75mcg Levo is just one step up from a starter dose, it seems incredible that after 24 years you're on such a low dose. Has it been higher before and reduced? Dose changed from time to time? Hashi's does tend to complicate things as you can swing from hypo to a false "hyper" episode and back again.
TSH 6.86 mU/L ( Range 0.27 -4.2)
Free T3. 3.92 pmo/L ( Range 3.1 6.8)
Free Thyroxine 14.000 pmo/L (Range 12-22)
These results currently show undermedication. 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, if that is where you feel well.
Your TSH is way too high, your FT4 is only 20% through range and your FT3 just 22.16% through range. All go to show that you need an increase in your Levo, 25mcg now, retest in 6-8 weeks. Probably require further increases. This could, of course, be a temporary swing to Hypo due to the Hashi's.
We need optimal nutrient levels for thyroid hormone to work properly, and when Hashi's is present this can lead to low levels or deficiencies, often due to gut/absorption problems which Hashi's can cause.
Ferritin 51.50 ug/L ( Range 13-150)
Are you male or female? That is usually the female range. Regardless, your ferritin level is low.
Ferritin is recommended to be half way through range (about 82 with that range) although some experts say that the optimal level for thyroid function is 90-100ug/L.
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.
Vitamin B12- Active 71.000pmo/L (Range 37.5-188)
Active B12 below 70 suggests testing for B12 deficiency. Yours is just over but I prefer mine to be over 100.
Folate Serum 6.29ug/L (Range 3.89)
This is low. The range is 3.89-19.45 and folate is recommended to be at least half way through range so that would be about 12 plus with that range.
You can help improve both B12 and folate levels by supplementing with a good quality, bioavilable B Complex containing methylcobalamin and methylfolate. My choice is Thorne Basic B. If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.
**When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
Vitamin D 32.90nmol/L (Range 50-200)
This is very low and would be considered just above Vit D deficiency in some areas where deficiency is defined as less than 30, other areas it is less than 25. It comes into the "insufficient" category and your GP may or may not prescribe, if he does then he's unlikely to prescribe enough.
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, which is a bit short of what the NICE guidelines recommend for Vit D deficiency if you were to follow their guidance for loading doses of 300,000iu over 6 weeks, this works out at 210,000 over 6 weeks.
Retest after 3 months to check your level.
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.
Optimising your nutrient levels may help with some of your symptoms, as should increasing your dose of Levo.
As you have Hashi's, are you gluten free? Some members have found this helps although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed. Whether reducing antibodies is helpful is debatable, as long as your thyroid is being attacked by the immune system then antibodies have a job to do.
Thank you so much for this. I have been on 75 mcg since April before it was 100mcg but I was told I was over medicated but have been on 200mcg and 150mcg in the past. I am female 63 and a life long vegetarian .Suddenly 3 years ago my thyroid flipped to overactive GP could not explain why I asked to see am endo was eventually referred in September last year and that was the first time I was tested for Hashimoto's September a year ago . I have been gluten free since April and lactose free..I had a bad response to Teva that has now been resolved with the pharmacyMy doctor's go off the blood tests and as I have read on here treat the results rather than the symptoms . I have been exhausted and trying to explain without gp seeing me has been difficult.
I have never supplemented with any vitamins etc I have always felt well with my diet apart from 6 years ago when I had fibroids and heavy periods a full hysterectomy resolved that. I take Wackart brand been fine on that .I will definitely address my vitamin levels thank you for your advice
Do not supplement before testing for B12 deficiency as it will skew results, although there is no really reliable test anyway 🙁. As a lifelong vegetarian, supplementing B12 is essential...... Hope you feel bettter soon Starmen.
Seaside Susie I am trying to buy the Thorne Basic B online found it on Amazon but I cannot find Vitabay or Vegavero for the Vit K2-mk7. Where do you buy your?
Both Vit D and Vit K2-MK7 are fat soluble vitamins so they both need fat to be absorbed. When taken at the same time they will compete for the fat. The only time I would take them together is when both supplements are oil based softgels. I use the Vitabay or Vegavero tablets so I take those at the opposite end of the day to my oil based D3 softgel, I take D3 with my breakfast and the K2 tablet with my evening meal.
Sorry to keep coming back however I want to test for B12 deficiency as suggested and do a full iron panel.I use Medichecks but not sure what test to order on the site.
This is the iron panel which can be done by fingerprick, it needs to be done after a 12 hour fast (water allowed) so early morning is the most convenient time:
If you order both then do separate orders or you'll only get one return envelope.
Have you not asked your GP to do further testing for B12 deficiency, it's an expensive test to do yourself. Did you check for signs of B12 deficiency with those links I gave, if you have any then your GP should be testing.
Thanks for this . Will check with GP but hard to get an appointment and not had a face to face since this started in February. Will try to get the. MMA from GP. Thank you
I have been symptomatic for about 3 years when my levels started to fluctuate.My medication was reduced gradually from 175 mcg to 75. I felt worse after each reduction but gp would not listen just looked at readings which he said were in range at that time. I have been practically incapacitated since February and been sent for Scans MRIs etc to rule out cancer and spine problems . I have always felt it was my thyroid .
I also have rheumatoid arthritis and taking biological drugs and immunosuppressive medication for 24 years . At least now I have the Medichecks results with my current levels to show gp
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Update to my test results
Medichecks: "Contradictory Results"
Medichecks results, please advise
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