Timings for Supplements

[AtemiM]

Good morning everyone.

Now that I'm over a month into my Levo prescription (50mcg trial agreed to by GP with some gentle persuasion from fabulous knowledge from you all ;)) I'm looking to start adding some supplements in gradually to try to get my vitamin levels back on track.

My D3 was low so GP has me on a loading dose (20,000ui twice a week for 7 weeks, I have 3 capsules left to go).

I was prescribed a months worth of ferrous fumarate (which I finished last week).

From recommendations here I'm looking to add the following (one at a time of course), and have sourced:

Better You Vit D3/K2 spray

Sublingual B12 (cytopan brand)

Jarrow B right complex

Magnesium glycinate (not citrate as I already have IBS issues. They are 100mg capsules so I can adjust accordingly).

My question is, how do you balance all these in terms of timing? I had no idea there were contraindications for so many supplements, what an eye opener!).

I'm currently taking my Levo before bed (which is around 9.30pm (I'm not a night owl. Lol)). I stop eating by 6.30/7.00.

I was taking the iron tablets in the morning and the Vit D capsules a little later in the day with a snack.

I know the Vit D spray isn't likely to affect anything else. The biggest issue I think is the Magnesium. I've read here there's more benefit to taking it at night and it can help you to sleep/relax but not sure how to fit that around the 9.30pm Levo. Do I have to leave a 4 hour gap before AND after?

Thanks in advance for any input.

Mx

[SlowDragon Administrator]

GP should (ideally) retest vitamin D at end of loading dose

If they don’t, suggest you test

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Or if not tested B12 and folate get FULL Thyroid and vitamin testing done before starting any B12 or vitamin B complex

Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Thyroid levels should be tested 6-8 weeks after any dose change or brand change in levothyroxine

Magnesium, must be four hours away from levothyroxine…..so taking late afternoon

GP should retest iron and ferritin after 2-4 months on iron supplements

[AtemiM in reply to SlowDragon]

Thanks SlowDragon My GP is going to call me back for thyroid panel, iron studies and FBC in a few weeks (he said 8 weeks or so after I had started the Levo trial).

I don't know if he will put Vit D on there again (I've read they don't test that more than once a year even if they've given you a loading dose? I'll try to get it put on the form if I can).

My B12 has been "normal" in the GPs regard the last 2 times but definitely down the lower end of range (see photo).

B12 test results

[SlowDragon Administrator in reply to AtemiM]

Yes looking at previous post…low folate too as well as 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 options that contains 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 serum B12 result 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...

[AtemiM in reply to SlowDragon]

I have the Jarrow B Right B complex as it was one of the ones I've regularly seen recommend here.

I will introduce the magnesium at first and leave the B12 until after my blood tests. I'm seeing the Endo for my first appointment on 5th April so want to get my updated blood tests in just before then (under the recommended conditions) here so they don't try to dispatch me for tests then and there which would likely not be optimal).

Thanks.

[SlowDragon Administrator]

As 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