Just had my first blood test after starting Levo back in January. (Last couple of years my vit D and B 12 was low, TSH was borderline at 4.9, and cholesterol was increasing. This January I was prescribed Levo 50. I discovered this site upped my vit D to 2000 and added a general vit B supplement.
I have just had my next blood test (9 months after starting Levo) results below.
My TSH. has dropped from 4.9 to 0.91.
Free T4 has gone up from 10 to 14.
TPO antibodies - first test - 21. Does this indicate autoimmune disease
Ferritin 72, folate 14.6
Vit D is up from 69 to 92 - do I continue with D3 at 2,000? Should I add K2, MK7 and magnesium?
Cholesterol has dropped from 5.9 to 5.5 but GP wants to talk about a statin. Going to refuse that.
Red blood count looks slightly high - not sure what that means.
Do I request a 25 increase in Levo to raise T4 further?
I haven’t had T3 tested yet.
Haven’t felt much different being on Levo 50 all these months - maybe a bit more lethargic. Sleeping really badly the past few weeks - only getting 4-6 hours sleep every night.
Any thoughts much appreciated. This is a great forum
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If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
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
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
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.
Majority of Hashimoto’s patients have high TPO or high TPO and TG antibodies, but a significant minority only have high TG antibodies, and NHS won’t test TG antibodies unless TPO antibodies are above range
Also 20% of Hashimoto's patients never have raised antibodies.
Vit D is up from 69 to 92 - do I continue with D3 at 2,000? Should I add K2, MK7 and magnesium?
If that was me I'd continue with that dose throughout the winter and retest in March. The Vit D Council recommends a level of 125nmol and the Vit D Society recommends 100-150nmol.
Definitely add K2-mk7 and magnesium.
D3 aids absorption of calcium from food and K2-mk7 directs calcium to bones and teeth where it is needed and away from arteries and soft tissue where it can be deposited and cause problems such as kidney stones and calcification of arteries.
Magnesium helps the body convert D3 into it's usable form.
Um, I’m vegetarian and I do like carbs, but have been trying to follow a cholesterol lowering diet for about a year. I haven’t been so good over the last couple of weeks, though, as pasta and pizza have crept back in after a period of abstinence.I obviously need to improve further. I was hoping getting my thyroid treated would help in lowering the cholesterol, And I think that’s why I allowed the diet to slip but is lowering the blood sugar a different thing?
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
Yes getting thyroid hormones increased should help lower cholesterol
Thanks for that. I feel a bit of an idiot not realising that, as a vegetarian for 40 odd years, I needed to supplement B12. I’m also quite ignorant about blood sugar - confusing it with cholesterol. Time for some reading and action.
Looking at your diabetic markers, cholesterol result and lowish b12 I'm wondering if you may not be absorbing many protein-based foods.
Pre-diabetes demands a rethink of nutrients and diet.
Protein contains useful minerals and amino acids such as carnitine and NAC that can prevent cholesterol build-up. B12 helps blood sugar metabolism among its many vital roles and is only found in animal protein, so it's important to supplement if you're vegetarian. You can feel pretty exhausted with low B12 (levels below 500 are too low if hypothyroid).
Magnesium is found in plant protein, specifically dark green leaves and zinc is found in nuts, seeds and meat. Both of these are vital for preventing insulin resistance. They work really well with B6 (p5p is the best type of B6 for absorption) and B12 and folate to improve cognitive and peripheral nerve function and lower homocysteine.
Note that carbs are nutritionally pretty worthless apart from providing energy. Some fats are good, because useful lipids, vitamin E and D are found in them and help our immune systems and hormone synthesis.
Taking Vitamin C is always a good idea and I'd recommend taking this all year round, because it doesn't get stored.
Thank you for your detailed reply. Although vegetarian I wasn’t supplementing B12 until I started with a B complex a few months ago. I do eat lots of green veggies, nuts and seeds, eggs, milk and cheese, and I recently started eating fish occasionally. I will look further into the whole diet and supplements issue.
I've been unconvinced of the supposed health benefits of modern day low fat dairy for a long time. Partly because I'm biased (actually allergic), but also because it's a recent phenomenon to have so much of it - especially the low fat, pasteurized, mass produced sort splashed over refined grain cereals.
The Japanese have virtually nil dairy (and gluten), but eat a lot of fish and eggs and not much meat. They have few nutritional deficiencies. The dairy lobby in the West is massive as it's so profitable, which makes me even more cynical!
My brother-in-law wouldn't eat meat or fish when he found out he was diabetic (he was already vegetarian), but he did give up dairy and wheat and started making his own nut roasts etc and had b12 injections and he's now very healthy and free of diabetes.
Thanks for adding this. That’s really interesting. I’ve read criticisms of low fat dairy before and I’m still not sure why full fat dairy is better than low fat. Avoiding dairy altogether seems more understandable but it’s not a path I have seriously considered (skimmed milk in tea....cheese...what more can I say)
Finally an explanation on the low v full fat! Thank you. Michael Mosley is one of my heroes and I have been trying to follow the Mediterranean diet. I was just wondering, this morning, what I was doing wrong when my partner came in with the shopping. “I got us a couple of knock down curries and these desserts were on special offer, so we can push the lentil Shepherds Pie onto tomorrow “....the penny is dropping!
Sounds like my other half! He's now, how shall I say, well educated and has full fat local organic milk and good cheese. It's a no go for me as I get horrid bloating, but I did experiment with Kefir for a while in a bid to restore my tolerance for dairy and it improved my energy a lot (it has high b12 and vitamin d and k2), but eventually my gut said, 'no'. It's a fun thing to try doing and healthy and I would recommend to anyone who's dairy tolerant and has no histamine issues. (Kefir is high in histamines.)
Bloods should be have been retested 6-8 weeks after starting.....such long gap has likely caused TSH to drop
guidelines on dose levothyroxine by weight
Even if we don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.
RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.
I just wanted to say that my cholesterol level was 6.3 when I was just diagnosed 4 years ago. Once on thyroxine it dropped to 5.5ish. I didn’t change my diet much (not saying you should or shouldn’t) other than I don’t eat shop bought cakes, only home made so I know what goes into them.
I have finally got good levels on the vitamins and minerals that you have been advised to sort. Plus my thyroid levels are pretty reasonable too. I feel the best I have felt for a very long time.
My cholesterol level was recorded as 4.9 on my latest test (range is less than 5.2).
I ate roast lamb the week before and leftover lamb and 3 mince pies (only one a day). But I do love salad and veg too.
So my point is, get all your levels right and hopefully your cholesterol will naturally lower.
Tell your GP you don’t want to rush into anything, they can’t force you to take the statins.
Hi when I was diagnosed hypo about 14 years ago my cholesterol was 14.85. About 3 to 6 months later and changing nothing apart from taking levo it came down to 4.5. Jo. Xx
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