Female 64, partial thyroidectomy 2001. eventually felt well on 100mcg Levothyroxine although still had some pain, diagnosed with fibromyalgia.
2014 started with flu type symptoms, increasing in length & frequency, I left work 2016. 2017 borderline low cortisol, synacthen test - 311 to 626 after 30 mins
Now suffer from burning, stiffness,pain & exhaustion, also sore tongue & cracks in corner of mouth. Rarely feel well now.
March 2021 100mcg. April 2019 100mcg
TSH 0.01 (0.35-4.94). 0.25
F T4. 18 (9-20). 14
FT3 5.7 (2.4-6.0) higher than normal. 3.4
Serum iron 13.4 (10-31). Transferrin 2.39 (1.8-3.82) Saturation 22.3% (18-55)
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
So your ferritin below 30 plus your dire serum iron level really should be shouting at your doctor IRON DEFICIENCY.
B12. 486 (187-883)
Although this is in range and wont worry your GP, 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."
So it's worth considering improving this level.
Folate 7.8 (3.1-20.00)
Low in range but not folate deficiency. Folate is recommended to be at least half way through it's range (although doctor wont know this).
With your B12 and folate results it would be beneficial to supplement with a good quality, bioavailable B Complex. My suggestion is Thorne Basic B. If you look at a different brand, ensure it doesn't contain Vit C as this keeps the body from using the B12 it contains.Vit C and B12 should be taken 2 hours apart. Look for the words "bioavailable" or "bioactive" and "methylcobalamin" (not cyanocobalamin) and "methylfolate" (not folic acid).
Vit D. 70 nmol/l (50-220)
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 your level you'd be looking at supplementing with 4,000iu D3 daily. Retest in 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:
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.
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.
Your cortisol test is too old to comment on.
March 2021 100mcg.
TSH 0.01 (0.35-4.94).
F T4. 18 (9-20).
FT3 5.7 (2.4-6.0)
Levothyroxine lowered to 75mcg end Mch
If you felt well on that dose with those results there was no need to reduce your dose of Levo. Both FT4 and FT3 are in range, and TSH being below range is not a problem according to Dr Toft, past president of the British Thyroid Association and leading endocrinologist, who states in Pulse Magazine (the professional publication 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 at
tukadmin@thyroiduk.org
Question 6 refers.
By reducing your Levo by 25mcg your FT4 and FT3 levels will have fallen.
On a quick read (will study fully) I knew I was quite low/ in some nutrients, wondering why this would be? I do have gut problems, eating homemade sauerkraut atm ( good source of K2 apparently) I have tried vitamin D (tablets & spray) b12 (tabs & sublingual) &/or B vitamins, but all seem to make my fingers burn more & stiffer when waking ( they improve after a while) Also desiccated liver tablets & magnesium spray. I never had a problem with taking vitamin D or B12 a few years ago.
Re: keep being ill doctor told me 'to go home, eat well & learn to live with it'
Thyroid medication has been reduced to 75mcg a few times & I've had to increase again to 100mcg, this time I was thinking I'll try it, hoping I was slightly overdosed. I was given 75mcg tab of Teva ( really bad gut pains) also had a problem with Mercury Pharma so asked for 2 x 50 mcg to split, so I can do 75, 75/100 or 100mcg of Accord.
Vit D tablets and spray contain excipients and possibly these are causing problems. Maybe try a good, clean D3 softgel which contains only D3 and extra virgin olive oil such as Doctor's Best. It is possible to find excipients free supplements.
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
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Help with blood test results, please
Help with blood test results please😳
Help please with blood test results.
Blood test result please help !
