Re cap on vitamins please.: Hi, I used to take... - Thyroid UK

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Re cap on vitamins please.

Pastille profile image
34 Replies

Hi,

I used to take regular supplements as per the great guidance on here. However, the supplements added up, in cost too, and tbh I just got fed up of ordering, paying for, and remembering to take my T4 plus T3 every day plus a whole load of supplements. So, yes, I stopped I went back onto T4 only ( I was worried that ordering from abroad would get more and more difficult and thought I'd rather just get used to it than be left without all of a sudden) and I stopped the supplements. After my last bloods my GP texted me to say my Vit D levels were low and prescribed 40,000 iu daily. ( my thyroid levels are okay, tsh is suppressed and t4 is in the top third) So, having felt pretty crappy with fatigue, aches and pains etc. I thought, maybe it's time I just accept I need these and start again. So I've started with Vit D which I'll continue. Today I've re started vit C, and B12, and I'm guessing my iron levels are okay as the Dr has not made any supplement suggestions regarding that. ( I'm registered with patient access and get all my test results online but for some reason they have started withholding some information, like low levels ) I don't know why. So I've no idea about some things. But my cholesterol is high and that's the main thing at the moment, I need to get that down and my nutrient levels up. So, basically, I want to ask you lovely, knowledgeable lot if you would mind giving me a helping hand with this. I'd much rather ask here than Google! Do I need to add vitamin B complex? Do I need to add vit k with vitamin D? Esp with such a high dose? And is there anything I've forgotten to add? I apologise that this is so long, I just like to explain properly !

Thanks very much in advance if anyone has time

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Pastille
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SeasideSusie profile image
SeasideSusieRemembering

Pastille

After my last bloods my GP texted me to say my Vit D levels were low and prescribed 40,000 iu daily.

Are you sure about that. Treatment for Vit D deficiency is 40,000iu per week not daily. See

Loading dose regimens:

cks.nice.org.uk/topics/vita...

When taking Vit D we also need to take it's important cofactors:

Magnesium - this helps the body convert D3 into it's usable form

Vit K2-mk7 - D3 aids absorption of calcium from food and K2-mk7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissue where it can be deposited and cause problems such as calcification of arteries and kidney stones, etc.

When taking B12 we need a B Complex to balance all the B vitamins.

Magnesium and Vit D need to be taken 4 hours away from thyroid meds and B vitamins 2 hours away from thyroid meds.

Both D3 and K2-mk7 are fat soluble so need fat to be absorbed. If you take them at the same time they will compete for the fat for absorption so it's best to take them at different times, each with some form of dietary fat such as cheese, full fat yogurt, etc.

B vits are best taken no later than lunchtime as they can be stimulating and you don't want them keep you awake at night.

Magnesium tends to be calming so best taken in the evening.

Different forms of magnesium are suitable for different things, check to see which is right for you :

naturalnews.com/046401_magn...

Don't start all supplements at once, start with one and give it a couple of weeks, if no adverse reaction add in the next one, give it a couple of weeks and again if no adverse reaction then add on the next one, etc. That way if you do have a reaction you will know what caused it.

Pastille profile image
Pastille in reply to SeasideSusie

Hi Seaside Susie, thanks so much for all of that. It's very much appreciated and helps me out a lot !! Re vitamin D. Yes my gp has prescribed 2 x 20,000 daily HuxD3. The box even says take One tablet every two weeks but the printed instructions from pharmacy says take two daily for 10 days. I've finished those today so too late now anyway ! It sounded a lot, I should have double checked with my gp or pharmacy but when I googled I found that from 4,000 to 50,000 iu daily is quite common ??

Thanks again for all this info , I'll read through and follow it all, and stick to it this time even !!

Knip profile image
Knip in reply to Pastille

Good luck Pastille, it's a minefield, isn't it! until reading Seaside Susie's reply I had no idea that the vitamins should be separated from Thyroxine. I have just plodded on in my ignorance taking everything except my statin together in the morning an hour after my Thyroxine. We live and learn. 🙂

Pastille profile image
Pastille in reply to Knip

It is! I wouldn't mind I've been told all this by the same people before and had it all right but as I said, stopped taking them.Stupid. I remember first coming here exhausted, crawling through work every day on 50mcg thyroxine until I found this site through googling for help. Then trying to take it all in through the brain fog was like doing a degree 🤣 but yes, if we listen, we get there !! Thanks, good luck with yours too

Kimkat profile image
Kimkat in reply to Knip

I set an alarm to take my thyroxine around 2.30am, so it doesn’t coincide with any of my other meds, it was difficult at first but now I’m used to it.

