These are my latest results from Medichecks from last week
I followed guidance from here with regard to blood being drawn before 9am nothing to eat or drink before hand and last dose of thyroxine 24 hours before test .Also stopped Thorne Basic B complex 7 days before test. I am currently on 100mcg thyroxine.
I take vitamin D. K2 . Selenium. Magnesium
Thorne Basic B Complex
I am vegetarian and follow a gluten free diet
CRP. 0.41 mg/L. (0-5) r
Ferritin . 58.8 ug/L. (13-150) r
Folate serum. 11.22 ug/L. (>3.89) r
Vitamin B12 active. 69.7 pmol/L (37.5-150)r
Vitamin D. 43.4nmol/L. (50-200nml/L)r
TSH. 0.06mu/L. (0.27-4.2)r
Free T3. 4.98pmol/L. (3.1-6.8)r
Free Thyroxine. 21.3pmol/L. (12-23)r
Thyroglobulin. 12.5 iu/mL. (>115)
Thyroid Peroxidase Antibodies. 583 iu/L.
(<34)r
I would appreciate your comments and guidance on these results. Thank you.
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Starmen
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Good result, the lower the better as CRP is an inflammation marker.
Ferritin . 58.8 ug/L. (13-150) r
Low. Ferritin is recommended to be half way through range, so around 82 with that range.
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.
Folate serum. 11.22 ug/L. (>3.89) r
Folate is recommended to be at least half way through range. Medichecks range is 3.89-19.45 so your result is OK.
Vitamin B12 active. 69.7 pmol/L (37.5-150)r
Low. Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
If you do 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 don't have any signs/symptoms you could consider taking a B12 sublingual along with your B Complex to keep all the B vitamins balanced. Once your Active B12 level has reached 100 then you could drop the sublingual B12 and just continue with the B Complex.
Vitamin D. 43.4nmol/L. (50-200nml/L)r
Low. How much D3 are you currently taking?
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.
As this is in the "insufficient" category you could discuss with your GP to see if he will consider prescribing D3. However, you're only likely to get 1,600iu (or even only 800iu) from your GP when really to reach the recommended level from your current level, you could do with supplementing with 4,000-5,000iu D3 daily so you may be better to address this yourself.
Retest after 3 months.
Once you've reached the recommended level 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
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.
Free Thyroxine. 21.3pmol/L. (12-23)r - there is a typo here, range is 12-22
These results aren't too bad. How do you feel?
FT4 is 93% through range and FT3 is 50.81% through range, this is showing that conversion could be better. This may improve when all nutrient levels are optimal. In particular the optimal ferritin level for thyroid function is said by some experts to be 90-110ug/L/
Thyroglobulin. 12.5 iu/mL. (>115)
Thyroid Peroxidase Antibodies. 583 iu/L. (<34)r
Your raised TPO antibodies confirm autoimmune thyroid disease (known to patients as Hashimoto's) - did you already know this?
Thank you for your detailed response.I am following the advice you have included taking all the vitamins and supplements you have recommended previously and brands.
Yes I know I have Hashimoto's a lot of my family do also. Being a life long vegetarian I know I need to increase certain nutrients.
My GP prescribes vitamin D only 400 daily so I will look into what you have recommended in your reply.
I feel much better but very tired which I am assuming is the vitamin D and Ferritin and possibly B12 ? I appreciate this help this forum has done much more for me than the health professionals thank you so much .
The accepted conversion ratio when on T4 monotherapy is said to be 1 / 3.50 - 4.50 - T3/T4 with most people feeling at their best when their conversion comes in at around 4 or under :
So to find your conversion ratio you simply divide your T3 into your T4 and I'm getting yours coming in at around 4.28 - so a little wide of centre and I'm sure this will improve once your vitamins and minerals are up and maintained at optimal levels.
From what I've read there seems considerable confusion as to defining high or low stomach acid when hypothyroid and if you can reduce / stop the Omeprazole there is a bicarb of soda test that you can do at home, however since you also have the complication of a hiatus hernia, I'm sorry, but now feeling out of my depth.
I take Wockhart which I am ok with. I had problems with Teva I am not celiac but find I am better gluten free . Thank you for the help with the dosage of vitamin D I was on a very low prescribed dose from go.
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