First Blood Results - Feelng Nervous!

[Levo50]

Hi

So after a few decades plodding along with an underactive thyroid and taking just a starter dose of 50mcg Levo (Accord) - I stumbled accross this site - decided recently it was critical I paid for a private blood test and the results are just in.

I believe from being around this site just a few months that adjustments are most certainly needed.

I want to be very cautious in my quest for optimisation; fortunately a GP has agreed to my personal request to increase my Levo by 25mcg per day - as I've been on 50mcg for soooo very long, I have increased by 12.5mcg from 02.02.2021.

I have to say I've been reading and googling (haemochromatosis) this morning and scaring myself half to death!

Sharing my results with any of you good people who would be caring enough to share your expertise and sound advice ...

OSERVATON DATE: 4-Feb-2021

Inflammation

CRP HS 0.78 mg/L (Range: < 5) = GREEN flag

Iron Status

Ferritin 207.00 ug/L (Range: 13 - 150) = RED flag

Vitamins -

Folate - Serum 9.86 ug/L (Range: > 3.89) = GREEN flag

Vitamin B12 Active 65.700 pmol/L (Range: > 37.5) = GREEN flag

Vitamin D 51.60 nmol/L (Range: 50 - 175) = GREEN flag

Thyroid Hormones

TSH 3.10 mlU/L (Range 0.27 - 4.2) = GREEN flag

Free T3 4.03 pmol/L (Range 3.1 - 6.8) = GREEN flag

Free Thyroxine 13.700 pmol/L (Range 12 - 22) = GREEN flag

Autoimmunity

Thyroglobulin Antibodies 22.600 kIU/L (Range: <115) = GREEN flag

Thyroid Peroxidase Antibodies 92.90 kIU/L (Range: <34) = RED flag

Doctor's Overview

Thank you for choosing to monitor your health with Medichecks. I can see that you take levothyroxine for an underactive thyroid gland.

You have high iron stores. This is likely to be due to a high dietary intake of iron or taking iron supplements. If you are taking supplements I recommend decreasing your intake. To exclude iron overload I recommend an iron deficiency check which will look at your other iron markers and help us to work out whether there may be iron overload.

You have normal levels of vitamin B12, but it is towards the low end of the normal range. To work out whether there is significant underlying B12 deficiency I recommend arranging a serum methylmalonic acid blood test.

Your vitamin D levels are at the low end of the normal range. This may progress to vitamin D insufficiency or deficiency if you don’t take steps to increase your vitamin D levels.

Low levels of vitamin D can cause reduced immunity, fatigue, bodily aches, poor memory and difficulties concentrating.

Outside of the winter months there is enough sun for your skin to make at least part of your daily requirement of vitamin D, so it is worth trying to get 15-20 minutes of midday sun when the sun is out. Vitamin D can also be found in fortified foods such as breakfast cereals, plant-based milks, tofu and some fruit juices. The only reliable natural source of vitamin D is in oily fish, although it can also be found in some mushrooms (portobello, maitake, morel, button, and shiitake are particularly good), you can improve this by leaving the mushrooms in the sun before cooking them.

We recommend supplementing with 400 - 800 iu of vitamin D per day for twelve weeks. If you are already taking vitamin D then I recommend that you increase your dose.

Your thyroid stimulating hormone is in the normal range which suggests that your levothyroxine dose is correct.

Your thyroid peroxidase antibodies are elevated. This antibody is commonly associated with autoimmune thyroid disease. It is frequently seen in conditions such as Hashimoto’s disease (where the thyroid becomes underactive).

I hope you find this information useful.#blood tests #ferritin test #vitamin b9 #levothyroxine #vitamins #t4 test #tsh test #vitamin d #vitamin b12 #thyroglobulin #t3 test #iron #haemochromatosis

[Lotika]

Hello Levo50,

I can’t comment on the vitamins, but you look desperately under medicated on the levo! I would be feeling quite rough on those levels I think. How do you feel?

That having been said, I think your conversion from T4 to T3 looks like a thing of great beauty - and maybe that helps in terms of how you feel?

Best,

Lotika x

[Levo50 in reply to Lotika]

Hi Lotika

Thank you for you reply!

