Hello again hope everyone is doing ok ,I’ve just been and picked up my print out of my thyroid test ,they didn’t do antibodies though,I’ve changed the way I’ve been taking my meds and have been taking them on there own thankyou for that
Hopefully you can give me your opinion about my test thanks again kowbie
Will have to try a different way as they are not going to send from here wish me luck
Hello kowbie.
You haven’t added the results. Did you have a image to add or may be easier to type out. Be sure to include any ranges & exclude any personal information.
Might be too soon to tell but have you noticed any improvements since changing how you take medication?
Kowbie
If you can't add an image, type them in, remember to add the ranges as well.
Hope they have come through to you x
Kowbie
No, they're not showing on the forum. Just do a reply in this thread and type them in .
Have they now
Kowbie
OK, so we have
TSH: 0.05 (0.35-3.5)
FT4:17.7 (7.5-21.1)
How much Levo are you taking?
Did you take last dose of Levo 24 hours before the test?
Did you do thetest before eating or drinking anything but water?
We can see that you had the blood draw at 9.27am.
How do you feel?
Your GP wont be happy with your TSH, he will say it's suppressed and may want to reduce your dose if he adjusts dose purely by the TSH level.
Your FT4 is 75% through range which is a good place to be.
However, it's really important to do FT3 test at the same time so that you can see how well (or not) you convert T4 (the inactive/storage hormone) to T3 (the active hormone that every cell in our bodies need. Unfortunately, doctors don't seem to understand this.
Forgot I’m on 200 mg
I did everything that you said
Kowbie
TSH: 0.05 (0.35-3.5)
FT4:17.7 (7.5-21.1) = 75%
FT3: 4.5 (3.8-6.0) = 31.82%
So we can now see that your conversion of T4 to T3 is rather poor.
The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges. One would expect to see your FT3 maybe around 5.2 or above if you converted well and that was where you feel well.
**
B12: 503ng/L
This is below optimal level but isn't dire by any means. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
**
Folate 2.5 (2.7-15)mcg/L
This speaks for itself and your print out has the comment that it is below range. Your GP should be doing something about this so if you haven't already discussed this then you should. It is classed as folate 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.
Your GP may prescribe folic acid.
**
Vit D: 76nmol/L
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.
If you want to improve this level then you could supplement with 3,000iu
D3 then retest in 3 months. Your GP will not prescribe at this level as it comes within the adequate category and that is good enough for the NHS. It's up to you whether you want to aim for optimal.
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:
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.
Thankyou very much for your help I have spoken to a dr today and she just said that I need to come down with thyroxine never mentioned anything about folate level at all, and about b12 do I mention that , what would you do. would you ring the dr and say about folate level , what do you think they would say , I will buy the other vitamins thankyou ever so much x
Kowbie
I have spoken to a dr today and she just said that I need to come down with thyroxine
No you don't, this is where we Hypo patients have a battle because doctors don't understand that TSH should not be used to adjust dose once on thyroid hormone replacement. It's useful for diagnosis but once on Levo it becomes irrelevant because it's not a thyroid hormone, it's a pituitary hormone, the thyroid hormones are T4 and T3 and it's the FT4 and FT3 results that tell us our thyroid status. But it's very difficult to convince them of this.
You can tell your GP that your FT4 is well within range and your FT3 is rather low, so your thyroid hormones are not at elevated levels so you don't need to reduce your dose and wish to stay on the dose you're on now. You can use the following information to support this:
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional magazine for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You can obtain a copy of the article by emailing ThyroidUK:
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
**
never mentioned anything about folate level at all,
Point out to your doctor that you have noticed your folate level is below range and apparently indicates folate deficiency according to the NICE Clinical Knowledge Summary. I have given the information about this above, show your GP and ask if she is going to treat it.
about b12 do I mention that
No, because it's well within it's range so if you want to improve this level then you will have to buy your own supplements. But before you do that, see what your GP is going to do about your folate deficiency.