Charlie-Farley profile image
Charlie-Farley in reply to Kimkat

Me too, but 3am - I’m normally trotting to the loo after giving into late cuppa tea- just works 😂👍

Kimkat profile image
Kimkat in reply to Charlie-Farley

Yep sounds familiar 😂

Pastille profile image
Pastille in reply to SeasideSusie

I'm a bit worried about this now incase they have got it wrong at pharmacy. Especially as my cholesterol is high, both high cholesterol and too much vitamin D can affect arteries? Should I be worried, do you think? At least I've stopped taking them, anyway. I think I'll leave vit D alone for a while before I continue with my much lower daily supplement. I'm at the pharmacy tomorrow as my T4 is due, so I'll double check with them.

Thanks

Update..I asked the pharmacist who agreed that the 40,000 daily was correct. She said it is a high dose but as its only for 10 days it's okay, it's to load up and sustain. She told me not to start taking my own lower dose of Vit D atall for a few weeks.

SeasideSusie profile image
SeasideSusieRemembering in reply to Pastille

I gave you the link to the dosing regimens for Vit D deficiency.

Also, here is the NICE Clinical Knowledge Summary for treatment of Vit D deficiency :

cks.nice.org.uk/topics/vita...

If rapid correction of vitamin D deficiency is needed, for example in people with symptoms or about to start treatment with a potent antiresorptive agent (zoledronate, denosumab, or teriparatide), prescribe a fixed loading dose followed by regular maintenance vitamin D therapy 1 month after loading.

The loading regimen should provide a total of approximately 300,000 international units (IU) of vitamin D, given either as separate weekly or daily doses over 6–10 weeks. See the section on Loading dose regimens in Prescribing information for more detailed information.

Maintenance therapy of vitamin D equivalent to 800–2000 IU daily (up to a maximum of 4000 IU daily for certain conditions such as malabsorption following specialist advice), given either daily or intermittently at a higher equivalent dose.

You were prescribed 2 x 20,000 for 10 days which totals 400,000iu. Loading doses should total 280,000iu - 300,000iu.

As for high cholesterol, that is listed as a symptom of hypothyroidism so may reduce when you are optimally medicated.

Pastille profile image
Pastille in reply to SeasideSusie

I agree thats quite worrying. I've added the image from the prescribed D3 to previous message as couldn't attach it to this one for some reason.

SeasideSusie profile image
SeasideSusieRemembering in reply to Pastille

Can't see the image anywhere?

alchemilla12 profile image
alchemilla12 in reply to SeasideSusie

Oh I didnt realise Vit D and K2 should be taken separately -many supplements put them both together eg Better You

SeasideSusie profile image
SeasideSusieRemembering in reply to alchemilla12

If both Vit D and K2 are both oil based, they could be taken together, one has to assume there is enough oil for both to be absorbed.

As for BetterYou spray, I don't know if it contains oil as I don't use sprays, but if it does hopefully there is enough but the sprays are absorbed through the mucous membranes in the oral cavity rather than the gut so I don't know if that makes a difference.

alchemilla12 profile image
alchemilla12 in reply to SeasideSusie

Ive just checked and the combined spray contains sunflower lecithin and Vit E so presumably that counts as oil? I normally take my Vit D as liquid oil drops and then a separate K2 spray but at the same time.Do you think they should be separate (the separate K2 has the same lecithin and vit e as the combined spray.)

SeasideSusie profile image
SeasideSusieRemembering in reply to alchemilla12

Ive just checked and the combined spray contains sunflower lecithin and Vit E so presumably that counts as oil?

Sorry, I have no idea. If it doesn't say oil then I'm not going to guess.

I normally take my Vit D as liquid oil drops and then a separate K2 spray but at the same time.Do you think they should be separate (the separate K2 has the same lecithin and vit e as the combined spray.)

