Read lots of posts but this is my first time posting.
Brief history, I am 46 years old and was first diagnosed hypothyroid and B12 deficient in 2014 when my periods were reversed (heavy bleeding 28 days a month, not bleeding 4 days). Having a coil fitted stopped this but I know if it was removed it would start again.
Didnt really have any other symptoms that I realised but looking back have always been tired all the time, weight gain/unable to lose weight, brittle hair / hair loss, brittle nails, dry skin, poor concentration etc. I just accepted that this was normal.
Since 2014 I have had 12 weekly B12 injections, used to feel a bit better for a while after but dont anymore. I was stared on 25micrograms of levo on 14/08/2014. On 2/10/2014 was increased to 50micrograms which I have been on ever since.
Have yearly blood tests done by GP but dont get the results and as they hadn't contacted me I didnt think about it and presummed all was ok.
Having read all your really helpful posts I decided to get a private test done as the tiredness, poor concentraion is starting to affect my work and I dont have a social life anymore as all I do when I get home from work is cook tea and go to bed!
I would be greatful for any help with these results.
Blue Horizon Medicals - Thyroid Check Advanced
Total Vitamin D 22 (75-200 nmol/L)
Zinc 14.5 (9.6-20.5 umol/L)
Selenium 1.04 (0.75-1.46 umol/L)
Serum Folate 3.15 (3.89-26.80 ng/ml)
Vitamin B12 ** (754 197-771 pg/ml)
Magnesium 0.87 (0.7-1.0 mmol/L)
Thyroid Peroxidase antibody <4 ( 0-24 IU/mL)
TSH 2.43 (0.27-4.2 mIU/L)
Free T4 13.17 (12-22 pmol/L)
Free T3 4.2 (3.1-6.8 pmol/L)
Ferritin 57.91 (13-150 ug/L)
** 12 weekly B12 injection on 30/0920, blood test 15/10/20 , only appoimtment I could get as finger prick didnt work
Is it worth contacting my GP about vitamins or should I just supplement myself? Would be greatful for advise on doses etc.
Your story sounds very similar to mine. It’s an ongoing battle🤔I’m not too sure about your vitamin levels but I’m sure someone with lots of knowledge in that area will be along soon. Your results look like you could do with a Levothyroxine increase to me. Your TSH looks too high for someone on Levothyroxine, most people (including me) feel better when TSH is below or around 1.0 and your T3 and T4 are both in range. We’re only overmedicated when our T3 is over range. As many have said on here go with how you feel to determine your medication. It’s tough at times but I believe forums like this help to keep me positive and believe we can make ourselves better 🙏🏻😊
I think you need to increase your levothyroxine because 50mcg is just a starter dose and should have been increased after 6 - 8 weeks by 25mcg until you feel well. Your TSH should be 1 or lower and your T4 and T3 should be in the upper third of the range. Your Ferritin could also be higher but this could be caused by your long periods. I was also given the Mirena coil which actually made me worse and it was only when my thyroid levels were right that my prolonged bleeding stopped. I decided to take Tranexmic acid tablets which slowed and finally stopped the bleeding. Also your vitamin D is much too low and needs to be a lot higher. I take the BetterYou Vitamin D spray which is easily absorbed on your tongue. Your folate is also too low but this could be because of your B12 and hopefully someone will be along to advise you about that.
If you have been reading lots of posts, you will know that 50mcg levothyroxine is only a starter dose
Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Your thyroid results show low Ft4 and Ft3
Clearly in need of 25mcg dose increase in levothyroxine up to 75mcg and bloods should be retested 6-8 weeks after each dose increase
Contact GP to request 25mcg dose increase in levothyroxine
What brand of levothyroxine do you typically get?
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
Are you currently taking Teva?
Teva, Aristo and Glenmark are the only lactose free tablets
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).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Even if frequently 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 or around 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.
The aim of levothyroxine is to increase dose upwards until Ft4 is in top third of range and Ft3 at least half way through range (regardless of where TSH is) ...important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works
Folate is also deficient - GP should prescribe folic acid, but you may prefer to take vitamin B complex
As you have B12 injections it’s recommended on here to also to supplement 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 between injections too
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 is another option that contain folate, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
Never supplement iron without doing full iron panel test for anaemia
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
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.
For a medic to leave you on 50mcg levo, for 6 years with your labs and symptoms, is a disgrace!
FT4 is only 11.7% through the ref range
FT3 is 29.73% ditto
Both should be approaching 75% through their respective ref. ranges
Those numbers help explain why you feel under par.
Your conversion appears to be adequate
You are seriously hypothyroid and need better treatment!
Your levo needs to be increased to 75mcg, re-tested after 6/8 weeks and the dose adjusted/increased as appropriate until you feel well and your frees as are above.
Your TSH should be close to 1.
Vitamin D needs a boost as does folate and ferritin.
Antibodies are low so autoimmune thyroid disease is unlikely
You comment, "I just accepted that this was normal"... this is a hole that many of us fall into, myself included! It is not normal, you can feel better with the appropriate medication.
I suggest you ask your GP for a levo increase asap
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