I'd been feeling weary so had bloods done at do... - Thyroid UK

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I'd been feeling weary so had bloods done at doctor's. My iron was low so GP prescribed iron tablets.

AnneEvo profile image
23 Replies

I'd been feeling weary so had bloods done at doctor's. My iron was low; it has been for years; (I think it's always been low, even when I ate meat. I was told by a doctor 30 years ago that I was slightly anaemic; I think at the time I was hypo but it wasn't diagnosed) so GP has prescribed iron tablets.

I was already taking Better You oral spray but as my ferritin was over range last time I had a blood test (with Medichecks) I had cut down. Instead of taking 4 sprays as advised I was taking sometimes 2 sometimes 3. Is ferrous gluconate any good? Obviously I could go back to 4 sprays of Better You but how do I keep my iron levels up without ferritin going over range? I did read that turmeric can help lower ferritin, does anyone know if there is any validity in this? - I do try to get information from reliable sources. I am vegetarian so won't be eating liver! Does eating foods high in iron keep iron levels up without adversely affecting ferritin levels?Also my B12 is 806pg/ml range 197-771. I hadn't taken any B12 for a week before having blood taken. As my B12 is usually quite high I have been taking it every other day rather than daily. The B12 I'm taking is methylcobalamin 100ug.

TIA. Anne

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AnneEvo
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SlowDragon profile image
SlowDragonAdministrator

Please add most recent results and ranges

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

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.

Do you have autoimmune thyroid disease?

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

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

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease

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)

Is this how you do your thyroid test

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

List of private testing options

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

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

AnneEvo profile image
AnneEvo in reply to SlowDragon

Sorry Slow Dragon, I wasn't worried about other results; having said that they only tested TSH (sometimes they do T4. I think it depends who requests them!) TSH is 1.3 (0.27-4.2). vitamin D is 104.0 >=50 nmol/L. Ferritin is 201 ug/L (12.0-233.0) This time ferritin is ok but I assume that's because I'd lowered iron dosage; because previously ferritin was over range. I do have a Medichecks test ready to do in the next couple of weeks. I am only on 50mcg but as I've said in the past I have very few symptoms so don't feel ill. I always have the same brand.

As an aside I did get tested for H pylori and was positive so am about to start antibiotics. I don't know if that has any bearing - I've had gut issues for 2 and half years but put it down to UAT and low stomach acid.

Mostew profile image
Mostew in reply to AnneEvo

Hopefully the H pylori will get sorted .. if you can afford it take some Optibac probiotics for after antibiotics . They have a good web site

and phone contact for advice.

SlowDragon profile image
SlowDragonAdministrator in reply to AnneEvo

I am only on 50mcg

Do you mean you are only on 50mcg levothyroxine?

That’s only a starter dose

How long have you been on just 50mcg levothyroxine

Just testing TSH is completely inadequate

You could have low Ft4 and/or low Ft3

Yes H pylori and hypothyroidism, especially autoimmune thyroid disease (hashimoto’s)……especially if under medicated

ncbi.nlm.nih.gov/pmc/articl...

thyroidpharmacist.com/artic...

endocrine-abstracts.org/ea/...

Looking through previous posts……couldn’t see any thyroid antibodies results

Do you have Hashimoto’s?

How much do you weigh in kilo

Guidelines on dose levothyroxine by weight is approx 1.6mcg levothyroxine per kilo per day

AnneEvo profile image
AnneEvo in reply to SlowDragon

I know it's only a starter dose but I don't feel any different whether I take levo or not except of course my TSH goes up. I buy kits from Medichecks once or twice a year to test T4, T3, antibodies etc. I have in the past tried Metavive ll and while my T4 and T3 were optimal I did not feel any different.

SlowDragon profile image
SlowDragonAdministrator in reply to AnneEvo

H Pylori likely due to low stomach acid which is result of being hypothyroid

High cholesterol linked to low thyroid levels

Low kidney function linked to low thyroid levels

SlowDragon profile image
SlowDragonAdministrator in reply to AnneEvo

Not surprising you feel weary on just 50mcg levothyroxine

Levothyroxine doesn’t “top up “ failing thyroid….it replaces it

That’s why virtually everyone will need to be on full replacement dose

guidelines on dose levothyroxine by weight

Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

AnneEvo profile image
AnneEvo in reply to SlowDragon

Sorry, I forgot to mention I do not have Hashimoto's. I have been tested for antibodies quite a few times - every time I do a Medichecks test.

