I just thought I’d put a new post so people could understand my situation a bit more. I’m a 20 year old male and was diagnosed with hypothyroidism in October, I also suffer quite bad health anxiety and depression and I am overweight if they are related or not I’m not too sure. I’ll add a photo of my test results from October I had a TSH of about 20 and T4 of 6 both obviously outside the reference ranges. I got prescribed 50mg levothyroxine and I got a bad reaction in first couple days with heart palpitations so went down to 25mg levothyroxine which helped me however I took that for two months and then had a test which I don’t have picture results of but my TSH went down to around 5 which my doctor said was normal range which I assumed I needed to stop the medication. Since then I have felt things have got worse and I have changed GP since as I have moved house so needed to get all that sorted. My plan is to get new bloods taken for my thyroid, nutrients and minerals to see how everything is then restart my Thyroid medication as soon as possible. I’ve read a lot about Vitamin D, B12 and other nutrients being vital also. I do try and have a multivitamin to help with these and eat healthier to help aid the weight loss. I thank everyone for there messages yesterday and will take as much on board as I can as I’m quite new to everything. I just want to try return to normal life and be happy with myself and I hope getting my thyroid sorted can help that.
My medication and thyroid levels: I just thought... - Thyroid UK
My medication and thyroid levels
First things
1
50mcg is only a STARTER dose levothyroxine
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
If you needed to reduce dose to 25mcg initially, then dose should have been increased to 50mcg after first test
Dose levothyroxine is increased slowly upwards over many months
Which brand of levothyroxine did you take
Many people find Teva brand levothyroxine upsets them
The aim of levothyroxine is to increase the dose slowly upwards in 25mcg steps until Ft4 and Ft3 at least 50-60% through range….typically TSH will be around or under one
Always test early morning and last dose levothyroxine 24 hours before test
2
Vitamin supplements
Multivitamins never recommended on here
Vitamin D 31nmol
GP should have prescribed
Vitamin D at 1600iu daily for 6 months
NHS Guidelines on dose vitamin D required
ouh.nhs.uk/osteoporosis/use...
GP will often only prescribe to bring vitamin D levels to 50nmol. Some CCG areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
Looking at improving vitamin D to at least around 80nmol and around 100nmol maybe better
Folate is deficient
Was folic prescribed by GP
Yh I went on folic acid, ok I’ll look into the specific vitamin d supplement if I’m deficient in the upcoming blood test.
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.
There’s a version made that also contains vitamin K2 Mk7. One spray = 1000iu
amazon.co.uk/BetterYou-Dlux...
Likely to need at least 2-3 sprays per day
Are you still taking folic acid on prescription?
Previous post you said your sister has autoimmune thyroid disease
So highly likely you do too
GP should test for coeliac disease when patient is first diagnosed with autoimmune thyroid disease
Request coeliac blood test if not already done
Was B12 level tested
Request B12 and folate are retested
Yh by b12 was at the bottom end and they didn’t do anything about it as it was in range
How low
Do you have any Low B12 symptoms
b12deficiency.info/signs-an...
Request testing for Pernicious Anaemia before starting on B12 supplements
If serum B12 result is below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
B12 sublingual lozenges
amazon.co.uk/Jarrow-Methylc...
cytoplan.co.uk/shop-by-prod...
healthunlocked.com/thyroidu...
It was 162 back in October but didn’t do anything about it
Can you see/speak to different GP
Can you have a supportive family member with you for consultation
GP should
Test for pernicious anaemia and retest B12 and folate levels
A coeliac blood test
Prescribe vitamin D at 1600iu daily
Retest thyroid…..or just renew levothyroxine prescription at 50mcg and retest thyroid in 6-8 weeks after getting to 50mcg dose…..you may need to do 2-6 weeks on 25mcg initially.
Or can try cutting 50mcg tablets in half, taking half in morning and half at bedtime
Which brand of levothyroxine did you have?
I can’t even renew the prescription as it isn’t registered at my new gp for some reason so I have to call them up about it. I do have 28 25mg levothyroxine tablets atm. Northstar I think is the brand. Like gold/pink packaging.
Northstar 25mcg is Teva brand
Many patients do NOT get on well with Teva brand of Levothyroxine.
But for some people (usually if lactose intolerant, Teva is by far the best option)
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
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...
Alright should I specifically ask for a different brand then like accord?
You might be perfectly fine with Teva brand……but if you have issues you can request to try different brand
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Accord only make 50mcg and 100mcg tablets
Alright thank you, btw if my B12 comes back low. Is there any suggestions on B12 supplements?
If B12 is under 300 GP should test for Pernicious Anaemia before starting any B12 supplements
Low folate and low B12
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-...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Thorne Basic B or Jarrow B Right are recommended brands that contain 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...
