Help with vitamin D

[lynnwin]

Hi posted yesterday .. is there anyone that can answer please xx

[SeasideSusie Remembering]

lynnwin

As far as I am aware there is no optimal level specifically for thyroid patients, the level recommended by the Vit D Society and Grassroots Health applies to all. That level is 100-150nmol/L (or 40-60ng/ml).

As for taking Vit D 4 hours way from thyroid meds, I have seen it said that because Vit D is a hormone then it should be taken 4 hours away from thyroid meds so there is no interference with absorption.

This article mentions 4 hours gap:

drugsdetails.com/can-i-take...

Can we take levothyroxine and vitamin D side by side

In my opinion, each and every supplement should be separated by 4 hours with the thyroid medication to avoid decrease in absorption of levothyroxine systematically . If their is changes in absorption of levothyroxine in patients then dose adjustment is needed to maintain the same therapeutic effect required to provide the biological effect to avoid any side effects in the body system and lead the body functioning smoothly.

and this one mentions Vit D or multivitamins and a 4 hour gap:

vitamins.lovetoknow.com/abo...

Supplementing Vitamin D

If you're taking Synthroid for hypothyroidism, ask your doctor about which multivitamin supplement, if any, you should take and have your vitamin D levels monitored regularly to make sure you're not deficient in this essential nutrient. If your doctor recommends you take a vitamin D supplement or multivitamin supplement containing vitamin D, make sure to have your thyroid and thyroid-stimulating hormone (TSH) levels checked regularly, always take Synthroid as directed, and avoid taking supplements within four hours of taking Synthroid.

Don't forget that when supplementing with Vit D there are important cofactors also needed, i.e. magnesium and Vit Kk2-MK7. Magnesium needs to be taken 4 hours away from thyroid meds.

[lynnwin in reply to SeasideSusie]

Thank you seasidesusie for your reply .. I have been taking mine a hour after my levothyroxine with my breakfast.. just had my blood tests back as follows

Vitamin D 271 😳

T4 21.3 (12.0-22.0)

FT3 3.9 (3.1-6.8)

TSH0.26(0.27-4.2)

So it seems it’s not affecting take up of T4

But wondering if it’s affecting conversion ?

Obviously I’m cutting back my Vitamin D drops . I don’t take magnesium orally as always upset my tummy so use it tropically and have had blood tests to confirm this is working and my magnesium is at top of range .. not added K2 before .. Xxxxx

[SlowDragon Administrator in reply to lynnwin]

Looking at previous posts you have Hashimoto’s (high thyroid antibodies)

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

Do you always get same brand levothyroxine

Which brand

Conversion of Ft4 to ft3 is very poor

Ft4 is 92% through range

Ft3 only 22% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Are you still taking propranolol?

Propranolol slows uptake and conversion of levothyroxine

You can’t just stop taking propranolol. Has to be weened off incredibly slowly

How much are you currently taking

Propranolol tends to lower magnesium levels too

Are you currently taking any magnesium supplements

(Must be four hours away from levothyroxine)

Essential to test folate, ferritin and B12 too

Are you on strictly gluten free diet

If nothing get coeliac blood test done BEFORE trialing strictly gluten free diet

[lynnwin in reply to SlowDragon]

Hi slowdragon yes my blood was taken first thing in the morning no food or drink just water and no Levo for 24 hours .. I’m a phlebotomist so i get my colleague to take it at 07.30 .. I am a coeliac so no gluten for 30 years my B12 is so high at 1200 doesn’t seem to drop since I had B12 injections .. Yes still take propranolol I was on 2 x 10mg a day then my GP said to increase to 20mg twice a day as working through the pandemic was making me anxious as I’m high risk and it did help with my anxiety.. I’ve now cut down to 30mg so 10mg less a day I also take 20mg Amitriptlyne at night for my PN .. My ferritin is high I even had that monitored as I thought I may have Haemochromatosis 😔 but it’s gone down a bit now ..With the magnesium I had a blood test that was low then said to my GP I will try organic magnesium tropically he replied that won’t help 🤷‍♀️ 3 months later after tropical use my blood test for magnesium was top of range .. he had to swallow his words then lol 😂 .. As you see my Vitamin D is way high and been taking that a hour after Levo with breakfast and I just wondered if it could be that affecting conversion but I think it must be the propranolol .. ? What do other people do who take Levo and thyroxine? Many patients I see are on both .. I always have the same brand which was activis now accord .. Dose was 75 /100 alternative days .. just increased to 100 everyday .. I feel ok but worry about my FT3 and that has improved since my last results in December.. xxxx

