I’ve got my new results today can someone help me understand it
Help understanding: I’ve got my new results today... - Thyroid UK
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TurkeY787
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Hi TurkeY787The Thyroid Peroxidase antibody (TPOab) is positive 189.
This means that Autoimmune Hypothyroidism is the cause of your hypothyroidism . ( this is the reason most of us go hypo, our immune system is mistakenly attacking our thyroid , meaning it can't produce enough T4 for us anymore..... so we take Levo , which is synthetic T4 ... there is no 'treatment' for the autoimmune part of the problem )
Are you still taking 75mcg Levo ?
Have you had thyroid bloods done for the the 75mcg dose ? (TSH /fT4 /fT3)
B12/ Vit D .. i think ? these are OK . SeasideSusie / SlowDragon will know
Folate could not be done .
Ferritin not done.
SeasideSusieRemembering
TurkY787
Assuming that you don't already take any supplements:
B12: 415pg/ml
This is on the low side. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Folate and B12 work together so really that should also be tested.
As long as you have no signs of B12 deficiency, which you can check here:
b12deficiency.info/signs-an...
b12d.org/submit/document?id=46
then it would be OK for you to take a B12 sublingual to raise your level, along with a good quality B Complex to keep all the B vitamins balanced. Once your B12 level has reached 550pg/ml then you can stop the B12 sublingual and just carry on with the B Complex, remembering that when taking a B Complex it should be stopped before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
I have used Thorne Basic B for a long time and always been happy. However, it's quite expensive so I have bought some of this one to try when I've finished the last of my Thorne. The amounts of the vitamins are very similar, it's liposomal which is said to absorb better, there are no unnecessary added ingredients and better priced:
amazon.co.uk/Liposomal-Vita...
If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.
When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
Vit D: 79nmol/L
I can't quite read the note underneath your result appertaining to people over 70 - is that at least 80nmol/L or at least 90nmol/L, I'd be grateful if you could clarify that because it's the first time I've seen it on an NHS test and that's quite important.
Regardless of that, 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.
To reach the recommended level from your current level, you could supplement with 2000-3,000iu D3 daily.
Retest after 3 months.
Once you've reached the recommended level of 100-125nmol/L then a maintenance dose 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:
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.
For Vit K2-MK7 I like Vitabay or Vegavero brands 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
natureprovides.com/collecti...
It may also be available on Amazon
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.
SlowDragonAdministrator
What are your most recent Thyroid results
TSH, Ft4 and Ft3
Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test
Which brand of levothyroxine are you currently taking
75mcg is only one step up from standard starter dose levothyroxine
You’re likely ready for next dose increase in levothyroxine
Looking at previous posts
You are already on strictly gluten free diet, is that correct?
High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s
About 86% of Hashimoto’s patients find strictly gluten free diet helps or is essential
You need ferritin and full iron panel test done
MCV is out of range…..suggests you might be anaemic
Yes I always stop taking my medication before my blood test and I make sure my blood test is early in the morning from all the advice on here what is fantastic x
Yes I got diagnosed with Hashimoto’s I went to see a private consultant sent me for antibody test what I put my results up earlier yes I am gluten-free as well but I’ve still been feeling very poorly my hair is falling out I still have no energy and I’m very tired my mood swings are dreadful too and the brand I’m on Tevn x
These are mar resort
So this thyroid test was after how long on 75mcg dose levothyroxine
Results show you need next dose increase in levothyroxine up to 100mcg
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.
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...
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
REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex
FT4: 15 pmol/l (Range 11 - 21.2) 39.22%
FT3: 3.6 pmol/l (Range 3.1 - 6.8) 13.51%
Helpful calculator for working out percentage through range
Most people when adequately treated will have Ft3 at least 50% through range
On just levothyroxine, Ft4 frequently needs to be at least 60-70% through range…….so you can see your currently a long way from this
Increasing dose levothyroxine should help
Bloods should be retested 6-8 weeks after each dose increase
hi I haven't been on here for that for a long time as my husband been very poorly so he's been look after him all. taking I been feeling very rubbish lately I keep having blood work done. They've just decided to increase me to 100 Levothyroxine and 20 for t3 i've noticed in the evening my legs are getting very tired again I am gluten-free I stop taking all my vitamins because I kept making me feel very grateful the vitamin days and I was also taking B complex but my hair is falling out again. I've noticed my eyedrops I'm still getting a lump underneath my eye I've been referred with my eye and they keep saying there's nothing wrong with it. I'm just feeling very down in myself. I'm getting a lot more brain fog to . I've been getting lots of heart palpitations to so they give me a heart monitor for three days to try to see what's going on, but I think it's either I'm undermedicated these are my new results
X
was this test done on JUST 100mcg levothyroxine or were you also taking 20mcg T3
was test early morning and last dose levothyroxine 24 hours before test
Do you normally split T3 as 2 or 3 smaller doses spread through the day
Day before test ALWAYS split T3 as 3 doses…10mcg waking, 5mcg mid afternoon and 5mcg Approx 8-12 hours before test
Do you always get same brand levothyroxine at each prescription
Did you stop vitamin B complex 5-7 days before test
ESSENTIAL to test vitamin D, folate, B12 and ferritin at least once year
hello know this test was done on 75 yes I always do my test at 7 in morning and I take my medication at 2 o'clock every morning, so I just stopped at 2 o'clock the night before I didn't take it when I went for my blood test .
yes I'm on Tara as it's the best one for me because I'm gluten-free and alway the same .x
So last dose levothyroxine was 30 hours before test Approx …so Ft4 is falsely low
Ideally
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
so you weren’t taking any T3 at all when this test was done?