Low B12 symptoms
b12deficiency.info/signs-an...
If your serum B12 result is below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
B12 sublingual lozenges
amazon.co.uk/Jarrow-Methylc...
cytoplan.co.uk/shop-by-prod...
Drops
It is not uncommon for people, if they're already diagnosed with an autoimmune disease, to develop others.
If B12 is low, you must not add anything before your doctor confirms or not that you have Pernicious Anaemia. There's a reason it is called pernicious:-
nhs.uk/conditions/vitamin-b...
If we have P.A. we have to have regular B12 injections as our stomach cannot absorb B12 through food.
Causes of vitamin B12 deficiency
Pernicious anaemia
Pernicious anaemia is the most common cause of vitamin B12 deficiency in the UK.
Pernicious anaemia is an autoimmune condition that affects your stomach.
An autoimmune condition means your immune system, the body's natural defence system that protects against illness and infection, attacks your body's healthy cells.
Vitamin B12 is combined with a protein called intrinsic factor in your stomach. This mix of vitamin B12 and intrinsic factor is then absorbed into the body in part of the gut called the distal ileum.
Pernicious anaemia causes your immune system to attack the cells in your stomach that produce the intrinsic factor, which means your body is unable to absorb vitamin B12.
The exact cause of pernicious anaemia is unknown, but it's more common in women around 60 years of age, people with a family history of the condition and those with another autoimmune condition, such as Addison's disease or vitiligo.
There are all sorts of reasons why taking a multi-vit is a bad idea:
* If your multi contains iron, it will block the absorption of all the vitamins - you won't absorb a single one! Iron should be taken at least two hours away from any other supplement except vit C, which is necessary to aid absorption of iron, and protect the stomach.
* If your multi also contains calcium, the iron and calcium will bind together and you won't be able to absorb either of them.
* Multi's often contain things you shouldn't take or don't need : calcium, iodine, etc. These things should be tested before supplementing.
* Copper and zinc need to be kept balanced, but hypos are often high in one and low in the other - often low in zinc. So, both should be tested before supplementing. Taking either of them when you already high in it, will reduce the other and make you feel worse.
* Multi's often contain the cheapest, least absorbable form of the supplement : magnesium oxide, instead of magnesium citrate or one of the other good forms; cyanocobalamin instead of methylcobalamin; folic acid instead of methylfolate; etc. etc. etc. This is especially true of supermarket multis.
* Multi's do not contain enough of anything to help a true deficiency, even if you could absorb them.
* When taking several supplements, you should start them individually at two weekly intervals, not all at once as you would with a multi. Because, if you start them all at once, and something doesn't agree with you, you won't know which one it is and you'll be back to square one.
* Most supplements should be taken at least two hours away from thyroid hormone, but some - iron, vit D, magnesium and calcium (should you really need to take it) should be taken at least four hours away from thyroid hormone.
*Vit C should be taken 2 hours away from B12 because it affects how the body uses B12.
*Never take magnesium/zinc/calcium at the same time as they affect the absorption of each other.
*Take zinc and copper separately as zinc affects the absorption of copper, if you need to take both.
*Vits A/D/E/K are all fat soluble vitamins, and if taken together can compete for the source of fat. They are best taken away from each other.
* The magnesium you take - and just about everybody needs to take it - should be chosen according to what you want it to do:
Magnesium citrate: mild laxative, best for constipation.
Magnesium taurate: best for cardiovascular health.
Magnesium malate: best for fatigue – helps make ATP energy.
Magnesium glycinate: most bioavailable and absorbable form, non-laxative.
Magnesium chloride: for detoxing the cells and tissues, aids kidney function and can boost a sluggish metabolism.
Magnesium carbonate: good for people suffering with indigestion and acid reflux as it contains antacid properties.
Worst forms of magnesium: oxide, sulphate, glutamate and aspartate.
With a multivitamin, you are just throwing your money down the drain, at best, and doing actual harm at worst. Far better to get tested for vit D, vit B12, folate and ferritin, and build up your supplementation program based on the results. A vitamin or a mineral is only going to help you if you need it, anyway. More of something you don’t need is not better, it's either pointless or even dangerous, as with iodine, calcium, iron or vit D.
Obviously, it's better if you can get all your nutrients from food. But, if you are hypo, you probably have low stomach acid, which makes it difficult to digest food and absorb nutrients. Which is why you need the larger quantities contained in supplements.
Not wishing to overload you with info, more to make you aware of the effect of stress on the thyroid; you’ve moved house which can be stressful on top of anxiety. That can mess with your cortisol levels which in turn can affect your thyroid. Online articles and videos about how stress affects the thyroid may help you understand cause and effect, and hopefully reassure you a little about some of the chaos you are feeling within. With guidance from more knowledgeable members than myself, you will iron this out 🙂
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