version is available as a PDF here:

dropbox.com/s/6h3h0qi4eqwi6...