I have just got the results back from my blood test from medichecks .
I started with an over active thyroid about 27 years ago and i had the operation to take some of my thyroid away . I was put on 50 mg of levothyroxine which was fine for nearly 20 years but over the last 8 years or more i have steadily gained weight and have gone up 4 dress sizes , i have tried dieting and working out at the gym which helped abit but still a steady climb in weight the drs upped my levothyroxine over the years until i am now taking 150 mg . I have also experienced swelling ankles now and again and joint pain in my thumbs and lower back and hips . My bloods from drs always seem to come back normal so after joining this forum and advice from a beautiful friend i got my bloods done wirh medichecks . Please could anybody have a look and tell me in your experience what is not right and what i need to do or take . The dr from medichecks says i am on to much levothyroxine and my vitamin d level is to low .
Inflammation CRP HS. 4.1
Ferritin. 59.2
Folate - Serum 3.68
Vitamin B12 - Active 63.8
Vitamin D 44.5
TSH 0.01
Free T3. 5.69
Free Thyroxine 24.6
Thyroglobulin antibodies. 11
Thyroid Peroxidase antibodies. <9
Thankyou in advance to any of you that can enlighten me on these levels x
My own gp has put my levothyroxine down to 125 mg and has referred me to slimming world which i have tried before and didnt get good results , i walk daily with my dog . I am 57 years old and have been through the menopause x
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Bluesparkle5
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Bluesparkle5 are the ranges printed alongside the results? If so, press the down arrow next to 'more' and then 'edit' to allow you to put in the ranges. Members cannot respond to results without the ranges because each lab may have different ones.
As Shaws has mentioned, we always need reference ranges when results are posted. However, I know Medichecks ranges so I will comment below and add the ranges that I am certain of.
Inflammation CRP HS. 4.1 (<5)
This is a non-specific inflammation marker so the lower the better. Yours is quite near the top of the range so may be indicating that there is inflammation somewhere.
Ferritin. 59.2 (13-150)
Ferritin is on the low side. Raised ferritin can also indicate inflammation but it's difficult to say whether this lowish level is raised above your normal level.
Some experts say that the optimal ferritin level for thyroid function is 90-110ug/L and always recommended here is half way through range so that would be about 82 with that range.
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
Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
Folate - Serum 3.68
This could either be >2.9 or >3.9 depending on which lab processed the tests. Whichever it is this level is low. Below 3ug/L is classed as folate deficiency.
You could discuss with your GP although s/he may say this is fine. It really does need raising into double figures.
Vitamin B12 - Active 63.8 (probably 37.5-188)
Active B12 below 70 suggests testing for B12 deficiency. Do you have any symptoms - check here:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
If you don't then I would suggest a good quality, bioavailable B Complex such as Thorne Basic B which should raise both B12 and folate levels.
Vitamin D 44.5nmol/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.
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 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.
Your FT4 is telling us that you may be taking a bit too much Levo even though your FT3 is within range (70% through range). Reducing Levo will reduce FT4 but also reduce your FT3 level.
I would concentrate on getting your nutrient levels optimal at this stage. Optimal nutrient levels may help T4 to T3 conversion so you may be able to reduce your dose of Levo to bring it within range and hopefully you will still have a good FT3 level from conversion.
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 would give it about 4 months then retest everything. Hopefully by then your nutrient levels will be optimal and we can see how that affects your thyroid levels.
I am not medically trained, these are my thoughts based on my own experience.
Thankyou so very much SeasideSusie for all this amazing info and your experience and for all the links explaining each nutrient and vitamin . I have read and then written it all out so i can sit and digest it and get all the vitamins needed and start to take them slowly under your advice and care , thankyou for looking into all my levels and explaining what is low and needed , i really appreciate your help time and good advice xx
Hi SlowDragon . My test with medichecks was done at 9am with only water to drink before test . The bloodtest i had done at the drs was done at 12 and was a surprise to me as wasnt told i was having one so i had had two cups of coffee plus my levothyroxine a couple of hours before , so drs test wouldnt have been as acurate as the medichecks one and yes for medichecks test the last dose of levo was 25 hours before so all done correctly for this test . I have just changed drs and the packaging on this levo is different to what i had before . Although dr told me to reduce the levo i havent done it yet as i wanted to get the medichecks test done with 150 that i was taking to see what is going on . The dr has cut my perscription down on my repeats but i still have some 50s left so i can take alittle more than the 125 perscribed for a little while . Thankyou for your advice it is appreciated x
Well, It looks like I'm a bit late to add anything !!
