Hi, can anyone please advise if my latest results are ok please
Serum free triiodothyronine 3.6 pmol(3.1-6.8)
Serum TSH 0.14 mlU/L (0.27-4.2)
Serum free T4 17.8 pmol/L (12-22.0)
I’m aged 65, weight 9st 10lb and taking 100 mcg levo
Thank you in advance
Essexlil
How much Levo are you taking?
Did you do your test as we always advise:
* Blood draw no later than 9am
* Nothing to eat or drink except water before the test
* Last dose of Levo 24 hours before the test
How do you feel?
FT3 is very low in range, FT4 58% through range. Room to increase dose if you feel the need.
Conversion of T4 to T3 is poor but what are your key nutrients like? Are they optimal because that's what's needed for good conversion. Have you got recent results for
Vit D
B12
Folate
Ferritin
Do you take any supplements? If so what and what dose and are you testing at least annually to check levels? Do you take them the correct amount of time away from your Levo?
Do you take any other medication which might affect absorption of Levo?
Hi, I’m gaining weight especially on my abdomen. I don’t feel too bad but when I’m put walking I seem to be getting a bit breathless.
I was taking vitamin D as my previous results stated ‘inadequate’ but I stopped just before the last blood test as I was getting strange heart rhythms and wondered if I was over medicated after three months on vitamin d. I am going to re-start vitamin D and I was taking it with my evening meal - I take levo in the morning. I’ve also got Berocca 11 vitamins and minerals supplement which I am going to take at lunch time. I’m waiting to take my supplements as I had a bad fall four weeks ago on my back and am on strong painkillers so wanted to wait until I feel a bit better. My results are:
Vitamin D3 level 56.9 nmol/L 50-75 adequate
B12 220 pg/ml (197-771)
Ferritin 628 ng/mL female ferritin 17-60 years 13-150 ng/mL
I can’t find folate but I have got full blood counts will it be amongst those results?
Thank you for your help.
Essexlil
I still can't add anything to the interpretation of your thyroid results as you didn't answer the question about whether you did the test the way we advise. The timing of the last dose of Levo is important to interpret the FT4 result.
As for your nutrient levels:
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Vitamin D3 level 56.9 nmol/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 4,000iu D3 daily.
Retest after 3 months.
Once you have 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...
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B12 220 pg/ml (197-771)
This is very low and people with a level in the 300s have been found to need B12 injections.
Do you have any signs of B12 deficiency – check here:
b12deficiency.info/signs-an...
b12d.org/submit/document?id=46
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.
Your GP may say your level is fine because it is within range; however, symptoms must take precedence over numbers where B12 is concerned so you must push this point if you do have any symptoms. Even if you don't need B12 injections you definitely need some sort of B12 supplement so please come back and tell us what your GP is going to do.
I can’t find folate but I have got full blood counts will it be amongst those results?
No, it's not part of a full blood count. B12 and folate work together so both results are often listed together on results reports.
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Ferritin 628 ng/mL female ferritin 17-60 years 13-150 ng/mL
Is this correct - 628ng/ml or is there a decimal point missing? If it is definitely 628 then have you had an iron infusion or taking iron supplements??? If not you need to discuss this very high result with your GP.
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I’ve also got Berocca 11 vitamins and minerals supplement which I am going to take at lunch time.
Multivitamins aren't recommended here for various reasons, they tend to have too little of anything to help low levels, they usually contain the cheapest and wrong form of active ingredient (eg cyanocobalamin instead of methylcobalamin, folic acid instead of methylfolate). They also often contain things we should be tested for first and only supplement if deficient, eg calcium, iron, iodine. If it contains iron then this affects the absorption of everthing else as iron needs to be taken 2 hours away from any other supplement. If it contains Vit C and B12 then the Vit C keeps the body from using the B12 as these should be taken 2 hours apart.
Best to test and supplement exactly what we need at the correct dose.
My serum ferritin is definitely the correct figure of 628 ng/mL - I haven’t mentioned that I’ve suffered from Sjögren’s Syndrome for around 20 years and I wonder if the inflammation is causing this? I’ve just been reading up and it seems Sjögren’s can cause low B12. Can I buy this myself or is it just prescription?
I’ve looked up B12 deficiency symptoms from your link and I do have some of them,however with two autoimmune diseases I never know what’s causing what as they all overlap. I find concentration difficult and often can’t find words when speaking. I’m also very tired and lethargic. I had covid in February and don’t know if my breathlessness when walking is due to that or not.
I’m afraid I didn’t follow the guidelines when going for my blood test. I was taking my levo at night then 10.30 and took the dose the night before my test and had my breakfast before the 9.30 test. Sorry I’m not being deliberately difficult but I sometimes wonder if it’s best to see the picture as you’re living day to day with the medication. I’m probably wrong but I don’t want false interpretations by missing medication - sorry I know you know far more about it than me but I never fast or miss my dose before blood tests because I have this niggling doubt.
I won’t take the multivitamins - haven’t started them yet. I was only taking 1000 vitamin D3 but my heart seemed to miss beats after three months and it stopped after I stopped taking it.
Any help would be greatly appreciated as I’ve never been referred to an endocrinologist even though I have Hashimotos antibodies and I haven’t seen a rheumatologist for years for Sjögren’s - I feel as if I’m just ticking along with annual blood tests for Sjögren’s interpreted by my GP and the odd thyroid test when I request it. Not great really.