I feel fine ha - apart from intolerance to alcohol, insomnia, lack of libido, brain fog, lack of concentration, poor memory, feeling the cold, lack of mojo, feel like something is desperatley lacking loss of vermillion border lower lip, swelling under right rib, occasional sugar drops, numbness mainly right hand in the morning ... I could go on and on (I've been this way for so long it is my normal I guess).

Oh my conversion from T4 to T3 if good then at least that's a bonus thank you

[Lotika in reply to Levo50]

Ha ha! That made me laugh!

Ah, well, I think we can safely say that being under medicated doesn’t suit you terribly well, then

[Levo50 in reply to Lotika]

Hi

I'm glad I made you laugh hehe!

it's not that long ago I used to wake up, take Levo, a handful of vits, coffee and breakfast, it's only with reading around here that I now take Levo with water only for the first hour, why nobody has ever told me different is pretty scary really!

[SlowDragon Administrator]

Ferritin Don’t worry about it. You’re post menopause. And have Hashimoto’s. Inflammation from hashimoto’s and no longer having periods means ferritin often goes up. GP won’t be concerned about high ferritin until up around 800

Vitamin D

Far too low and needs improving to at least around 80nmol and around 100nmol maybe better

What dose vitamin D are you currently taking?

Likely to need higher dose than 800iu

Folate and B12

Ok but not brilliant. Looking for B12 over 70 minimum.Might benefit from daily vitamin B complex

High TPO antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Did you know this?

Tried strictly gluten free diet?

If not....get coeliac blood test done BEFORE considering trial on strictly gluten free diet

Obviously significantly under medicated.....hardly surprising been left on 50mcg ludicrously long time

Yes, don’t rush the increase. After so long on inadequate dose, take small increase. (75mcg/50mcg alternate days - or 67.5mcg daily) Wait 6-8 weeks. Either retest, before increase to 75mcg daily.....or retest after being on 75mcg daily minimum 6-8 weeks

[Levo50 in reply to SlowDragon]

Hi SlowDragon

Thank you for your reply.

Ferritin - oh that's reassuring I was a little worried.

Vitamin D - I have just found some Vitamn D complex in my cupboard, it says 800 D2 and 800 D3 so I hav cut one in half and had it with my lunch (4 hours after Levo).

I have some B12 and B Complex but maybe I should just introduce one vitamin at a time?

amazon.co.uk/gp/product/B00...

No! I had no idea I had Hashimotos

I've never tried strictly gluten free this must be hard to eliminate all gluten, I always thought I tolerated gluten fairly well.

Why would I need Coeliac test - how would I go about askihng GP for this, would I share my private blood results?

Ok, I have a blood test booked with GP in 6 weeks time for TSH, I will stick with 62.5mcg and see what the results say - do markers move significantly?

[SlowDragon Administrator in reply to Levo50]

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...

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

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

Notice how much vitamin D many medics are taking

vitamind4all.org/letter.pdf

Retest vitamin D 2-4 months after starting on vitamin D supplements

Then test twice year

You may need more in winter than summer

[Levo50 in reply to SlowDragon]

Thank you SlowDragon that's a lot of info and a lot of reading, I will pick away and learn as I go hopefully, it is all fascinating and concerning in equal measures - I've done nothing else but read up on all this today and I feel quite drained, guess that's another symptom 😂

[SlowDragon Administrator in reply to Levo50]

One step at a time

You have increased levothyroxine to 62.5mcg

Suggest you order a vitamin D mouth spray with K2

In 10-14 days look at adding a magnesium supplement (usually best afternoon or evening) must be four hours away from levothyroxine

That’s enough for now!

[Levo50 in reply to SlowDragon]

Hi SlowDragon.

I am picking away through your replies, starting with the easiest...

Yes I’ve increased to 61.25 with my little pill cutting gadget, nothing to report as far as any changes I’ve noticed.

I started the vitD 1000 mouth spray last week as it was only the 3000 which had K2 - is that ok?

Is the magnesium essential - as I used to take such an array of vitamins I am keen to only take those absolutely essential or beneficial to my health.

I’ve put together a bloods excel spreadsheet - work in progress...

