Thyroid Results

[Wob58]

Hi oops forgot about personal data thanks for removing. Have rectified that and it should now be the right way up. Test completed by 08:40 only drank water. Taking Levothyroxine 75mcg daily. Last dose was 24 hours prior to test. Only take Vitamin D and that was last taken 24 hours prior to test. Hope that helps.

[SeasideSusie Remembering]

Wob58

CRP very good, the lower the better as it's an inflammation marker.

Ferritin good, some experts say that the optimal level for thyroid function is 90-110ug/L.

Folate would be better in double figures.

Active B12 would be better over 100.

To improve both folate and B12 levels you could consider a good quality, bioavailable B Complex. My preference 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).

Vit D is recommended to be 100-150nmol/L by the Vit D Society and Grassroots Health, with a recent blog post on Grassroots Health recommending at least 125mol/L. If you want to achieve this level you would need to be taking probably 3,000iu D3 along with D3's important cofactors - magnesium and Vit K2-M K7.

Thyroid Hormone results 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. Your TSH is a bit too high, your FT4 is 49% through range and your FT3 is 30.27% through range. You could do with an increase in your Levo of 25mcg, retest in 8 weeks.

Thyroid antibodies low so don't suggest autoimmune thyroid disease.

[Wob58 in reply to SeasideSusie]

Thank you for taking the time and effort to analyse results. How do I now go back to GP to get my Thyroxine upped. I assume I do the B12 and up my Vit bit myself without GP consent.

[SeasideSusie Remembering in reply to Wob58]

Wob58

Unfortunately there is nothing official (such as in NICE guidelines) that says anything about where FT4 and FT3 should be, only where TSH should be. The nearest I can quote you is this from GP online:

gponline.com/endocrinology-...

Under the section

Cardiovascular changes in hypothyroidism

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

and that gives leeway for the TSH to be much lower than yours so you would have to discuss with your GP that even though your TSH is within that quoted range, your FT4 and FT3 are rather low in range and you still have the following symptoms ............. list them ............ and emphasise how you feel and how it is impacting your life.

Other than that, the only other thing is the following from 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 confirmed, during a talk he gave to The Thyroid Trust, that this applies to Free T3 as well as Total T3 and this is when on Levo only. You can hear this at 1 hour 19 mins to 1 hour 21 minutes in this video of that talk youtu.be/HYhYAVyKzhw(Not working as expected?)

You can obtain a copy of this article from ThyroidUK:

[e-mail]

print it and highlight Question 6 to show your GP.

Many doctors, including my own, will only look at TSH and use that to adjust dose, if it is anywhere within range then they are satisfied and discount any symptoms the patient mentions as nothing to do with thyroid. It is a difficult and very frustrating situation. If you feel that you would benefit from an increase in dose, I wish you luck in persuading your GP. If your GP is open to compromise you could ask for a trial increase for, say, 3 months to see if you benefit, and if you have any signs of overmedication then you will contact him immediately.

[SeasideSusie Remembering in reply to Wob58]

I assume I do the B12 and up my Vit bit myself without GP consent.

Sorry Wob58 I forgot to address this bit.

You don't need GP consent to take vitamin supplements. As your results are within range your GP will be satisfied. They aren't interested in (and no know nothing about) optimal levels, they are only obliged to address deficiencies.

See how you go with the Thorne Basic B, maybe retest in 3 months. If there's not much improvement in your B12 then you could always add in some sublingual B12 lozenges at that point (one pot of 1,000mcg is ususally enough).

As for the Vit D, K2-MK7 and magnesium, 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. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.

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.

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...

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.

[Wob58 in reply to SeasideSusie]

Does Thorne Basic B only come in capsules don't like swallowing large tablets. Also where would be the best place to buy your recommendations Magnesium, D3, Vitabay Thanks

[SeasideSusie Remembering in reply to Wob58]

Thorne Basic B only comes in capsules. I find them as easy to swallow as coated tablets, uncoated tablets I find hard.

I normally get my Doctor's Best D3 from Dolphin Fitness, they are usually the cheapest but do a price comparison with Amazon and Ebay.

Vitabay and Vegavero K2-MK7 you can find on Amazon or Ebay, but as they are a German brand they are sometimes out of stock. You can order direct from their websites in Germany if you can translate.

Magnesium isn't possible to help with because only you know which form of magnesium suits you (assuming that you have checked with the links I posted), which may be different from what suits me.

[Wob58 in reply to SeasideSusie]

Thank you again. Probably know the answer but can you break the capsules and take it that way. Yes I have looked at the links re Magnesium not sure what's right for me yet. Don't want it to upset my bowels or stomach. Need it for my heart. Will have another read.

[SeasideSusie Remembering in reply to Wob58]

Wob58

Probably know the answer but can you break the capsules and take it that way.

With capsules (like most medication I assume) I'm guessing they're designed to break down in a specific area of our digestive system (I'm guessing the stomach, I expect the capsule shells don't survive stomach acid), so I expect the active ingredient is meant to work from where it's released from the shell. But I can't say for sure, so I don't know whether you can break the capsules and use them that way. I suggest you contact Thorne Research for a definitive answer.

Need it for my heart.

Have you looked at magnesium taurate?

[SlowDragon Administrator]

How do you feel

Ft4 only 49% through range

Ft3 only 30% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Most people when adequately treated will have Ft4 at least 60% through range and Ft3 at least 50% through range

Suggest you request increase in dose

Initially 75mcg and 100mcg alternate days and retest in 6-8 weeks

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

Remember to stop taking vitamin B complex a week before test