Again, I don't know anything about the spray. I've not looked into sprays as it's something I wouldn't take, there are too many excipients in it which I would rather avoid.

alchemilla12 profile image
alchemilla12 in reply to SeasideSusie

If you take it what form of Vit K do you take? most capsules have lots of bulking agents so I assume you avoid those too?

SeasideSusie profile image
SeasideSusieRemembering in reply to alchemilla12

I have taken Vitabay oil based K2-MK7 drops. I haven't been able to get them recently so currently I take Vitabay tablets. I try to keep excipients to a minimum but accept that sometimes there's no alternative. I prefer Vitabay or Vegavero brands for K2 because they use the All-Trans form rather than the Cis form. The All-Trans form is the bioactive form, the Cis form is inactive (a bit like methylfolate is the bioactive form of folic acid).

SlowDragon profile image
SlowDragonAdministrator

High cholesterol is linked to being under medicated for thyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

How much levothyroxine are you currently taking

What were Ft4, Ft3 at last test

Do you always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

my gp has prescribed 2 x 20,000 daily HuxD3. The box even says take One tablet every two weeks but the printed instructions from pharmacy says take two daily for 10 days.

Ask GP to test vitamin D having finished the prescription

Pastille profile image
Pastille

I actually didn't fast or leave out my meds on my last blood test as it was an evening clinic, the only appt I could get. Due to my high cholesterol levels I have to return to do a fasting test tomorrow morning at 10am. What I'll do is I'll call the surgery beforehand to ask if they can also re test thyroid levels while testing chokesterol and I'll come back here with the new results as I've only just realised that my latest results are useless !!

Thank you very much indeed

greygoose profile image
greygoose in reply to Pastille

At 10 am your TSH will be quite low - possibly lower than your evening labs. TSH is highest in the middle of the night, and drops through the morning until 9 am, when it drops quite sharply, and continues dropping until around midday. Then it starts to rise again. So, perhaps not a good idea to get it done at 10 am tomorrow.

High cholesterol is due to low T3, not statin deficiency! Doubt they will test your FT3 with your cholesterol, but will probably want to prescribe statins for high levels. Resist! The last thing you want to do is take statins.

Make sure you take your vit C at least two hours away from your B12. Vit C affects the way your body uses B12. And, yes, you do need to take a B complex when taking B12, to keep all the Bs balanced. :)

Tonyd789 profile image
Tonyd789 in reply to greygoose

Your thoughts are interesting & ring my bells. I was warned off B6 and A & E because I have cancer. Do you have any thoughts on that?

greygoose profile image
greygoose in reply to Tonyd789

I'm afraid I know nothing about that, sorry.

Pastille profile image
Pastille

Thanks so much GG. So pointless me asking then, I'll just try to re arrange but I doubt they'll do another one now after doing it recently, I'll have to do it at BH. And yes statins!! Don't fancy them, no, much rather try to get it lower naturally, through diet and exercise. After optimising thyroid meds and getting T3 right, of course.

greygoose profile image
greygoose in reply to Pastille

But, as I keep saying, cholesterol levels have nothing to do with diet and exercise. And a high cholesterol level are not a problem, anyway - it's a symptom, not a disease, and will come down when your T3 is right for you.

SeasideSusie profile image
SeasideSusieRemembering

Can you see it? I can't.

Pastille profile image
Pastille in reply to SeasideSusie

I can, but I've done it a few times and it keeps on disappearing !!

SeasideSusie profile image
SeasideSusieRemembering in reply to Pastille

It's there now 😊

Well I'm puzzled. Did the GP write 2 daily on the prescription or did the Pharmacist make a mistake. Seeing as it has to be checked by someone else before being dispensed then that would mean two people making a mistake at the pharmacy. Do let us know.

