I decided to purchase one of the Medichecks Thyroid private blood tests to check my Thyroid, Vitamin, Inflammation, Iron & Autoimmunity. The results are,
CRP HS - 1.53 [0 to 5]
Ferritin - 59.5 [13 to 150]
TSH - 1.75 [0.27 to 4.2 ]
Free T3 - 3.92 [3.1 to 6.8]
Free Thyroxine - 15.5 [12 to 22]
Vitamin D - 11.6 [50 to 200]
Foliate - 4.5 [>3.89]
Vitamin B12 active - 52.89 [37.5 to 188]
Thyroglobulin Antibodies - 22 [<115]
Thyroid Peroxidase Antibodies - 88.3 [<34]
It seems my Thyroid is functioning at the current level of Thyroxine I'm on which is 150mg per day. However I'm concerned that my Thyroid Peroxidase Antibodies are high. It is a sign of Hashimoto disease, but I always thought that was another name for an underactive thyroid, is this correct or is it something different?
I have bought Vitamin D today, however do I take this at the same time I have my Thyroxine or can I take it after once I've had something to eat?
Any information is greatly appreciated.
Arielathekitten
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Arielathekitten
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Ariela Vit D should be 4 hours taken away from levothyroxine. Your level is so low though that it needs to be treated by the doctor. SeasideSusie will hopefully be able to give advice on levels. B12 could be better too but is not dire.Antibodies fluctuate but are useful for the diagnosis of what caused the thyroid problem in the first instance. Your antibody result confirms Autoimmune Thyroid Disease which can also be called Hashimotos (autoimmune + goitre) or Ord's disease (autoimmune without goitre). Whatever it is called it is hypothyroidism where the immune system attacks and eventually destroys the thyroid gland. The treatment is the same.
I would treat the Vit D deficiency first and then see how you feel and what your thyroid levels are then. Personally I would need FT4 , and FT3 higher.
It seems my Thyroid is functioning at the current level of Thyroxine I'm on which is 150mg per day.
No, your thyroid is not functioning at all. It is not functioning BECAUSE you're taking levo. Levo is not a drug to make your thyroid work better, it is thyroid hormone replacement, meaning that as your dose of levo rises, and the TSH drops, the thyroid stops working and the levo replaces the hormone your thyroid is no-longer making.
But that's a good thing, because, due to the Hashi's destroying your thyroid, it was no-longer able to make enough hormone to keep you well.
You cannot take anything else at the same time as you take your levo. Levo should be taken on an empty stomach, one hour before food or any drink apart from water. The majority of supplements and other medication should be taken two hours away from levo, but iron, calcium, vit D and magnesium should be taken four hours away from thyroid hormone.
It seems my Thyroid is functioning at the current level of Thyroxine I'm on which is 150mg per day.
A couple of questions here.
1) When did you take your last dose of Levo before this test? Last dose of Levo should be 24 hours before the test, if taken any closer to the test you get a false high FT4, if taken longer than 24 hours you get a false low FT4.
2) Do you take Biotin supplement or any other supplement containing biotin, eg B Complex or hair and nail supplement? Biotin can give false test results so needs to be left off for 3-7 days before any blood test (time depends on dose of biotin).
I wont ask how you feel because your nutrient levels suggest that you don't feel good!
CRP HS - 1.53 [0 to 5]
This is an inflammation marker so the lower the better, your's isn't too bad.
**
Ferritin - 59.5 [13 to 150]
Ferritin is recommended to be half way through range and some experts say the optimal level for thyroid function is 90-110ug/L.
You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
**
TSH - 1.75 [0.27 to 4.2 ]
Free T3 - 3.92 [3.1 to 6.8]
Free Thyroxine - 15.5 [12 to 22]
Generally speaking, the aim of a treated hypo patient on Levo only 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.
Your results show that your FT4 is only 35% through range and FT3 is 22.16%. These are very low for someone on thyroid hormone replacement and suggest that you could do with an increase in your dose of Levo.
