Please help low tsh new Medichecks results

[Timetraveler67]

I posted last week gp low tsh results was advice to get full test So here are Medichecks results Which are - TSH 0.23. T3 4.09. T4 21.5. The Drs report Said talk to my Dr about reducing my dose as T4 is in the high range with low tsh. Folate is 16.59 B12 is 150 ( Drs report said if I’m on any supplements to stop them ( I’m not taking any supplements for B12) Vit D is 66 My gp is ringing me Friday morning and I’m so confused about these results please can you help me? It’s taking me 4 years to get to 100mg of levo due to intolerance and now it looks like I’m going to be told to reduce.. please advise me thank you so much everyone I appreciate you all x

[SlowDragon Administrator]

What vitamin supplements are you currently taking

Vitamin D is to low

How much vitamin D are you currently taking

Are you currently taking any vitamin B complex

Ferritin result?

Was this test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

FT4: 21.5 pmol/l (Range 12 - 22)

Ft4 is 95.00% through range

FT3: 4.09 pmol/l (Range 3.1 - 6.8)

Ft3 is only 26.76% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

So like many, many people on just levothyroxine, you have poor conversion of Ft4 to Ft3

Likely to benefit from addition of T3 prescribed alongside levothyroxine, and small reduction in levothyroxine

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3

[e-mail]

[Timetraveler67 in reply to SlowDragon]

Ferritin was 74 I did the test in the afternoon I thought that would be ok as my last dose of levo was early hours. I take vitabotics 1,000 tablet every day but sometimes I take 2 tablets. I don’t take any B supplements so don’t understand high B12, can you please tell me what’s made my tsh drop so low, and will it come up again do you know? I emailed the address you gave me twice last year but the email bounced back each time I tried but I will try again tonight. Do I tell my Dr I’m going to see a private Dr? What are the rules Please? The supplement s I take Every day are magnesium, COD liver oil vit D and K2 and probiotic. Zink and selenium I take only twice a week I take eltroxin brand levo thank you for your help x

[SlowDragon Administrator in reply to Timetraveler67]

Exactly what vitabiotics supplement

TSH is highest very early in the morning….(about 3-4am)

Obviously impractical to test thyroid levels then

Advice is to always test EARLY morning, ideally before 9am and last dose levothyroxine 24 hours before test

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

TSH daily variation

healthunlocked.com/thyroidu...

So it’s very important when you test TSH ....

researchgate.net/publicatio...

“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”

“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”

If delaying taking levothyroxine until after blood test, you likely want to not eat or drink anything apart from water before taking levothyroxine

It may (or may not) make a difference to TSH if fasting ….opinions differ

Eat as normal the night before.

But just have water between getting up in morning and thyroid test

ncbi.nlm.nih.gov/labs/pmc/a...

ncbi.nlm.nih.gov/pubmed/252...

[Timetraveler67 in reply to SlowDragon]

I’ve really messed up then as I did the test in the afternoon.. I don’t know what to do now. I take vitabiotics 1000 iu one a day sometimes 2, I do always make sure all my Other meds and all my Supplements are 4 hours away from my levo. Thank you for the links I’ll read them now

[SlowDragon Administrator in reply to Timetraveler67]

Which vitabiotics…..you mean just vitamin D

vitabiotics.com/products/ul...

Suggest you consider Vitamin D mouth spray by Better You

It’s is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

Try 3 sprays per day, after breakfast

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need. You might need 4-5 sprays per day to increase dose and then 2-3 as maintenance dose

Everyone is different how much they need

But with Hashimoto’s and gluten intolerant likely to be at higher dose

Personally I found (after 6 years testing twice year)….I need 4-5 sprays per day in winter as maintenance dose. 3-4 sprays per day in summer and as much sun as I can get. I usually have very good tan all year and would normally go away on at least one winter sunshine holiday every year. Obviously that’s not been happening with Covid

Other people might only need 1-2 sprays per day

Important to test vitamin D regularly twice year while learning what dose you personally need

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

[Timetraveler67 in reply to SlowDragon]

Yes that’s the vitiboitics I take 1000 iu just the D on it’s own but I’ll order the better you d3 plus k2 tonight thanks for your help

[SlowDragon Administrator in reply to Timetraveler67]

Every day are magnesium, COD liver oil vit D and K2 and probiotic.

Zinc and selenium I take only twice a week

Magnesium supplements should be afternoon or evening,, minimum 4 hours away from levothyroxine

Vitamin D supplements you swallow should be minimum 4 hours away from levothyroxine and with main meal of the day

Vitamin D mouth spray can be anytime (best at least an hour away from levothyroxine)

Red Better You vitamin D with vitamin K2 mouth spray

one spray = 1000iu

How much vitamin D are you currently taking

Aiming to improve to at least around 80nmol and around 100nmol maybe better

[SlowDragon Administrator]

As you’re gluten intolerant, it’s almost inevitable you need addition of T3

[sobs1962 in reply to SlowDragon]

That's very interesting, I was tested for coeliac disease last year and tests came back negative for the required level of antibodies to have coeliac disease, so it appears I have non coeliac gluten sensitivity and try to avoid wheat if at all possible and eat oats instead, didn't realise that gluten intolerance affects ft3 levels,mind you trying to get my practice to understand any of that is like trying to get blood out of a stone, they're so woefully ignorant regarding vitamins and nutrients ,it makes me wonder what they get taught in medical school or if they actually get taught anything at all.

[SlowDragon Administrator in reply to sobs1962]

Many, many autoimmune thyroid patients develop gluten intolerance or wheat intolerance on just levothyroxine

Recent research suggests low Ft3 (on just levothyroxine) can result in leaky gut and development of numerous food intolerances

Only 5% of Hashimoto’s patients are coeliac, but a further 80% find strictly gluten free diet helps or is essential