Firstly I wanted to thank everyone for their incredibly helpful comments and advice on my previous post.
As recommended, I have ordered a full thyroid panel through MediChecks which I shall be completing tomorrow.
I also requested my previous results again from my GP surgery (they certainly were inconvenienced by my request but did eventually agree to print them out). And now I am even more confused and wondering if my doctors are correct to be brushing me off as my levels appear to be great. For context I am only on 25mcg of Levothyroxine (have been for the past 2-3 years) and still really symptomatic.
In May 2020:
TSH: 3.24 (0.27-4.2)
Free T4: 18.1 (12.0-22.0)
September 2020:
TSH: 1.89 (0.27-4.2)
Free T4: 15.6 (12.0-22.0)
May 2021: (Most recent)
TSH: 1.98 (0.27-4.2)
Free T4: 16.0 (12.0-22.0)
Viamin D: 31.5 nmol/L (I was advised due to this result that my levels are “a little low” and recommend to buy and take a supplement of 800-1000 iu.
I will update once I have the result of my full panel tests. I am completely unsure what brought my TSH level down so much from May 2020 as there have been no alternations in my medication at all. I am worried that my current results suggest I am wasting my time pushing this and no doctor is going to treat me?
Written by
ellecoco
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No, your levels are not great, I'm afraid. They are in-range, but that doesn't automatically make them great.
Your TSH is much too high for someone on thyroid hormone replacement (levo). A euthyroid TSH would usually be around 1, but certainly no higher than 2. Hypos tend to need it much lower than that: 1 or under - suppressed, even.
Your FT4 is only 40% through the range, which isn't even euthyroid - that would be at least 50%. And, once again, hypos tend to need it higher, more like 75% through the range.
So, you are under-medicated on 25 mcg levo - which isn't surprising because that isn't even a starter dose.
I am completely unsure what brought my TSH level down so much from May 2020 as there have been no alternations in my medication at all.
The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or lower with FT4 in the upper part of it's reference range. Your TSH is too high, your FT4 is only 40% through range. If your GP insists they are within range, emphasise any symptoms you are still experiencing and request a trial increase in dose of 25mcg and retesting in 6-8 weeks to see what happens. Reassure your GP that if you have any symptoms of over medication you will immediately reduce your Levo and contact him (that worked very well for me with one GP a few years ago).
Viamin D: 31.5 nmol/L (I was advised due to this result that my levels are “a little low” and recommend to buy and take a supplement of 800-1000 iu.
Unfortunately doctors aren't taught much, if anything, about nutrition hence the ridiculously low recommendation here.
Vit D deficiency in some areas is diagnosed when level is below 25nmol/L and in some areas when it's below 30nmol/L so you can see just how close to deficiency you are.
You have two options here:
1) Treat as if you have Vit D deficiency and follow the NICE Clinical Knowledge Summary for loading doses or
"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 25 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.
* Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
This would then be followed by a retest to check your level and your follow on dose would be based on that new level then the information in Option 2 would apply.
Option 2
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.
To reach the recommended level from your current level, you could supplement with 5,000iu D3 daily.
Retest after 3 months.
Once you've reached the recommended level then you'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. You 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.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
For Vit K2-MK7 I like Vitabay or Vegavero brands which contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
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 you 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.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
Make sure you do medichecks test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Latest NHS test shows that you are under medicated
Ft4 is only 40% through range
Helpful calculator for working out percentage through range
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Thyroid results 
T3 very high
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Thyroid results but no ranges given! Is there a standard range available?