However, because your nutrient levels are dire this might be the reason your thyroid results are poor because all nutrient levels need to be optimal for thyroid hormone to work properly.
As a first step it might be a good idea to optimise nutrient levels and see what effect this has on your thyroid results.
**
Vitamin D - 11.6 [50 to 200]
This is severe Vit D deficiency. I had this with a level of 15nmol/L which I discovered myself with private testing. Ideally you should speak to your GP and s/he should provide loading doses. I didn't bother, I treated myself. It's up to you which way you want to do it. Here is the NICE Clinical Knowledge Summary which your GP should follow if you decide to go that route:
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.
* Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
to now saying:
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.....
If correction of vitamin D deficiency is less urgent and when co-prescribing vitamin D supplements with an oral antiresorptive agent, maintenance therapy (800–2000 IU daily) may be started without the use of loading doses.
If you want to self treat then you can follow those guidelines and as your level is so low I'd go for the 50,000iu per week for 6 weeks. I'd take it split over daily doses rather than once a week. Maybe buy some 5,000iu dose D3 and take 5,000iu x 4 days and 10,000iu x 3 days.
After the loading doses you need to retest to check your level.
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.
Come back with results of your new test at that time and we can see what follow on dose you require.
Once you've reached the recommended level (100-150nmol/L) then a maintenance dose for life will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
We're all different in what maintenance dose we need. Mine is 5,000iu per day winter and summer, that would be far too much for some people and they may only need 1,000-2,000iu so it's very important to test.
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.
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.
For D3 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. Tablets and capsules are the least absorbable forms of D3.
For Vit K2-MK7 I like Vitabay or Vegavero brands (may be available from Amazon or Ebay or direct from their own German websites) 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.
If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The company has told me the K2-MK7 is the Trans form
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.
This is low despite it being over their low limit. Medichecks range is actually 3.89-19.45 and I have no idea why they no longer show this. Folate is recommended to be at least half way through range so at least 12 plus with that range.
**
Vitamin B12 active - 52.89 [37.5 to 188]
Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
Reference range:>70. *Between 25-70 referred for MMA
There is a link at the bottom of the page to print off the pdf to show your GP. Your GP may or may not agree to test; however, symptoms of B12 deficiency should take precedence over test results so you can check here for any signs of B12 deficiency:
If you do have any then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
If you have symptoms and GP is reluctant to test then refer to NICE guidelines:
Vitamin B12 level — interpret the results of the serum cobalamin test taking into account clinical symptoms,
**
Thyroglobulin Antibodies - 22 [<115]
Thyroid Peroxidase Antibodies - 88.3 [<34]
Your raised TPO antibodies confirm autoimmune thyroid disease (known to patients as Hashimoto's) which is where the immune system attacks and gradually destroys the thyroid. Hashi's isn't treated, it's the resulting hypothyroidism that is treated.
Here is some general information about Hashi's:
Fluctuations in symptoms and test results are common with Hashi's.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. It would seem that this is the likely cause of your dire nutrient levels.
PS - I am not medically trained, my comments are based on personal experience and my reading/research to help myself.
This is really helpful and informative, thanks! I am wondering how you've worked out what the correct dose of Vit D to go for is? I have gone for the betterU 3000 + k2 spray. I was 60 (50-250) which is a bit better but still quite low. If you have been low is the past is it never going to be possible to stay optimum through diet and sunshine?
In this case the OP is severely deficient so I just went with the NICE guidance for treatment of Vit D deficiency that I have quoted above. She needs a total of 300,000iu and one of their suggestions is 50,000iu per week for 6 weeks. I think daily doses are better than one weekly dose so I worked out one way of getting 50,000iu over 7 days.
Your situation is different because you are not deficient.
If you have been low is the past is it never going to be possible to stay optimum through diet and sunshine?
Some people can make Vit D naturally from the sun, others can't. I'm one who can't. Those who have been diagnosed as deficient tend to need supplements for life.