TSH is low, but Ft3 is pretty good
(Result looks like one from someone on levothyroxine plus T3)
Did you stop Vitamin B complex 5-7 days before test?
Next step get vitamin levels tested ideally including iron panel test
Just vitamin and mineral testing including iron panel test £69
Test early morning and just water between waking and test.
If currently taking iron supplements stop these 5-7 days before test. Don’t eat iron rich dinner night before test
randoxhealth.com/Vitamin-an...
yes the last of taking my tablets was it 2 o'clock on a Saturday night I didn't take him Sunday as I was going for the blood test on the Monday. Yes and I am on T3 medication to say the last time I took this medication before the test was Saturday night at 2 o'clock. No more medication until Monday after blood work so dumb I stop taking B complex because he was making my stomach very gassy and bloated . So what should my ft4 be as it low thank you for your help x
Yes and I am on T3 medication to say the last time I took this medication before the test was Saturday night at 2 o'clock.
Ft4 result would have been a bit higher if last dose levothyroxine was 24 hours before test…..not 29 hours as you did …..How much higher impossible to say
Had you been taking 20mcg T3 per day for at least 6-8 weeks before test? Do you normally split the T3 as 2 or 3 smaller doses spread through the day?
Day before test ALWAYS split T3 as 3 smaller doses, 10mcg (1/2 tablet) waking, 5mcg mid afternoon and last 5mcg dose approximately 8-12 hours before test
Did you do this
hello no I didn't spit t3 medication. I took it on the Saturday the same time as my T4 medication. Yes I been on t3 now for 1 year now. X
So Ft3 result is false low result
Suggest you retest correctly
Test early morning, just be 9am
Last dose levothyroxine 24 hours before test
Day before test split T3 as 3 smaller doses (cut with sharp scalpel) …..take last 1/3rd of daily dose T3 Approx 8-12 hours before test
I've got another blood test booked for six weeks. I'm on medication is going up to 100 now. Do you think I should put my T3 up my consultant said that they was fine and I told him that they wasn't I never listen thank you x
no
Only ever change one thing at a time
So Levo has been increased by 25mcg to 100mcg per day
Still Teva brand presumably
Retest in 6 - 8 weeks
Last dose levothyroxine 24 hours before test
Day before test ALWAYS split T3 as 3 smaller doses spread through the day…..last 5mcg dose 8-12 hours before test
ok thank you so much x
Hi got new blood test done My Consultant, rings me next week need some advice please
X
Was last dose levothyroxine 24 hours before test
Day before test did you split T3 as three doses spread through the day and last dose T3 approximately 8-12 hours before test
When were vitamin D, folate, ferritin and B12 last tested
What vitamin supplements are you taking
Most importantly how do you feel
yes my last days was 24 hours. Before my test I split my T3 time day before test I take 100 off levethyroxine and 20 mcg off t3 i've got another blood test on Friday for to check my vitamin di and B12 and ferritin. I've been feeling rubbish. My hair is so much i'm feeling very tired I have no energy my skin feels very itchy all the time .
Folate needs testing too
Thank u x
Thank u I do that to x.
Here is my results
X
Can’t see folate result
Vitamin D good
B12 too low
Ferritin too low
I've only just started taking vitamins d and B complex and should I be taking B12 now and my folate was done but there's nothing I will contact the doctor about it and thank u so much to 😚
What vitamin supplements are you currently taking
Low B12 symptoms
b12deficiency.info/signs-an...
methyl-life.com/blogs/defic...
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and add a separate vitamin B Complex after a week
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
B12 drops
natureprovides.com/products...
Or
B12 sublingual lozenges
uk.iherb.com/pr/jarrow-form...
cytoplan.co.uk/shop-by-prod...
B12 range in U.K. is too wide
Interesting that in this research B12 below 400 is considered inadequate
healthunlocked.com/thyroidu...
Low folate
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
healthline.com/nutrition/fo...
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 recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
Other options
healthunlocked.com/thyroidu....
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...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Post discussing how biotin can affect test results
healthunlocked.com/thyroidu...
I've got some B12 drops for now and I've got some B complex how much the B12 how much do you take to take it daily?
Start B12 drops FIRST
Read the instructions on bottle as to what is full daily dose
If it’s Nature Provides B12 - that’s 13 drops approximately
Suggest first 2-3 days you start on less ….eg 1st day 5 drops. Next day 10 drops …..then full dose day 3
A week after starting B12 drops add daily vitamin B complex
Thank u so much x x
hello I got my new blood test results are and this was with the increase of thyroxine 100 and the 12th and theB complex as well
X
How do you feel?
What about TSH, Ft4, and vitamin D, folate, B12 and ferritin results and ranges
ALL thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test
I’ve tried lots of plants but because I can’t tolerate Lakeside so I have to have the brand that I’m on is the one that doesn’t make me go to the toilet so much make me feel that I’m well by taking it I go back to see my consultant in two weeks my doctor said today I don’t need to increase my ties but I’ll ask my consultant when I go back I had a test eight weeks after going up from 50 to 75 and then I had another one seven weeks after and they said it was fine x
Thank u x
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