Cholesterol and uric acid

[Geegee777]

I've just received bloods results from my gp. My cholesterol is 7.4 and my uric acid is high, (I've requested a print out of results). Can anyone advise me on best course of action?

I take levothyroxine 100, vitd/k2 and magnesium glycinate.

[Marz]

I noticed on one of your posts your FT3 level was low in range - Has it improved since that time ? Think it was around 9 months ago ! Often it is low T3 that can cause raised cholesterol.

[Geegee777 in reply to Marz]

Hi, I've finally got a private blood test on 6th December. I shall post results on this forum, I also seem to have trouble converting t4 to T3. I will ask my GP what he thinks about prescribing t3 🤞🤞🤞🤞

[Marz in reply to Geegee777]

Why do you have to wait so long for a Private Test ? Have I missed something ? Will you be testing B12 - Folate - Ferritin - VitD ?

[Geegee777 in reply to Marz]

Hi, I get my bloods drawn at my local community hospital, I was surprised at how long I had to wait too, usually its the following week after arranging appointment.

Its the advanced thyroid function test, which covers vitamins too

[Marz in reply to Geegee777]

Quicker to do it on-line ! 🌻

[Geegee777 in reply to Marz]

Apologies for my technical ignorance, how do you do it online?A bit of a dinosaur in that department

🦖

[Marz in reply to Geegee777]

Oh sorry - go to Thyroid UK website and seek out home testing kits from various companies. Used by 1,000's on this forum. Speedy results by email

thyroiduk.org

[SlowDragon Administrator in reply to Geegee777]

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Low vitamin levels common as we get older too

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Private blood draw available at local to you private clinic for Medichecks or Blue horizon

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[Geegee777 in reply to SlowDragon]

Does different branding affect blood results?

[SlowDragon Administrator in reply to Geegee777]

Absolutely…yes

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

New guidelines for GP if you find it difficult/impossible to change brands

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. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[Geegee777 in reply to SlowDragon]

I had Accord brand delivered this evening instead of my usual Teva, I'll get onto it first thing in morning.

I have had north's tar once, which gave me headaches, which is why I insist on Teva

[SlowDragon Administrator in reply to Geegee777]

Many people find Levothyroxine brands are not interchangeable.

Many patients do NOT get on well with Teva brand of Levothyroxine.

Teva contains mannitol as a filler, which seems to be possible cause of problems.

Teva is the only brand that makes 75mcg tablet.

So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

But for some people (usually if lactose intolerant, Teva is by far the best option)

Teva, or Aristo (100mcg only) are the only lactose free tablets

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets

Accord only make 50mcg and 100mcg tablets

Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets

beware 25mcg Northstar is Teva

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Posts that mention Teva

healthunlocked.com/search/p...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

[SlowDragon Administrator in reply to Geegee777]

Northstar 50mcg and 100mcg are Accord brand

[Geegee777 in reply to SlowDragon]

So I've got north star 100? In accord packaging?

[SlowDragon Administrator in reply to Geegee777]

Northstar is the box …Accord is the brand inside ….in both 50mcg and 100mcg tablets

But Northstar 25mcg…..then brand inside is Teva …..because Accord don’t make 25mcg tablets

[helvella Administrator in reply to Geegee777]

The other way round!

Accord is packaged under Northstar livery - see the PL Holder in the attached image:

Image of Northstar box

[JAmanda in reply to Geegee777]

You can pay extra for a nurse to come do it.

[Geegee777]

I think I'll stick with Teva and have a chat with the chemist, I think I'm OK with Teva, but still not right though, bloods results will be posted soon after 6th Dec.

I'm beginning to feel everything is going against my best efforts, but feel better thanks to this wonderfully supportive forum🌸🌸🌸🌸🌸🌸🌸🌸

[userotc]

Besides thyroid, kidney disease can lead to high cholesterol so maybe worth GP checking that too with uric acid high. My mum's cholesterol level is about the same as yours and she has CKD with increasing urinary protein.

[Miffie]

High levels of uric acid usually cause symptoms. I have to take alopurinol daily for this problem. If not it causes gout which is not p,easant. Have you been treated for gout at any time? Diet can help but for sone of us it’s not enough and medication is needed. Your GP really shoukd be discussing these results with you.

[Geegee777 in reply to Miffie]

I haven't been diagnosed as having gout, but I've been quite uncomfortable at times, which I now presume was gout.Hopefully I can source t3 in near future🤞🤞🤞🤞

I'll see my GP after my Medichecks results, maybe I can show him😬😬

And just maybe he may work with them🤔🤔🤞🤞🤞🤞🤞🤞

[Partner20 in reply to Geegee777]

Your GP should be addressing the high uric acid level, particularly if you have been experiencing symptoms of gout. In the meantime, check that your diet does not contain foods high in purine, such as red meats, some types of fish, and dairy products, and limit or cut out those. Google high-purine foods, and those which help reduce its production.