Interesting, thanks. I have been diagnosed as deficient in the past when I was very poorly, before I was put on thyroxine and was given dr prescribed vit d. I put it down to living in Edinburgh and not getting out in the sun enough.
Hi SeasideSusie, thank you for your reply it was very helpful. To answer your questions. The blood test was taken at 9.30am and my previous dose of Thyroxine was the previous morning at 9.30. I was aware that I needed to have 24 hrs between last dose & blood test. I don't take a biotin supplement.
The information on Vitamin D was excellent. The Dr's report from Medichecks recommended that I start with 4000 iu on a daily basis for 10 weeks then 400iu per day to maintain my level. I wasn't aware that taking K12 would be required so I will look into that as well. As I need to take the vitamin D at least 4hrs after my Thyroxine then I assume that I can take the K12 supplement at the same time as the Vitamin D?
I will definitely do more research into Hashimoto and the other supplements.
Thank you again for replying it's been a great help.
I wasn't aware that taking K12 would be required so I will look into that as well. As I need to take the vitamin D at least 4hrs after my Thyroxine then I assume that I can take the K12 supplement at the same time as the Vitamin D?
It's K2-MK7 not K12.
Vit D in softgel, capsule or tablet form needs to be taken 4 hours away from Levo. Capsule or tablet will need to be taken with dietary fat. Softgels tend to be oil based and will have their own fat.
Oral sprays and sublingual liquids can be taken any time because they are absorbed through the mucous membranes in the oral cavity rather than the gut.
Vit K2-MK7 is, like Vit D, fat soluble so needs to be taken with dietary fat of some sort unless it's an oil based supplement. If Vit K2-MK7 is tablet or capsule then if you take it at the same time as a softgel, capsule or tablet D3 then they will both compete for the fat to be absorbed so in this case best to keep them apart. If Vit K2-MK7 is oil based and D3 is oil based then there will be no problem as each supplement should have enough fat for it to be absorbed.
That's great information and apologies for my error, I read it while still half asleep.
If the D3 and K2 -MK7 are oil based then they can be taken at the same time but 4hrs after my Thyroxine and with a fat rich meal. If both are tablet or capsule then it's best to take them at separate times. Would I be right in thinking the D3 at lunch then the K2 at dinner?
I've still to look into magnesium, though from your previous reply it's best to take this at night time?
I'm still trying to work everything out, but I'm focusing on the Vitamin D deficiency first then will move on from there.
Once I've been taking the Vitamin D, K2 and Magnesium supplements for the 10 weeks I will purchase another blood test from Medichecks to see where my levels are and to see if my Thyroid measurements have changed in a positive way.
Hi, so I have purchased both my D3 & K2 from Vitabright. The D3 is a softgel and is 4000IU as stated by the Dr and they also confirmed that the K2 is the trans form, which is a capsule. So this means that I will need to take the D3 at lunch & K2 at dinner or if I am having a late breakfast but 2 hrs after my thyroxine dose. I am still looking into Magnesium, however I should hopefully get that ordered some point this week. Many thanks for your help.
Recommend getting coeliac blood test done via GP BEFORE considering cutting gluten
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but a further 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
Before considering trial on gluten free diet get coeliac blood test done FIRST just to rule it out
If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)
If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
My vitamin d when found was 3, Im guessing you feel awful with yours, I know I had a lot of bone pain .
I dont know the protocol for such a low vitamin d only what I was given and that was fultium d3 but its never been a huge dose, not needed it.
In a few months my level went up to around 3/4 through range, pain disappeared couldnt believe a vitamin deficiency could such severe pain and so simple to fix.
To avoid levo I take it an hour before dinner.
Sorry I cant help with your other results, youve had excellent advice anyway but you’ll so much better just correcting your vitamn d.
My folate when tested was 3 too, I cant say wether thats made a difference to how I feel only that I was refused help from doctor so I started supplementing and improved my diet. Its pretty stable quite high a range with a low maintenance dose.
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