BLOOD RESULTS, Advice appreciated.

[SPD1]

Hi Everyone,

i would really appreciate any advice, help or input regarding my latest Blood Results, the draw was last Monday at 8.50am fasting and last dose of Levothyroxine was 24 hours previously. These were done on the NHS not private.

Serum Free T4 20.09 (range 9 - 22.0)

Serum Free T3 4.9 (range 3.5 - 6.5)

Serum TSH 0.03 (range 0.10 - 4.00)

Serum B12 311 (range 160 - 820)

Serum Folate 24 (range <4.0)

Serum Iron 18.1 (range 14.0 - 31.0)

Serum Ferritin 121 (range 22 - 322)

Serum Cortisol 383 No Range given and advised "Normal"

Serum Magnesium 0.79 (range 0.70 - 1.00)

I also had the usual Full Blood Count etc which came back "Normal"

I requested that Vitamin D and Zinc were also tested, the nurse that took the blood put them on the form but when i got the results back it stated that the Lab had not tested!

I do know that my Vitamin D is low as i private tested with Medic checks 9 months ago and it was 42.6, unfortunately i cant seem to tolerate any supplements whatsoever, for some reason i get palpitations and they raise my resting heart rate so something is quite obviously not right.

On going Symptoms

Alarming head hair loss for over 12 months yet in the last 8 weeks or so my beard growth has slowed noticeably but i am also growing hair like Wildfire on my arms and legs which seems utterly bizarre. I have never come across Hair Loss and Hair growth at the same time with thyroid issues, its normally one or the other isnt it??

Extremely irritable.

Sleep pattern is Dire, go to bed at 12 midnight and waking every hour up until 5.30 and then can not sleep any further even though i am incredibly tired.

Struggling to keep weight off.

Resting heart rate is definitely quicker than it used to be even without taking any supplements.

Eyebrows thinning.

Transitory muscle twitching in the evening when sat or lying still, mainly my legs.

Any advice or help regarding the results would be very much appreciated indeed.

Many thanks

Steve.

[SlowDragon Administrator]

Ft4 is 85.3%

Ft3 46.6%

So poor conversion

Calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

What vitamin supplements are you currently taking

B12 rather low

Magnesium low too

You need to test Vitamin D

Good idea to test zinc

[SPD1 in reply to SlowDragon]

Hi Slow Dragon,

Thanks for your reply.

What is the optimal T3 percentage through range ?

My B12 has dropped from 366 9 months ago which is surprising as i have not altered diet at all, i shall have to try and supplement, is there a particular B12 Supp that is good and what particular strength would be best? or would i be better taking a general B complex? is there one in particular you would suggest ?

What is the best Magnesium supplement to take ?

Will get Vit D tested

Only taking a high strength Fish oil Omega 3 at the moment.

In your experience with thyroid have you ever come across or read about anyone with severe head hair loss but at the same time growing body hair (arms, legs) like wildfire, seems bizarre to me and perhaps not necessarily down to thyroid ?

Many thanks.

[SlowDragon Administrator in reply to SPD1]

Recommend supplementing a vitamin B complex (and separate B12 initially)

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

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

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...

Low B12 symptoms

b12deficiency.info/signs-an...

With such low B12 result taking a B12 supplement and a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

cytoplan.co.uk/vitamins/vit...

Or Jarrow B12 sublingual lozenges

[SlowDragon Administrator in reply to SPD1]

Only start one supplement at a time and wait at least 2 weeks before adding another (to see if any reactions to each supplement)

Not tolerating vitamin D, might be due to low magnesium. Recommend starting magnesium supplement first....and not add vitamin D for at least 2-4 weeks

Any magnesium supplements must be four hours away from levothyroxine

Lots of different options on magnesium supplements. We all have our personal favourite.

Calm vitality magnesium powder is cheap and easy to use. Best taken afternoon or late evening (four hours away from levothyroxine) Starting at low dose and increase slowly . Can be helpful if suffer from constipation.....too much can cause diarrhoea

Re-Mag developed by Dr Carolyn Dean, who wrote the Magnesium Miracle. (Well worth reading). Re-Mag doesn’t alter bowel habits. It is however expensive.

I couldn’t tolerate vitamin D before starting on magnesium

[SlowDragon Administrator in reply to SPD1]

Vitamin D

Get tested first....see where level is now

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, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need to bring to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

With your Vit D, are you also taking it's important cofactors - magnesium and Vit K2-MK7?

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

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...

[SlowDragon Administrator in reply to SPD1]

You can test Zinc and selenium

Selenium supplements may help improve conversion of Ft4 to Ft3 as well

Retest thyroid levels 8 weeks after adding last supplement

Making sure to test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Only test on Monday or Tuesday morning and post back via tracked 24 hour postal service

Remember to stop taking any supplements that contain biotin a week before any blood tests

[SPD1 in reply to SlowDragon]

Thank you very much indeed Slow Dragon for such fantastically detailed replies, it is all Very informative and extremely helpful indeed

[Rosannaclare]

Have you tried the BetterYou oral sprays? I take the Vit D3 3000 and 1000 (depending on my levels) and tolerate them perfectly compared to tablets.

[SPD1 in reply to Rosannaclare]

Hi,

thanks for your reply,

i did try the BetterYou oral spray, Vit D 1000iu and i got palpitations, it is really weird how i dont seem to be able to tolerate supplements, can't understand it, it happens with tablets, capsules or spray.

[Rosannaclare in reply to SPD1]

That’s a shame!

[JAmanda]

I wonder if the hair growth is a hormonal thing? Too much Oestrogen?

