Vitamin B complex - ideally look at one that contains folate, not folic acid
Any supplements that contain biotin need to be stopped a week BEFORE ALL BLOOD TESTS
Obviously you need to test vitamin D, folate, ferritin and B12
Just testing TSH is completely inadequate
Most people when adequately treated will have Ft3 at least 60% through range and Ft4 roughly similar. TSH likely to be very low...typically 0.4 or less ...it’s irrelevant
Come back with new post once you get full thyroid and vitamin results
Recommend Thriva or Blue Horizon if doing via DIY finger prick test
Medichecks test including folate is private blood draw only
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
I think it was Dr request after seeing TSH at 0.4 Below normal in the eyes of NHS guidance. I've tried asking, but just get turned down, or Dr thinks it's not the cause and wants more antidepressants !!
Thanks for the calculator, I've written twice to Dionne for details on Dr Toft and to request a list of specialists.
Many thanks for the fantastic responses since last Thursday. I've pulled together the main details and will be working on it over the next few weeks. Time for action is now I hope I can keep my Dr on board during this next phase.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
(That’s 58% minimum through range)
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor
Just to add I think it is wonderful the way you are helping your wife to regain her health. None of my family including my husband have ever taken any interest in my thyroid disease. I can actually see their eyes glaze over if I try to explain anything about it. They rarely ask how I am feeling and now think I am *cured* because I am well at the moment.
Long term illness is a problem for those not inflicted. I've had Polymyalgia for the last 6 years (NHS guide is 2 years) In the main I've had to fight my own corner, Doctors don't understand and just want you to stop the steroids, that way you'll be alright. My wife does get a bit bored with it, but is sympathetic, so she keeps quite, that also means she doesn't tell me when I notice things are going wrong, until it gets worse.
What's worse is you want to trust the Doctor, when they give you conflicting advice (maybe they're right) and give it a try.
Currently I'm in a better place with PMR and have got the energy to get something realistic done. For some time my wife has been convinced it's nothing to do with the thyroid, does glaze over if I try and prove she's missing the facts, showing her printouts of the info I've collected over 11 years. It was only a couple of weeks ago we we're having coffee with the neighbours, one who was a nurse and she very nicely pointed out how much support I was giving her and she should take more notice from somebody who wasn't feeling so ill and able to see things as they are, rather than from a point of anxiety, nausea and generally feeling awful.
Since then she has relaxed and gone with my diagnosis and wants to try new methods.
Hopefully we can get connected to a specialist that can support her and get onto an even keel. There's alway HOPE. But time for us is running out, unless we can get some of Major Tom's genes.
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Vitamins 
Multi vits
Supplementing but vitamins going down especially Folate and Vit D
Received this email, concerned about their comment re vitamin B9 and B12