If your doctor has reduced your dose on the back of the late morning blood test, just ask if s/he can reconsider as you had taken your medication prior to the blood test and " not as usual " so inaccurate and a bit skewed.
As previously explained T4 needs to convert to T3 in the body and lowering the T4 will lower your T3, and you need as high a T3 as possible as it is your level of T3 that gives you your wellness, and metabolism.
The accepted conversion ratio when on Levothyroxine only is said to be 1 / 3.50 - 4.50 - T3/T4 with most people feeling at their best when their conversion comes in at around 4 or under.
So to find your conversion ratio you simply divide your T3 into your T4 and I'm getting yours coming in at 4.32 : so going out a little from optimum :
Optimising your vitamins and minerals as already detailed will likely improve your conversion ratio and this should then alleviate some of your hypothyroid symptoms.
Conversion can also compromised by any physiological stress ( emotional or physical ) , inflammation, depression, ageing and dieting - so there could be something else there to think about, as dieting, does not work, as we need calories for conversion of the T4 into T3.
Your inflammation - CRP - looks a bit high - is there anything causing this that you are aware of ?
I now aim to maintain my ferritin of around 100, folate at around 20, active B12 at around 75++ and a vitamin D at around 100 :
I'm sure once your vitamin and minerals are supplemented and your levels maintained at optimal you'll find you will feel better and your T4 convert to a higher T3 and not be over range or need a dose decrease in Levothyroxine.
Hi my lovely , thankyou so much for replying to me again with important infomation for me to consider . Dr has asked me to book another blood test for 6 weeks to see if the lower dose is ok for me l i havent lowered my dose yet as was unsure til i knew what my results were here but he has altered my repeat perscription to the lower dose . Its hard to see a dr at the moment to ask him , so i will book the test and do it properly and see what the results say . I do have pain in my thumb joints at moment and some depression going on , i left my husband a year ago now and miss my boys who are in their 20s now and live with him , i feel lost at times like i have no purpose and dont belong anywhere , so i guess this doesnt help much . I will take all that into consideration . And work at getting all my vitamin and mineral levels up . So much to consider with the thyroid , i never realised and i have had this condition for nearly 30 years . All my dieting hasn't worked and now i see it was making it worse . I have felt for along time it was down to my levels and i have kept asking the drs but they kept telling me no your thyroid is normal 🤯 , thank goodness i have found you all and can start to make sense of it all . Thankyou so much for your time and kindness and experience in helping me x
You can use this as argument NOT to reduce dose Levothyroxine
guidelines on dose levothyroxine by weight
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.
No worries, once your vitamins and minerals are optimal your conversion of the T4 into T3 will improve and that means your T4, even on the higher dose will likely reduce into a higher T3 which is what you need.
I may have a solution to your ferritin level :
I found the basic iron tablets difficult to tolerate so switched to an iron bisglycinate formulation which I found " kinder " on my stomach.
I took Gentle Iron but there are other brands :
Eating liver is the quickest most natural way to build up your ferritin and I now maintain my level with 1 tub a week of Asda frozen chicken livers - they are very clean and mild to taste :
Once defrosted, flash fry in a little olive oil for around 5/10 minutes:
Whizz down into a pate/paste, and add a little Mayo if it's too dry and store in an old jam jar in the fridge.
I find a spoonful of this , with dollop of Hellman's, helps this medicine go down :
Sorry to read of your personal circumstances, you have a been through, and still are dealing with a lot of " stuff " :
It will come right, don't beat yourself up, and for once in your life, focus on your " you " and what you need to do for yourself to get back to better health, where everything in life is then more easily managed.
P.S. My ferritin was at 22 when I had a blood test, so, it can be done, and you will do it, in order to feel better.
Thankyou so much , i have written down all the info you have given me and tips and i have now added this to it . I am vegetarian and i hate liver but if needs must i will do this to get my levels up , needs must . Thankyou . I am making a lental and leek soup today which i think has iron in so hope this helps to .Thankyou fir your care over my circumstances but its life and we all have our crosses to bare but i am taking that all into consideration that it doesn't help my thyroid problem and yes at long last i am putting my health first and trying to get to the bottom of this as nhs drs are no help . Thankyou again lovely lady x
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