[SlowDragon Administrator in reply to lynnwin]

As you are coeliac you will almost certainly need small doses of T3 prescribed alongside levothyroxine

First getting levothyroxine dose increased and fine tuned so that Ft4 is at top of range

All four vitamins need to be optimal

As you have B12 injections are you also taking daily good quality vitamin B complex to keep all B vitamins in balance

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...

Obviously need to get completely off propranolol before you can really see what your conversion rate is like

You might also want to get Dio2 gene test done

If you test positive this can help persuade NHS to prescribe T3

thyroiduk.org/deiodinase-2-...

[Digger031145 in reply to SlowDragon]

Her ft4 is already tipping top of range

[SlowDragon Administrator in reply to Digger031145]

Yes, but once off propranolol that may change as conversion of Ft4 to Ft3 improves

[lynnwin in reply to SlowDragon]

Thank you for your reply .. I no longer have B12 injections and my B12 hasn’t dropped in 5 years .. my FT4 is high already .. I do take B1 B2 B6 but only if my bloods show I’m deficient.. I have them tested by Biolab being a coeliac they are Often low .. I have lots of patients on Levo and propranolol and similar obviously I don’t see their results I just bleed them but what can patients do if they need propranolol or something similar ? I will keep a eye on my FT3 and try and keep reducing my propranolol.. If it doesn’t improve I will ask for FT3.. Many thanks for all your help xxx

[SlowDragon Administrator in reply to lynnwin]

You could have different medication for anxiety

Propranolol is used to treat hyperthyroid patients. Many medics don’t seem to realise propranolol not good idea when hypothyroid and on levothyroxine

pubmed.ncbi.nlm.nih.gov/168...

Extremely difficult to get T3 prescribed on NHS

Email Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3

NHS and Private

[e-mail]

Taking a vitamin B complex that contains all B vitamins might better as keeps all B vitamins in balance

[lynnwin in reply to SlowDragon]

Thank you yes I was given it when hyperthyroid.. when I came off it my migraines returned so GP kept me on a low dose it seems to point to propranolol as my FT3 was ok until increased propranolol.. I will gradually cut it back I was fine on 20mg a day propranolol it must have been the increase ? Xxxxxc

[SeasideSusie Remembering in reply to lynnwin]

lynnwin

It's said that testing magnesium is unreliable. About 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood. So testing what's in the blood isn't giving an accurate picture of our magnesium status.

A red cell magnesium test is the better indicator of magnesium status, not the standard serum magnesium test.

If you want to read the science, this information is from this article:

ncbi.nlm.nih.gov/pmc/articl...

That's not to say you don't have a good magnesium level.

Vit K2-MK7 is important because D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

K2 is fat soluble so should be taken with the fattiest meal of the day or some form of dietary fat, or an oil based K2 supplement.

[Digger031145]

Lynn is celiac and already keeps to a strict diet avoiding all gluten

[SlowDragon Administrator in reply to Digger031145]

Only recently diagnosed.

Takes at least a year or two for guts to recover

[Digger031145 in reply to SlowDragon]

No she’s been celiac for many many years

[lynnwin in reply to SlowDragon]

Been coeliac for over 30 years slowdragon so been on GF strict all that time xx

[SlowDragon Administrator in reply to lynnwin]

Sorry, also having conversation with another member, just recently diagnosed coeliac

[AnnaA339]

You mention your B12 is in the 1000 and has not dropped down after you stopped B12 injections. After genetic testing, it was discovered that I do not methylate, so my B12 tests in the 1000s were a false number as my body was not using the B12. I now take a methylated version of B12 supplements Methylcobalamin (Methyl B12). Now it is more readily available, even some supplements use this version. I was told that with the high amount of unusable B12, it takes a while for the body to realize it has the methylated version to use instead.

[lynnwin in reply to AnnaA339]

Hiya thank you so much for your message I do believe I had a test with biolab to check this .. Did your GP test you ? I will look through my results from biolab .. What test did you have Anna ? Xxxx