Thankyou ever so much for all your help it’s funny when she said about dropping the dose I said to her I would rather stay on what I was on , she said to have another blood test 3 months time so I can stay on it at the moment, I also said to her you didn’t do any antibodies she said that wouldn’t make any difference,but would do them next blood test , but thanks for all you have done I appreciate it xxx
Hello again thought I would just let you know I wrote a letter to the dr and mentioned folate he said it wasn’t that low but I asked him if he would prescribe them to see if it helped me as I still keep falling asleep at different times of the day and am a bit on the low side , I also asked him if he could tell me of an endocrinologist as the wait is 26 weeks at least but he said he couldn’t he said he had written a letter but would have to find one myself ,I’ve been taking magnesium vit d and was thinking of getting some b12 wondering if you could advise me which would be the best please I hope I’ve told you everything I can’t always think straight but thankyou for listening to me, and I hope your do ok kowbie I forgot to say that he said my t3 was ok as I had mentioned that
Kowbie
I wrote a letter to the dr and mentioned folate he said it wasn’t that low but I asked him if he would prescribe them to see if it helped me
Well, all I can say is that the doctor needs to go to Specsavers. Your level is 2.5 (2.7-15)mcg/L so not only is it low it is below range and your GP should be addressing this because NICE class this as deficiency.
* Has your GP prescribed folic acid?
For B12 you will need a sublingual lozenge. When I took B12 I used Cytoplan
cytoplan.co.uk/vitamin-b12-...
It contains 2 forms of the active forms of B12 methylcobalamin and adenosylcobalamin.
If you are going to take this then because your B12 level is not that bad at 503 (187-883) then just use one pot and stop. That should raise your level sufficiently.
When taking B12 we need a B Complex to balance all the B vitamins so you will need to buy this as well and take daily. My suggestion would be Thorne Basic B, this contains the bioavailable forms of active ingredients. If you don't use Thorne then look for another brand containing methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid) and avoid any that contain Vit C as this keeps the body from using the B12.
After you stop the B12 sublingual lozenges you continue with just the B Complex and that should then maintain your B12 and folate levels.
When taking B Complex we should stop this 3-7 days before any blood test. This is because it contains biotin and it causes false results when biotin is used in the testing procedure (which most labs do).
I forgot to say that he said my t3 was ok as I had mentioned that
He's saying that it's OK because it's within range. This is where their ignorance of treating hypothyroidism shows. Just because it's within range doesn't mean that it's at an optimal level. I pointed out in my previous reply that your conversion of T4 to T3 was poor as shown by your FT4 being 75% through it's range (which is good) but your FT3 was only 31.82% range. FT4 and FT3 should be reasonably well balanced (in the upper part of ranges) when on Levo only.
Good conversion of T4 to T3 needs optimal nutrient levels. I've pointed out what needs improving but I can see I didn't mention your Ferritin level of 46ug/L (23-300). This is poor. Ferritin should be half way through range and some experts say the optimal ferritin level for thyroid function is 90-110ug/L. You shouldn't self supplement with iron tablets unless you have an iron panel to see where your serum iron and transferrin saturation lie. If these are already good then taking iron tablets can take them too high and too much iron is as bad as too little. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
bda.uk.com/resource/iron-ri...
everydayhealth.com/pictures...
Supplementing with selenium is said to help conversion of T4 to T3, Cytoplan sell a good selenium supplement:
Thankyou for getting back to me he has said he will put a prescription out today for me which I’m off to pick up now ,how you spoke about the b12 that you thought it’s not too bad I think I’ll hold off with that at the moment but you said about ferritin level do I need to do something about that , and t3 if when I get my next blood test and it’s say the same what would you do about that please I really appreciate you getting back to me so thankyou for that kowbie
Kowbie
but you said about ferritin level do I need to do something about that
Yes, you need to improve that and I outlined above what to do and the level to aim for. You could ask your GP to do an iron panel but I imagine he'd say it's fine. Iron deficiency is classed as below 30 by NICE so I would be surprised if he agrees to do further testing but you could ask. If not then eating liver, etc, is the way to go.
As for T3, again you will be told it's in range and that it's fine. Your GP will know no better. GPs can't initiate a prescription for T3, that has to be done by an endo, and you won't get a referral to an endo because your results are within range. Long term you need to optimise nutrient levels, maybe supplement with selenium, and see if your conversion improves.
Thankyou for all your help just like to ask selenium how much and what make should I go for sorry to be a pain x
I linked to a good selenium supplement above, the one from Cytoplan. It's a 100mcg tablet, you could take one or two, no more than 2 though without testing.
Seasidesusie. Thanks again for your advice appreciate it
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