Hair skin nails supplements.

[Kubz16]

Hi I am currently taking 75mg on levothyroxine but no improvements on hair skin or nails, please could you advise which supplements for best. Thank you

[greygoose]

The best supplements for anything are the ones you need. So, you should get your vit D, vit B12, folate and ferritin tested, and go from there.

[Kubz16 in reply to greygoose]

I get my blood tests every 3 months and every time I either get prescribed Vit D or Iron tablets. Sorry might sound silly but does the blood test pick all the above you have suggested or do I need to request ? (Also thank you for the prompt response)

[greygoose in reply to Kubz16]

With most doctors you need to request them individually because doctors know nothing about nutrition and don't realise the importance.

Always get a print-out of your results, post them on here, and then people can help you understand what you need to take. Your doctor will probably prescribe the wrong thing and/or not enough of it.

[Kubz16 in reply to greygoose]

Ah ok for my next blood test I will request the above, thank you for your help. I have my last blood results

[greygoose in reply to Kubz16]

OK, well, post them here, with the ranges, and let's have a look.

[SlowDragon Administrator in reply to Kubz16]

How much vitamin D are you currently taking

What was result before starting on vitamin D

Levels should be retested twice yearly

GP budget only allows testing once every 2 years, so you will need to test yourself

[Kubz16 in reply to SlowDragon]

I am currently taking 20,000 unit of Colekal-D3

[SlowDragon Administrator in reply to Kubz16]

So that’s loading dose of vitamin D (total of 300,000iu over 6-8 weeks)

So vitamin D must have been very low at less than 25nmol to be prescribed loading dose

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

Vitamin D

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

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...

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, you will definitely 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

amazon.co.uk/BetterYou-Dlux...

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 level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

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

Taking too much vitamin D is not a good idea

chriskresser.com/vitamin-d-...

Web links about taking 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...

2 good videos on magnesium

healthunlocked.com/thyroidu...

Vitamin D and Covid

Note how much vitamin D many medics are taking

vitamind4all.org/letter.pdf

[SlowDragon Administrator]

75mcg levothyroxine is only one step up from starter dose

Do you always get same brand of levothyroxine

Which brand

What vitamin supplements are you currently taking

Please add most recent results and ranges

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels (and thyroid antibodies if not been tested yet)

Low vitamin D is especially likely with darker skin too

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Also vitamin D available as separate test via MMH

Or alternative Vitamin D NHS postal kit

vitamindtest.org.uk

[Kubz16 in reply to SlowDragon]

I was on 25mg for 12 months but no changes in any of my symptoms, then after blood test was given iron and 50mg Levo again no changes and about 3 months ago after my blood test I was prescribed 75mg of Levo and 7 week course of vit d

[SlowDragon Administrator in reply to Kubz16]

Thyroid levels should be retested 6-8 weeks after EACH Dose increase

What brand levothyroxine are you currently taking

You are legally entitled to copies of your blood test results

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

The aim of levothyroxine is to increase dose upwards in 25mcg steps until TSH is always under 2

When adequately treated, TSH will often be well under one.

Most important results are ALWAYS Ft3 followed by Ft4.

When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)

Extremely important to have all 4 vitamins at optimal levels too as this helps reduce symptoms and improve how levothyroxine works

guidelines on dose levothyroxine by weight an help push GP to increase

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 eventually on, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

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.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

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.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

[Kubz16]

Thank you I will give this a read and follow 👍🏼

[SlowDragon Administrator in reply to Kubz16]

Starting on 25mcg was ludicrously small dose...and ridiculous to be left on this a year

Get hold of actual results and come back with new post

[Kubz16 in reply to SlowDragon]

I have uploaded my latest result it only allows me to add 1 pic however

[SlowDragon Administrator in reply to Kubz16]

You can now add results to replies within posts

[Kubz16 in reply to SlowDragon]

Oh ok how so? Can I add more pic to my original post?

[SlowDragon Administrator in reply to Kubz16]

When you open a reply ....look bottom right there’s a rectangle with mountain ....click

Choose image