Essexlil
I’ve just been reading up and it seems Sjögren’s can cause low B12. Can I buy this myself or is it just prescription?
I’ve looked up B12 deficiency symptoms from your link and I do have some of them,however with two autoimmune diseases I never know what’s causing what as they all overlap.
As you have other autoimmune diseases, and the fact that Pernicious Anaemia is autoimmune, I think it's best to mention this to your GP and get properly tested. Discuss your Ferritin level also.
Ok thank you
Do you always get same brand levothyroxine at each prescription
Testing for low vitamin levels next step
Hi, at the moment since my last increase the pharmacy keep changing between Teva and MercuryPharma - I’m going to ask them to keep me on Mercury before my next prescription. I do seem to be ok on either but Mercury I believe most people tolerate best
gov.uk/drug-safety-update/l...If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient
Hi, thanks - I did ask pharmacy to keep me on Teva but when my dose was increased they sent Mercury then Teva now Mercury again! I’m feeling really tearful at the moment and quite down, but not sure if it’s the Mercury brand or my back problem getting to me.
Request/insist GP specify Teva brand only on all future prescriptions
Have those Gov guidelines to hand to back up your request
GP’s and pharmacies frequently deny there’s any difference between brands……but there absolutely is for many people
Thank you, your help on this forum is so appreciated
Hi, I have sent SeasideSusie my vitamin level results above. Thank you for your help
I guess it depends how you feel. I didn’t feel great when my T3 was that low but others seem fine.
Hi, this is the first time I’ve had my T3 measured, I asked my GP as my mum had Hashimotos and was never well on whatever dose of T4 they gave her (she passed away 14 years ago) so I wondered if I had a genetic conversion problem. Does my result mean I’m not converting well? As it’s in range my GP hasn’t commented
Well you can calculate how far through each of the ranges you are it does look like you don’t convert that well… but it kind of doesn’t matter where you are in range of you feel well. Do you have energy throughout the day and evening and no pains or other symptoms? If not, that’s great.
Hi, I’m gaining a lot of weight especially on my abdomen, and most days even after a good nights sleep I just wish I could go back to bed I’m so tired. I get better towards the afternoon. I also get mood swings and anxiety. I have Sjögren’s Syndrome too so sometimes it’s hard to judge which illness is causing my symptoms! The reason I wondered about the conversion problem is that when my GP increased my levo from 75mcg to 100 mcg my weight gain was even worse, it’s as if the higher the dose, even though it made me feel better, the faster I put on weight. My mum had Hashimotos too and passed away 14 years ago. She was never well on levo and tried Armour but nothing seemed to work for her.
I guess you can only experiment going up and down with your dose and trying taking meds at night or spread across the day… or get a trial of T3.
Yes I may ask for a trial of t3 I can’t keep putting weight on as already bought a size bigger clothes and it’s depressing
Don’t emphasise weight as main issue
Many people find they need to fine tune dose ….eg 100mcg 5 days and 125mcg 2 days week….or vice versa etc
First step is to get all vitamins optimal
Ok thanks - I’m taking B12 and will start D3 again soon, but with magnesium added which I didn’t do last time
As you only left 11 hours between last dose Levothyroxine and test your Ft4 is falsely high
In reality if left 24 hours Ft4 likely significantly lower
Your probably under medicated
Looking for Ft4 and FT3 at least 50-60% through range (testing as recommended)
Hi, thank you I’ll definitely fast and leave thyroxine off for my next blood test
With such high ferritin levels you need full testing for hemochromatosis
Full iron panel test by GP to see if iron is high too
redriverhealthandwellness.c...
Approx how old are you?
As you have Hashimoto’s
Are you on strictly gluten free diet already
If not get coeliac blood test BEFORE considering trial on strictly gluten free diet
Are you lactose intolerant that you are on Teva?
Hi, I’m almost 66 butI have also got Sjögren’s Syndrome and have always thought that is why I have high ferritin levels because of inflammation caused by two autoimmune diseases. My levels been high for years, I’ve had Sjögren’s for around 20 years. I’m not lactose intolerant it’s just by chance I’ve been given Teva. I’ve never cut gluten out. Thank you for your help
Well ferritin of 300-400 might be inflammation
But ferritin over that should be investigated
Many many people find Teva brand upsets them
Do you find it best option
How many brands have you tried?
Accord (Almus via Boots or Northstar via Lloyds)
Mercury Pharma
Wockhardt
Hi, I’ve got Mercury Pharma this month and I seem fine so I’ll ask pharmacy to make sure I get this each month. The ferritin level is worrying - I’ll phone my GP and ask her about all of this - thank you for explaining it all
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
Before considering trial on gluten free diet get coeliac blood test done FIRST just to rule it out
lloydspharmacy.com/products...
If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)
If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
ncbi.nlm.nih.gov/pubmed/296...
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
ncbi.nlm.nih.gov/pubmed/300...
The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease
nuclmed.gr/wp/wp-content/up...
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
hypothyroidmom.com/how-to-l...
Eliminate Gluten. Even if you don’t have Hashimoto’s. Even if you have “no adverse reactions”. Eliminate gluten. There are no universal rules except this one.
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