I am also going to book a coleliac test next

Thank you for all your help and advice

[SlowDragon Administrator in reply to Levo50]

Better You vitamin D with K2 is confusing...because the bottle says 3000iu .....but actually to get 3000iu it’s 3 x sprays per day

(Whereas the green Better You 3000iu spray without vitamin K2 is one spray = 3000iu)

So you can get the one with K2 next time. Or buy now and alternate it with the blue one

Many people on levothyroxine need higher dose vitamin D than typical

You likely need at least 2000iu daily ....possibly a lot more to get levels to improve up to at least around 80nmol and around 100nmol maybe better

But some people find levels increase rapidly......others very slowly...we are all different

So important to retest vitamin D after 2-3 months see if you’re taking enough

It’s trial and error what dose suits you.

Likely to need more between Oct and April than summer

Personally I need 3000iu daily in summer as maintenance dose, plus as much sun as possible.

And I need 5000-6000iu in winter. (Especially this year with no winter sunshine holidays) But that’s higher dose than many people would need

[Levo50 in reply to SlowDragon]

Oh that’s crazy - would have been helpful if the lady in H & B up selling the buy one get one half price deal had as much knowledge 👍

[SlowDragon Administrator in reply to Levo50]

With the exception of few names brands ....I wouldn’t buy in H&B

But to be fair.....it’s only by reading the small print on side of bottles

Many people have gone from green 3000iu bottle (one spray = 3000iu) and assumed that the red 3000iu bottle was also one spray = 3000iu

It’s misleading

[SlowDragon Administrator in reply to Levo50]

Yes definitely only add one supplement at a time

Start with vitamin D

Wait at least 10-14 days to assess before adding another

Perhaps magnesium next.

Then vitamin B complex

supplementing 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 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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Probably don’t need separate B12 as well

[tattybogle]

Well i know nothing much about iron , so i'll leave that part to someone who does. But i think you are wise to get the prescription for an extra 25mcg , but only take an extra 12.5 for now , and see how you feel .

I would give it at least 6 weeks on 62.5mcg and preferably a while longer (i'd say more like 8/10 wks) before you make your mind up how you feel on it.

[Levo50 in reply to tattybogle]

Thank you tattybogle - I'm happy to take baby steps, I have only upped from 50 to 62.5 and would much rather do it this way - GP has booked next blood test for 6 weeks, would you suggest I try to extend this to 8 weeks perhaps then?

[tattybogle in reply to Levo50]

I wouldn't bother moving the blood test , and the results should be as accurate then as they are ever going to be, But i have noticed it has taken me 5 weeks to feel even remotely stable after a dose change of 12.5mcg,...so i'd give it a bit longer before deciding what to do based on the results of that blood test AND how you felt , once you are sure that IS how you feel ,and isn't going to change again next week .

[Levo50 in reply to tattybogle]

Perfect thank you

[SlowDragon Administrator]

Only make one change at a time

So increase in levothyroxine

Slowly adding vitamin supplements

Then, perhaps look at trialing strictly gluten free diet

You don’t need any obvious gut issues, thousands of Hashimoto’s patients are astonished at the improvement

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

healthcheckshop.co.uk/store...?

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Gluten can be a cause of brain fog

[Levo50 in reply to SlowDragon]

Hi SlowDragon just a little update following your advice...

Two weeks into increase on Levo from 50 - 61.25mcg (Accord) using my little pill cutter gadget

Introduced Vit D 1000iu mouth spray - today I have tried 2 sprays after going on the VitD calculator which indicates I may need much more! Awaiting my 3000iu with Vit K to arrive, I’ll stick with 2 sprays

I have also ordered nature’s calm magnesium citrate powder, I will start with a low 1/2 tsp and see how I feel before increasing (insomnia is driving me mad)!

I will add in your recommended B complex in a few weeks

Coeliac private test done today is negative

Thinking of buying books on Gluten free and what do you think of Isabella Wentz Hashimotos Protocol?

With all this change hoping to see some improvements, especially with the brain fog and insomnia

Going for blood tests again just to check where my Ferritin levels are at

Thanks for all your guidance help and support 🦋