My dad has been advised on medichecks to lower his medication due to a low tsh, I have doubts on this, any thoughts? He constantly yawns, very mood and tired, no weight loss and generally feels awful. He is currently on 200mcg thyroxine long terms.
They say his vitamin levels are fine but I think folate and vitamin are low at 58vit d and only 5.71 for folate. Active B12 was high at 121.
Thank you for any advice
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Pinky3
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Alas, Medichecks doctors don’t seem to be any better informed than most GPs. The advice therefore is the “party line”—low TSH must mean that someone’s overmedicated.
But as you suspect, that isn’t true. Your father’s FT4 and FT3 aren’t overrange, in fact, he might feel better if they were a bit higher.
I wouldn’t reduce dosage. It’ll only make things worse.
I totally agree, so frustrating to see them recommending to reduce. If he must increase, should this be 25mcg? What could make the TSH lower after very stable results? He takes a high strength methyl B13 daily.
Who would make him reduce? These are private blood tests aren’t they? Have you had them done before NHS ones in an attempt to pre-empt what his doctor will say at the next appointment?
In all honesty, I would resist all requests to reduce dosage and get your father to say he wants to stay on the same dosage. Reducing would make him feel far worse. A low TSH doesn’t mean someone’s overmedicated in the presence of in-range FT4 and FT3 results.
Edited to add—doh, just realised you’d written “increase” not “reduce”. How did I get that wrong?
Yes, 25mcg. Could be added every other day to make it an average raise of 12.5mcg daily.
What could make the TSH lower after very stable results? He takes a high strength methyl B13 daily.
I see he has thyroid antibodies so it could be that the Hashimoto’s has been active recently—that might be the cause of lower TSH. But it seems to happen sometimes when people are stable on a dosage.
And I thought he must be taking B12. In that case, he definitely needs to supplement folate, as B12 uses up folate—and a folate deficiency can present very similar symptoms to B12 deficiency. It might be causing some of that fatigue.
Aha, that’s great! It explains a lot. I have sent him links to order supplements and told him to take them away from his thyroxine 4hrs. He said he’s keen to fix the folate then start increasing the thyroxine once the folate has increased as he wants to see if this eliminates his symptoms.
They say his vitamin levels are fine but I think folate and vitamin are low at 58vit d and only 5.71 for folate. Active B12 was high at 121.
Active B12 of 121 is not "high", it's a good result considering the range is 37.5-188, right where I'd like mine to be.
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L. To reach the recommended level from 58nmol/L, the suggested dose of D3 would be 4,000iu daily and retest after 3 months.
Once the recommended level has been reached then he'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. He can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3.
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.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
Medichecks range for Folate is 3.89-19.45 and it's recommended to be at least half way through range, so he's looking at 12+
With his Active B12 at 121 he no longer needs to take a B12 supplement but just maintain it with a B Complex, and the methylfolate in it will help raise his folate level. I would suggest one containing 400mcg methylfolate and to look at either Thorne Basic B which contains 400mcg B12 and 400mcg methylfolate in the suggested dose of 1 capsule, or Igennus Super B which contains 400mcg methylfolate and 900mcg B12 in the suggested dose of 2 tablets.
B Complex should be left off for 7 days before any blood tests as it contains Biotin and can give false results when Biotin is used in the testing procedure (which most labs do, including Medichecks).
Thank you for taking the time to reply, the vitamin D advice is great as I also need to increase my own vitamin d and this is very valuable info. Thank you
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