HRH8591 profile image
HRH8591 in reply to AnneEvo

My understanding is that Helicobacter Pylori may well be present in the gut naturally, it's just what the level is. Did you have a full Microbiome Test by a lab specialising? I did. If you do antibiotics be aware that it will clear out the good flora too not just the HP. Balance of flora is an important factor so an excellent Pro & Prebiotic essential and focus on natural food prebiotics. It can take time to re-establish the balance. In my test I had a few things that needed addressing so I was prescribed Kirkhams Biofilm Defense and Olive Leaf extract. I had, like you, had gut issues for quite some time but after following the instructions by my nutritionist it addressed the problem. Some bacteria develops biofilm which is hard to remove (it protects the bacteria) and can make treatment even with antibiotics difficult in some instances. If you want to consider ahead of trying antibiotics, happy to share in more detail.

AnneEvo profile image
AnneEvo in reply to HRH8591

Thanks for the information. I don't know exactly what test was done. Someone else mentioned some particular probiotics. I had already thought that I would try not to eat certain foods, initially and build up different types of foods. I do have sprouted seeds which I believe are prebiotic.

HRH8591 profile image
HRH8591 in reply to AnneEvo

Conventional medicine unless you are in a specialist unit will just identify presence I believe not whether the levels are acceptable so clearing it out might not be necessary as you will be throwing out the baby with the bathwater as they say. My GP said they know very little about it. As I said, if you want to give it a try, happy to share detail. Sounds as though you are on the case with the prebiotics - if you Google you can get a full list. Sprouts are good.

AnneEvo profile image
AnneEvo

I really do appreciate all the information given but I would like to know how to keep iron levels up without ferritin going over range.

Roadrunnergreg profile image
Roadrunnergreg in reply to AnneEvo

You could try supplementing with Vitamin C for absorption of ferretin, or increase these food types in your diet. But you ought to get all labs checked to see if anything has changed Hope that helps

AnneEvo profile image
AnneEvo in reply to Roadrunnergreg

My supplementation of vitamin C us hit and miss. I will try to take it regularly and test again in a few weeks.

Roadrunnergreg profile image
Roadrunnergreg in reply to AnneEvo

Hit and miss?? I'm guessing you mean you don't take it regularly?? You need about 1000-2000mg a day I use an effervescent one 1000mg fast release In three gulps, generally vitamin C is short lived of about four hours, hence a timed release as well and a 1000mg timed release too myself given the many benefits if vitamin C

AnneEvo profile image
AnneEvo in reply to Roadrunnergreg

I don't take it regularly because it's on a different shelf to my other supplements 😏 I thought we only needed a very small amount a day. I'm sure I've read qtr of a teaspoon 🤔

Roadrunnergreg profile image
Roadrunnergreg in reply to AnneEvo

Yes you can do that, but given lots of different things in our lives I tend to take a lot more on some supplements my own choice, between nalnourished foods, soils, and the amount of toxins in our lives we need more to keep in top form nutrient wise in my experience and opinion now.

You need to realise that the RDA or NRV recommendation is to avoid outward signs of a deficiency, and not optimal health on the inside never mind the outside.

AnneEvo profile image
AnneEvo in reply to Roadrunnergreg

Yes of course.

Cornwaller profile image
Cornwaller

There are reports that green tea, quercetin, resveratol and turmeric can help reduce or chelate high ferritin; however, I am not sure that this has been confirmed by robust human trials. That said one or more may be worth trying as it is generally reported that they are safe and may be helpful supplements.

AnneEvo profile image
AnneEvo in reply to Cornwaller

I had read about turmeric. I usually do have turmeric, ginger, honey and lemon tea. But I haven't been drinking it much lately. I need to do it again; I have a Medichecks kit so can check in a few weeks to see if it helps, or at leadt if my ferritin is ok after taking the tablets GP prescribed.

radd profile image
radd

AnneEvo,

The idea behind turmeric reducing ferritin levels refers to elevated ferritin induced by inflammation, common during infection or when CRP levels are high. It doesn't influence skewed iron mechanisms caused by low thyroid hormone, anemaias, etc except in the sense of helping reduce any resulting inflammation.

AnneEvo profile image
AnneEvo in reply to radd

My CRP is usually a little high but I don't know if that's caused by being hypo?

Roadrunnergreg profile image
Roadrunnergreg in reply to AnneEvo

You could read thus, vitamin C can lower CRP/inflammation marker levels

pubmed.ncbi.nlm.nih.gov/189...

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