Are any thyroid supplements worth it?

[Hama102]

I had a partial thyroidectomy in May. The remaining lobe isn't working well on its own so started thyroxine a month ago. I had a look online at supplements that support thyroid function. Some reviews recommended them, others said it isn't worth it. What are your thoughts?

[SeasideSusie Remembering]

Hama102

What does it contain?

Generally they're not worth it.

Most include iodine which we shouldn't take without first testing, then only take if we are deficient and under the guidance of an experienced practioner.

Other than that they often contain a mixture of vitamins, so it's basically a multivitamin.

Best thing to do is test your key nutrients:

Vit D

B12

Folate

Ferritin

and post results on the forum. We can tell you if you have any deficiencies or levels low enough to need supplementing, suggest a dose and maybe a brand of supplement.

[Hama102 in reply to SeasideSusie]

SeasideSusie the blood results showed I was deficient in folate and vitamin D, so I guess I would be best to focus on those? There are so many brands - are any better than others?Thank you

[Hama102 in reply to Hama102]

Also don't know why the whole thing is underlined - sorry!

[SeasideSusie Remembering in reply to Hama102]

Underlined because you may have inadvertently clicked on the underlined "U" below the message box.

[SeasideSusie Remembering in reply to Hama102]

What were the results and reference ranges of Vit D and Folate.

Also what were B12 and Ferritin results/ranges (plus units of measurement for B12).

[Hama102]

SeasideSusie Thanks. I have had the following checked with Vitamin D and Folate coming back as low/suboptimalVit D - 57nmol/l (50-200)

Folate 8nmol/l (8.83-60.8)

Active B12 108pmol/l (37.5-188)

Ferritin (118ug/l) (44-150)

[SeasideSusie Remembering in reply to Hama102]

Hama102

Folate 8nmol/l (8.83-60.8)

Your folate level is suggestive of deficiency according to

cks.nice.org.uk/anaemia-b12...

Folate level

◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.

◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.

It may be worth discussing this with your GP who may wish to do their own test and prescribe folic acid but may also dismiss it.

If your GP isn't helpful I would suggest you buy your own methylfolate supplement, as I prefer to buy as clean a supplement as possible (when I can) to avoid any excipients that may cause problems, when I have bought methylfolate as a stand alone supplement I have used HealthLeads:

healthleadsuk.com/folate-l-...

If you have Amazon Prime (or know someone who has and can order for you) then you will save the delivery charge of £3.50 that HealthLeads charge:

amazon.co.uk/L-Methylfolate...

I would suggest you retest when that tub of 1000mcg strength has been finished.

Once you get your folate level up into double figures I would then change to a good quality, bioavailable B Complex which keeps all the B vitamins in balance. One with 400mcg methylfolate should be enough. Consider Thorne Basic B which is the one I prefer and have always done well one.

Vit D - 57nmol/l (50-200)

Your Vit D level has come scraped into the "adequate" category. The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L and Grassroots Health's latest blog entry recommends at least 125nmol/L.

To reach the recommended level from your current level, you could supplement with 4,000-5,000iu D3 daily.

Retest after 3 months.

Once you've reached the recommended level then a maintenance dose will be needed 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. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.

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, and large doses of D3 can induce depletion of magnesium. 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.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

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.

I am very envious of your ferritin level, I try hard but can get nowhere near that!

[Hama102 in reply to SeasideSusie]

Thanks SeasideSusie that's really helpful.

[SlowDragon Administrator]

How much levothyroxine are you currently taking

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Which brand of levothyroxine are you currently taking

Extremely important to maintain OPTIMAL vitamin levels

all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

[Hama102 in reply to SlowDragon]

Thanks@ slowdragon . I am currently taking 50mcg and have a blood test in 3 weeks. I have been booking tests before 9am as advised on here. The first box was Teva, the second box was something different, will have to check what brand it is when I get home. Should I not swap brands?

[SlowDragon Administrator in reply to Hama102]

50mcg is only the standard starter dose of levothyroxine

Bloods should be retested 6-8 weeks after any dose change or brand change in levothyroxine

Dose is increased slowly upwards in 25mcg steps until TSH is ALWAYS under 2

Most important results are Ft3 followed by Ft4

Aiming for high enough dose to bring Ft3 at least 50-60% through range, usually Ft4 will b3 slightly higher

Typically dose by weight is approx 1.6mcg per kilo of your weight

Many people find different brands are not interchangeable, especially Teva upsets many people

[SlowDragon Administrator in reply to Hama102]

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 or Aristo 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

beware 25mcg Northstar is Teva

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

New guidelines for GP if you find it difficult/impossible to change brands

healthunlocked.com/thyroidu...

academic.oup.com/jcem/artic...

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

verywellhealth.com/best-tim...

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