[Geegee777 in reply to Partner20]

Thanks, I'll speak to my GP ASAP.Also I'll keep my eye on my diet

🌸🌸

[Miffie in reply to Geegee777]

Usually gout presents as exceptionally pain , hot, red and very swollen joints. In my case the short episodes I had in toe joint made it impossible to put my foot into a shoe and I had to hobble round on my heel. These episodes had to be treated with naproxen and another drug but I forget what in addition to co—codamol for pain. Luckily this has only happened three times all told. This was how I had always understood gout presented.

However some years ago I was referred to a rheumatologist as I had had a swollen ankle for over thirty years. I was totally unable to wear even ankle boots, some shoes, especially trainers were impossible as my ankle was so swollen and misshapen. He diagnosed gout! He explained that it’s just a form of arthritis . Taking diuretics for so long was already predisposing me to high uric acid levels. I had a history of kidney stones previously which suggested I may also be genetically predisposed to high uric acid levels. ( being adopted it is all unknown). I was not convinced and left very sceptical. His solution was solution high dose Allopurinol for life. He would review in 12 months unless it became worse or symptoms changed.

It took around six months to show any improvement but after a year it was massively better. I bought boots! My ankle is still not the right shape and bigger than the other but they believe that’s all those years undiagnosed. Too long in the tooth now to be vain and accept that trainers are a no no unless low cut. He did explain that it was unusual to see it present as my ankle did and see why I was dubious having had acute gout attacks previously.

It it is possible you have the same.

Good luck with the GP. My surgery and a local endo completely disregard any private testing. I loved that the endo was rude about MMH results which of course come from NHS lab in Exeter, he then advised that the results he gave me from tests at the same lab were very accurate indicators of my health. 😄

[Geegee777 in reply to Miffie]

It's a tricky situation when you have to explain to your gp what you have researched. When you k ow he very probably will disregard everything you say in order to follow his given protocol.. Ho bloody hum🙄

[Miffie in reply to Geegee777]

I suppose you will have to see what the doctor makes of uric acid levels initially. I assume you know current levels and how over range they are. I isn’t untoward to ask them to look at you swollen joint and they can feel how hot it is. Then asking outright if it’s gout is very reasonable. It is just the long term gout in my ankle that was a problem, always compounded by fluid in my case. That masked it to some extent. I never imagined I had gout.

Have you lots of other examples of people in the same boat? I have never known anyone have gout other than the those with very painful, hot , red , swollen sites requiring short term heavy duty meds.

Your GP may want to run further tests and suggest a change in diet first.

Good luck

[JAmanda]

My cholesterol went down by 25% when I got my t3 high in range.

[Geegee777 in reply to JAmanda]

Could you pm me how you sourced t3?

[SlowDragon Administrator in reply to Geegee777]

Before considering adding T3 you may simply be not on high enough dose levothyroxine

Approx how much do you weigh in kilo

Essential to test TSH, Ft4 and Ft3 together, plus test vitamin D twice year and folate, ferritin and B12 annually

What vitamin supplements are you currently taking

If Teva brand suits you best, are you lactose intolerant?

If lactose intolerant then likely to need higher dose levothyroxine than typical

Come back with new post once you get FULL thyroid and vitamin testing

Only do private test early Monday or Tuesday morning

Stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results

Only test after 6-8 weeks minimum on unchanging dose and brand of levothyroxine

Email Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3 alongside levothyroxine

...NHS and Private

[e-mail]

[Geegee777 in reply to SlowDragon]

I've just collected my NHS blood test results, didn't realise I'd have such a list.

My NHS results

[SlowDragon Administrator in reply to Geegee777]

No ferritin result

Need TSH, Ft4 and Ft3 tested together

Vitamin D is good

B12 ok…better over500

Folate low

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial. This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Suggest you start taking vitamin B complex ….then retest thyroid levels after 6 weeks via Monitor My Health or Medichecks or Blue horizon

[Geegee777 in reply to SlowDragon]

My GP advised me to stop supplementing vit d, he said I've been over supplementing, then have another bloodtest in 2months. Not sure what to do.

[SlowDragon Administrator in reply to Geegee777]

Vitamin D and thyroid disease grassrootshealth.net/blog/t...

[Geegee777 in reply to SlowDragon]

Thankyou very much, my mind is made up, I shall stick with my maintenance dose and retest in 6 months or so.I don't know what I would be like if it wasnt for this forum.

🌸🌸🌸🌸🌸🌸🌸🌸🏴󠁧󠁢󠁷󠁬󠁳󠁿🏴󠁧󠁢󠁷󠁬󠁳󠁿

[Geegee777 in reply to SlowDragon]

I'm approx 77kg, my Medichecks will be a new post as soon as I get results

NHS results continued

[SlowDragon Administrator in reply to Geegee777]

77kilo x 1.6mcg = 123mcg as likely daily dose levothyroxine required

Ft4 is only 49% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Most people when adequately treated will have Ft4 at least 60-70% through range on just levothyroxine

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

[Geegee777]

Thanks for your replies, I do usually eat banana in mornings with honey and full fat Greek yoghurt, alas I'll have to review my diet, another avenue of pleasure redirected🌸🌸🌸