Just had my recent blood tests back, these are my second lot since starting on thyroxine and I’ve been increased to 50 mcg. Would like opinions please
July VitD 131.4 (50-250)
B12 412. (170-730)
Ferritin 20. (10-291) Abnormal
Folate 7.4 (3-19)
Calcium 2.18 (2.20-2.60) Abnormal
My thyroids weren’t on this one as I had specifically asked for these above but I’m due another lot this month.
So vitamin D was tested in July
Were you taking any vitamin D supplements?
The other test results done more recently?
What vitamin supplements are you currently taking?
Yes I’m taking the VitD +K spray, others Supps are vit c and marine collagen at the moment. What upsets me is that my ferritin and calcium are showing as abnormal but my gp has never brought this to my attention and discussed it with me. My August thyroids are just in and they are
TSH 5.10. (0.3-5.00) Abnormal
T4. 14.5 (11.5-22.7)
No T3
I’m due more bloods at the end of this month which I will have done early morning and delayed Levo etc from day before.
Usually calcium is low BECAUSE vitamin D is low
Was vitamin D very low before you started supplementing?
Ferritin is likely low because you are under medicated and still hypothyroid
You can’t assume iron is also low. Would need full iron panel test
See if ferritin improves as levothyroxine dose increases
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
List of iron rich foods
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
I have been taking VitD now for a long time as I broke my ankle 5 years ago and I had a bone scan which was ok but gp put me on Supps then and told me that once I had finished the course to take a maintenance dose, which I did but it was low before I started on the oral spray . I try to eat iron rich foods as often as possible 🙂 my hair is thinning so I assume that’s with the low ferritin. I should have been having a telephone appointment with the endo at the end of this month but he’s put me back until November now, surprise surprise.
Perhaps ask for referral to endo or osteoporosis specialist re low calcium
Did you have total thyroidectomy?
Were any parathyroids damaged?
Ask about calcium levels
yourhormones.info/endocrine...
I’ve had two partial thyroidectomies and RAI which was two years ago, I was only started on Levo 3.5 months ago. I don’t know about para thyroids.
So how long had you been on 50mcg levothyroxine when this thyroid test was done?
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
Teva and Aristo are the only lactose free tablets
healthunlocked.com/thyroidu...
Teva poll
healthunlocked.com/thyroidu...
academic.oup.com/jcem/artic...
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).
I have been given Teva and I have asked for Mercury next time, which should be ready now for me to collect. I haven’t felt great tbh but that could be something else, who knows
That’s why it’s important to not change brands...especially when dose is increased
I was on Mercury then put on Teva, I’ve had slight headaches since starting Teva and they have given me that again, even though I asked for Mercury.
Do you get paper prescriptions or electronic one sent direct to pharmacy?
Paper prescription allows you to ring around different pharmacies until get brand you need
If electronic, perhaps ask GP to add note to all future prescriptions saying “mercury Pharma only”
Though headaches are hypothyroid symptom, and likely due to being under medicated, as shown by high TSH
I have electronic prescriptions and have asked for Mercury but they have given me Teva which is probably the reason for my headaches but I will be taking them back unopened on Monday and having a word with the pharmacist. They’re pretty good there but if he can’t help I’ll definitely get in touch with the gp. I didn’t have any headaches when I was taking Mercury, so I assumed it was that but my tsh is coming down slowly From 14.5/7.53 and now 5.10.
So it is probably the Teva causing headaches
If Pharmacy won’t change it, ask GP for new prescription and to add either “mercury Pharma only” or “no Teva”
Packet of levothyroxine is dirt cheap £1.26 for packet of 28 tablets of 50mcg
So I got my new prescription and even though I had asked specifically for Mercury I was again given Teva so I rang the pharmacist and explained they were giving me continuous headaches, ‘ok I’m a locum I’ll speak to the pharmacist and ask her advice’ I could clearly hear the conversation and him giving her the lowdown on my problem, she then said ‘we don’t know what’s coming in from one week to the next, so she’ll have to make do in the future but I will change them this time’ !!!! So everything that I have been told about having a word with a pharmacist as they will be able to help, is a load of bull and obviously don’t really care whether you’re in discomfort or not! I’m going to try and have a word with the GP if that doesn’t work I’ll be contacting my endo.
Your Doctor needs to write a specific brand on your prescription, the Pharmacist will then be obliged to dispense that brand.
No - it is not a load of bull. It is variable.
Some pharmacists try very hard.
Others don't - or can't manage to do so within the confines of their company.
Generally small independent pharmacies are more helpful
The one I use is part of our surgery and have always been very obliging but recently there has been a change in pharmacists, never seems to be the same one, which is a shame. The fact that I’ve suffered two months of headaches in total and she didn’t seem to take that into account was a bit off putting 😟
Looking like you are ready for next 25mcg dose increase in levothyroxine
Ft4 is only 27% through range
Helpful calculator for working out percentage through range
TSH should be under 2 on levothyroxine
Many people find TSH drops under one when adequately treated
I have been on 50 fir approximately 7 weeks now and my tests were done early on around 3-4 weeks but that was because I insisted on an increase, my next one will probably be better hopefully and more accurate.
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