[SPD1 in reply to JAmanda]

Hi,

thanks for your reply. yes i was wondering if it may be hormonal, not sure how i would identify that, probably need to speak to GP and request a full hormonal screen if there is such a thing ?

[FancyPants54 in reply to SPD1]

There is, and yes you could do with one. Testosterone might be dropping.

[SPD1 in reply to FancyPants54]

Hi,

thanks for your reply. They tested my Testosterone last week, it came back "Normal" apparently and i have spoken to the Endocrine nurse at the Pituitary Foundation Support Line and she said it seems fine, but, it might be fine generally speaking and as far as the NHS guidelines are concerned but how do i know it's fine for me and hasnt altered.

Testosterone 20 (range 8.4 - 28.7)

Do you know what else is included in a full hormone screen, wonder if i could get on NHS or if i would have to battle to get it done and maybe have to do privately...hmmmm

[FancyPants54 in reply to SPD1]

I have my hormones tested privately as part of my HRT prescriptions and reviews because the NHS are crap at menopause care and privately is the only way for us to get testosterone, which we need as much as men do.

Your level is high up in range though. Probably isn't that giving you the problems.

[SPD1 in reply to FancyPants54]

Hi,

just been reading about having too much testosterone in body and its not good, its a fine balance between too much and too little..

Any chance you could let me know precisely what they test for when you have your hormone test apart from testosterone, my symptoms do indicate hormonal imbalance..

Thanks.

[FancyPants54 in reply to SPD1]

All hormones are a delicate balance. Too much is just as bad as too little and often the symptoms are the same.

I have my oestrogen and testosterone levels checked because I use both through the skin. Oestrogen patch and testosterone cream (the only one in the world made for women!) and we need to make sure I don't go too high or low.

[SPD1 in reply to FancyPants54]

Thanks for that info, aye it is a balance indeedy

[Lora7again]

I was reading about pituitary gland symptoms and some of yours like increased body hair can be caused by either a swelling of the gland or a benign tumour. I think they both can be treated with medication so I would ask your GP about being referred for further tests.

[SPD1 in reply to Lora7again]

Hi Lora,

going to speak with MY GP tomorrow on phone and request further testing and an Endo appt as well if she will agree to it..

Its really bizarre to be losing hair on head at a serious rate of knots, have my beard growth slow noticeably yet be growing hair on arms, legs and hands like wildfire.. certainly never come across hair loss and hair growth at the same time be attributed to thyroid.. i will check out swelling and benign Pit issues.

Thanks.

[jrbarnes]

I had serum T4 and T3 levels exactly like yours and felt unwell. I was taking too much. My suggestion would be to lower your Levo by 12 to 25 mcg depending on which dose you're taking. Bring your T4 down to 1.6 to 1.8 which may bring your T3 levels into the 3.8-4.4 range. See if that relieves some of the symptoms. Like if you're on 100mcg right now, come down to 88mcg. You could even stop your levo for a few days and if the symptoms go down then you know to decrease your dose. Everyone responds differently though due to your body's conversion of T4 to T3 so your numbers may look different.

I also had B12 levels in the 300s. I'm using Metagenics Intrinsi B12/folate. I also use their Thyrosol which has a small handful of vitamins and minerals not in high doses. I've been able to bring my B12 up to 750, however that didn't change any of my symptoms so I was able to rule out that. In the winter my Vitamin D is 33 and in the summer 80. Your folate and ferretin is really good.

[SPD1 in reply to jrbarnes]

Hi,

thanks for your reply. When you say you felt unwell, in what way?

You were taking Levo only ? what dose? Where was your TSH ?

If my T3 lowers wont i feel worse ?

I'm on 150mcg Levo only nightly.

Do you not supplement Vit D as its very low in winter ?

How long did it take you to raise from 300's to 750?

Thanks.

[jrbarnes]

I had just switched from taking only 88mcg of Levothyroxine to a natural desiccated thyroid medication. Levothyroxine stays in your system for a month or two after you stop taking it. I immediately started taking 120mg of natural desiccated medication which drove my T4 up to 2.2 and T3 up to 5. It drove my TSH down to .05. I was feeling hot and like I had blood pressure problems. Lightheaded upon kneeling and standing. Tasks were difficult like working in my garden. I felt like I had to sit down a lot. I just felt overworked and not energetic. People often think if you overload yourself with Levothyroxine that you'll feel more energetic but that's not the case. In fact, lowering your medication just a little bit could make you feel better. It's all about getting to the right ratio and you won't know it until you try it. It's more about how you feel and less about the numbers game. It's possible that your T4 and T3 are too high at the same time. This is where you see a lot of people reducing their Levothyroxine a little if it's too high and if they still feel tired after 6 weeks they then add a little bit of T3 to increase the T3 to a level that's right for you. I would suggest a slight reduction in your Levothyroxine first. I'm in the States and it's probably easier to get T3 from a Dr here than in the UK, from what I read here. Most literature says T3 levels should be 3.5 or more to get rid of hypo symptoms but that 4.4 is like a cutoff. Again, it's all up to a person's individual needs.

I'm off the natural desiccated because the ratios of T4/T3 didn't work for me. I've gone back to Levothyroxine and trying different brands. My T3 is terribly low right now so I supplemented today with 2.5 mcg of T3 because I was so dizzy and my body temp dropped super low. Messing around with natural desiccated put me on a leave from work. I'm glad it works for some people but it didn't for me.

I will definitely be supplementing my Vit D with Vit K this winter. Good luck!

[SPD1 in reply to jrbarnes]

Thanks for sharing your story and info, the very best of luck to you as well

[Lora7again]

3 months have passed now and have you made any progress?