Pastille profile image
Pastille in reply to SeasideSusie

Yes, I thought the same, two people making the same mistake. Still, they're only human and I'm still here. Tomorrow I'll know for sure. The thing is, I don't even know how low my vitamin D is, as I said earlier, they seem to be withholding abnormal readings for some strange reason !! I don't know if that is connected to my self medicating on T3 in the past or what, but tomorrow I'll see what they say about the dose, find out my Vitamin D level precisely, and yes, sure, I'll come back and let you know.Thanks again

Pastille profile image
Pastille in reply to SeasideSusie

Hi Seaside Susie, well apparently the dose was correct ! I've asked the receptionist to ask the Dr this morning and been told it was the right dose and not to worry. I guess my Vit D levels must have been pretty low. Though I don't have the test results myself yet but when I get them I'll let you know. ( Saying that, I don't actually know if the receptionist asked the Dr or just checked recent prescriptions), in which case, I suppose it could still be a mistake. I'll ask at the pharmacy later, see what they say.Thanks

SeasideSusie profile image
SeasideSusieRemembering in reply to Pastille

Guidelines are clear - Vit D deficiency is when level is less than 25nmol/L (or less than 30nmol/L in some areas) and the treatment is the same, i.e. 280,000-300,000iu over a number of weeks, usually 6 or 7. I think someone has got it wrong.

Pastille profile image
Pastille in reply to SeasideSusie

Maybe, and they don't want to admit it, I don't know. I do have bone issues, friebergs disease in my foot, which can be painful in the bones. Maybe they give higher doses for that? That's all I can think of. I will say though, while I'm here, my eyesight has been terrible, very blurry which I suspect is due to low levels of vitamins as its not usually this bad. I only wear glasses for reading. I feel like low vitamin D has affected my eyes and may be useful info for someone in the future so thought I'd mention it.

Knip profile image
Knip

I take my Thyroxine in the morning around 5-6am then return to bed for a while before venturing downstairs for my breakfast and other tablets.

UrsaP profile image
UrsaP

Regarding your results. You can ask for a print out of your lab results. You are entitled to your results they should not be withholding any. If you know or suspect they are withholding you coukd ask.them or this is away around it. As I said you are entitled to.them and there should not be a charge. I always ask for a hard copy, state 'lab results' not just their 'normal no further action' Assessment.

Useful to get and keep copies of all bloods and tests done. Helps with the bigger picture, can see if something suddenly goes out of sync, corrects itself or not and because it is amazing how much goes missing off records!

Roadrunnergreg profile image
Roadrunnergreg

ok vitamin D, it's a case of getting upto the ideal level and taking enough to keep it there. although they say below 50nmol is deficient and below 30nmol is very deficient, the ideal range is between 80-120, if your in that range your not only looking after your bones and bone pain, your also looking after muscle strength, prevents bacterial and viral infections via the activation of antimicrobials known as cathlicidens that go round the body like pacman, plus you have protection from several cancers, i read a report recently that said 125nmol had a 70% protection against breast cancer. remember also vitamin D absorption is magnesium dependent, so if you feel rough on vitamin D your likely low in magnesium, a lot of people are...

As for cholesterol i wouldn't worry if its slightly high, remember the Liver makes 85% of your dailt cholesterol, if there a bacterial infection in the Liver odds are it's causing the liver to make more cholesterol than needed.

Statins, if your going to take them you'll need a CoQ10 supplement, as they deplete CoQ10 that's the reason for the devestating side effects of statins.

If your taking T4 Levothyroxine, that depletes Iron hence why some folks take T4 and feel well for a while then the fatigue comes back, anemia fatigue thinking the returning fatigue is i need more T4, maybe they do but it's worth evaluating Iron levels first...

Symptoms of Iron Deficiency Anemia

Many with mild to moderate forms of iron deficiency anemia do not experience any symptoms. However, if the deficiency progresses and gets more severe, uncomfortable symptoms may start. The most common symptoms of iron deficiency anemia include:

Fatigue (most common symptom)

Headache

Dizziness

Difficulty concentrating

Shortness of breath

Weakness

Chest pain

Cold hands and feet

Restless leg syndrome

Brittle nails

Pale skin

There's also an Iron-Zinc-Copper triangle balsnce to look at as a high in one can suppress the other so need to check all three ideally...

B vitamins, you can take a high dose singular IE B12 etc but it needs to be acompanied with a B Complex too . B vitamins are also dependent on adequate stomach acid for breakdown and absorption, as well as other B Vitamins hence the need for a B complex too...

Hope this helps...

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