after 6 months I’ve been 50 g of Levo I’ve had a blood test. Would some kind soul help me understand the results and any advice ?
Serum ferritin: 340 ug/L
(normal range: 30 - 300)
TSH (ON T4 RX)
Serum TSH level: 5.75 mIU/L
(normal range: 0.27 - 4.2)
Serum free T4 level: 14.1
pmol/L (normal range: 11.2 -
20.2)
VITAMIN D
Serum total 25-OH vit D level:
43 mol/L (normal range: 76
250)
HBA1C FOR DM DIAGNOSIS
HbA1c levl - IFCC
standardised: 39.0 mmol/mol
(normal range: 20 - 41)
Best wishes
Pauline
Nambo
Serum ferritin: 340 ug/L (normal range: 30 - 300)
As you have thalasseama I imagine you have already discussed this with your GP. It's not something I can comment on.
Serum TSH level: 5.75 mIU/L (normal range: 0.27 - 4.2)
Serum free T4 level: 14.1 pmol/L (normal range: 11.2 - 20.2)
These results show that you are undermedicated. 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, if that is where you feel well.
I very much doubt you are feeling well with those results, they suggest that you need an immediate increase in your dose of Levo, 25mcg now and retest in 6-8 weeks, it's very likely that you will need further increases so please ensure you are retested every 6-8 weeks and dose is increased until your levels are where they need to be for you to feel well.
Serum total 25-OH vit D level: 43 mol/L (normal range: 76 - 250)
6 months ago your level was 50nmol/L and I gave you information about what dose of D3 to take and the important cofactors that are needed when taking D3 (magnesium and Vit K2-MK7). Did you start taking these?
Your HbA1C is within range.
I bought D3 and have not been consistent in taking it. I also found it confusing when and how to take it. So like what I do with the thyroid stuff I shy away. It’s all to consuming to get my head around it.
In short though no but I will spend time over Christmas to read and understand it all.
I do appreciate this site and your direction.
Nambo
All you need to do with D3 is take the amount I suggested every day, I suggested that the right amount for you was 4,000-5,000iu daily. Just make sure that you take the D3 4 hours away from your thyroid meds.
Did you not also buy the magnesium and the Vit K2-MK7, I explained how important these were.
Need to buy the right magnesium also
OK, so you take 1 x D3 daily, 4 hours away from thyroid meds. As there is olive oil in the D3 you don't necessarily need to take it with the fattiest meal of the day, the olive oil will help it be absorbed.
As for the magnesium supplement, that one appears to contain D3 and zinc, I have no idea how much but you don't need them.
I gave you the link previously about what the different forms of magnesium are useful for so choose from them, here are the links again
naturalnews.com/046401_magn...
drjockers.com/best-magnesiu...
Magnesium should be taken 4 hours away from thyroid meds and because it is calming it's probably best to take in the evening.
I also gave information about K2-MK7 before here:
healthunlocked.com/thyroidu...
so those brands are sometimes available on Amazon or Ebay but because they are German brands they are sometimes out of stock, you could order direct from their websites but may need to translate.
Vit K2-MK7 should be taken with dietary fat, either the fatties meal of the day or with a full fat yogurt, chunk of cheese, buttered toast, etc. Don't take at the same time as D3 because the K2 will compete with the D3 for the fat for absorption. K2 should be taken 2 hours away from thyroid meds.
Ok I will do ! Thank you 😊
Make an appointment with GP and request 25mcg dose increase in levothyroxine
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking levothyroxine
Also to test vitamin D, folate, B12 and ferritin
sps.nhs.uk/wp-content/uploa...
Graph showing TSH in healthy population
web.archive.org/web/2004060...
Aim is to bring a TSH under 2.5
UK guidance suggests aiming for a TSH of 0.5–2.5
gp-update.co.uk/SM4/Mutable...
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
Which brand of levothyroxine are you currently taking
Many people find different brands are not interchangeable
Many people don’t get on with Teva brand levothyroxine. Teva is the only brand that makes 75mcg tablets.
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...
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.
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.
What vitamin supplements are you currently taking
When were folate, ferritin and B12 last tested
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)
Obviously vitamin D is far too low
How much vitamin D are you currently taking
I’m on accord, at the start they put meOn 100 and my heart was so fast I couldn’t sleep. Maybe I will respond differently.
No I haven’t done a celiac blood test … I will
I haven’t been taking my vitamins as previously suggested which is stupid I know but will do
Many, many people have to start slowly on levothyroxine
Standard starter dose of levothyroxine is 50mcg
Dose is increased slowly upwards in 25mcg steps until TSH is ALWAYS below 2
Increasing from 50mcg to 100mcg was too much too soon
You can increase even slower initially, 50mcg and 75mcg on alternate days for few weeks, before increasing to 75mcg daily. Bloods should be retested 6-8 weeks after getting to 75mcg daily
Making appt to see doctor for increase. I must push for blood tests sooner as they only want to do it 3-6 months
pathlabs.rlbuht.nhs.uk/tft_...In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months. The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Dose is stable when 2 or 3 consecutive tests give similar TSH results 2-3 months apart and symptoms are dramatically improving. Usually that’s TSH well under 2, Ft4 in top third of range and Ft3 at least 50-60% through range
Far too often GP will start a patient on low dose levothyroxine ….do one retest after 3-6 months and if TSH is under 5 will leave them under medicated and no further test until a years time. That’s completely incorrect
You need testing every 2-3 months until you are well and stable on decent dose levothyroxine
Being under medicated for thyroid results in low stomach acid, poor nutrient absorption and low vitamin levels as direct result
Low vitamin levels tend to lower TSH because we need good vitamin levels for good conversion of Ft4 (levothyroxine) into Ft3 (active hormone)
So it’s important to maintain optimal vitamin levels and retest at least annually
Retest vitamin D twice year when supplementing
Aiming for vitamin D at least around 80nmol and around 100nmol maybe better
TPOab 124 (0-24.0) ***
T4 12.5 (11.2-20.2)
TSH 6.32 (0.27-4.2) ***
eGFRcreat 81 (90-120) ***
B12 488 (180-770)
Folate 6 (4-26)
Looking at your very first post
High thyroid antibodies confirms autoimmune thyroid disease
Folate was very low
B12 borderline
Are you currently taking any vitamin B complex to improve low folate and B12
Have you had coeliac blood test done
If not get tested before considering trial on strictly gluten free diet
I suggest you might find some helpful information in my document - including detailed explanation of the units used:
helvella - Vade Mecum for Thyroid
The term vade mecum means:
1. A referential book such as a handbook or manual.
2. A useful object, constantly carried on one’s person.
Please don't get put off by the number of pages!
Not everything is in this one document - my major medicines document is still separate!
From Dropbox:
dropbox.com/s/vp5ct1cwc03bl...
From Google Drive:
Cholesterol and thyroid test results
Blood test results - advice please.
Please help with these test results
Blood tests results advice please... 
Test results
