Thank you for the great information and advice you provide on the forum. I’ve learnt so much by reading the posts and replies here, and I’d like to ask for your advice on my recent blood test results.
I am female, live in the UK, and was 62 when diagnosed with autoimmune hypothyroidism in November 2019. Before diagnosis I’d had many hypo symptoms - over at least three years - and it was awful fatigue, being thirsty and putting on weight for no reason that finally got me to the GP - I knew nothing about the thyroid and thought it might be diabetes.
I had a blood blood test which showed T4 was <1.3 (range 12-22 pmol/L) and TSH 110 (range 0.27-4.20 mlU/L), was put on 100 mcg of Levothyroxine, and felt a lot better. After a few months, dosage was reduced to 75 mcg, based on TSH and T4, and how I felt - including palpitations. Over time I became increasingly fatigued again, and this March the GP agreed I should up the dose to average 87.5 mcg, based on my weight.
Until recently I’ve felt somewhat better - almost normal! - but now fatigue has returned - with one very bad day - plus palpitations, puffy eyes and neck, and tingling hands and feet.
I’ve finally taken a Medichecks advanced thyroid function blood test. The test was at eight in the morning, before breakfast, and 24 hours after last dose of Levo, and I haven’t been taking any supplements. I’m attaching a pic of the test results. Medichecks advise taking vitamin D, and I wonder if B12 would be a good idea too - I worry about B12 a bit because my Dad had pernicious anaemia. I wonder too if I should be increasing Levo to100 mcg, based on the TSH, FT4 and FT3 levels and continuing fatigue, or if the tendency to have palpitations goes against this.
Thank you for reading all this, and I’d be grateful for your comments and advice.
Written by
northandsouth
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Thank you for replying SlowDragon. It’s good to know what level of vitamin D to aim for. I didn’t know about vitamin D spray, and hadn’t really appreciated the value of taking magnesium as well as vitamin K. I can plan my vitamin D improvement campaign properly now🙂.
Thorne Basic B is an option that contain folate, but is large capsule. You can tip powder out if can’t swallow capsule
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)
IMPORTANT......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
If serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
Also ferritin Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Your results suggest you are under medicated and need small increase in dose
Most people when adequately treated will have Ft4 and Ft3 at least 50-60% through range
Perhaps try increasing to 100mcg daily
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Teva, Aristo and Glenmark are the only lactose free tablets
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but doesn’t make 25mcg tablets
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
Some people also find it better to split dose - half in morning and half at bedtime
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex
Thanks SlowDragon, You’ve given me the confidence to increase Levo to 100mcg. I’ve also ordered D3 with K2 spray, the super B complex, and a magnesium complex. I’ll make sure to get more iron into my diet too. Thanks again for being here, and I hope you and all the forum stalwarts have a lovely summer!
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