I had a rise in levothyroxine in nov 2021 and would appreciate any thoughts on my recent results and whether I need more or if I may need to see if I need to supplement with T3. I'm sure your laughing by now as I know that its rare to get T3 now.I started taking b12 daily plus k3 d3 both as a spray and a broad b vit supp after advice on posting the Nov results.
I have hashimotos and coeliacs and use hrt patches
I did reply to my previous post in Nov so apologise if this post repeats
Thanks in advance.
7/4/22 results (only just got them as hosp / dr lost them)
Serum TSH level - 0.62 mIU/L {0.27 - 4.2}
Serum free T4 level - 20.7 pmol/L {11.0 - 21.2}
Serum free T3 level - 4.5 pmol/L {3.1 - 6.8}
Serum vitamin B12 - 562 ng/L {197 - 771}
Serum folate - 2.5 ug/L {3 - 20)
22/11/21 results
Serum TSH level - 2.45 mIU/L {0.27 - 4.2}
Serum free T4 level - 17.9 pmol/L {11.0 - 21.2}
Serum free T3 level - 3.5 pmol/L {3.1 - 6.8}
Serum vitamin B12 - 385 ng/L {197 - 771}
Serum folate - 6.4 ug/L {3 - 20)
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debra135
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7/4/22 results (only just got them as hosp / dr lost them)
Serum TSH level - 0.62 mIU/L {0.27 - 4.2}
Serum free T4 level - 20.7 pmol/L {11.0 - 21.2}
Serum free T3 level - 4.5 pmol/L {3.1 - 6.8}
When did you take your last dose of Levo before this test? It should be 24 hours to give a measure of your normal circulating hormone.
I started taking b12 daily plus k3 d3 both as a spray and a broad b vit supp after advice on posting the Nov results.
Serum vitamin B12 - 562 ng/L {197 - 771}
It looks like your B12 has improved nicely, as long as you are taking a good quality B Complex which contains methylcobalamin and not Vit C then you should be able to ditch the B12 supplement now.
Serum folate - 2.5 ug/L {3 - 20)
Folate is dire, this is folate deficiency. What B Complex are you taking, does it contain methylfolate or folic acid and how much is included?
Thanks for your reply.I took my levo in the evening so no more than 12hrs I forgot I was having the test the next day.re folate I take on off the Birch and wilde vit b complex which hae the methyfolate I think. Dr said to add folic acid to my diet so I have just started taking a folic acid tablet each day. Not at home so cant check but its a standard one from pharmacy. I have read that folate deficiency is common in hypothyroidism.
I took my levo in the evening so no more than 12hrs I forgot I was having the test the next day
So your FT4 level is probably showing a bit higher than your normal circulating level. Unfortunately we can't make a guess at what that would be so we can't work out if you are a poor converter or not. Best retest to with advised timing before doing anything about T3.
Serum vitamin B12 - 385 ng/L {197 - 771}
Serum folate - 6.4 ug/L {3 - 20)
Those are you old levels, let's base comments on your current levels of:
Serum vitamin B12 - 562 ng/L {197 - 771}
Serum folate - 2.5 ug/L {3 - 20)
There is 10mcg B12 in that supplement which will do absolutely nothing to improve your B12 level, also the supplement contains Vit C and this can stop the body using B12 so it wont even be absorbing the measly amount it does contain.
Methylfolate is better than folic acid, folic acid is synthetic and the body needs to convert it to folate, folate is the natural form which is bioavailable so it's best to use a supplement containing methylfolate:
Personally I wouldn't bother with the folic acid, it's usually prescribed at 5mg daily when one is folate deficient (lower than 3ug/L). If my level was 2.5ug/L I would buy a separate folate supplement, maybe something like this one (note that it is 1,000mcg dose):
I would also buy a decent quality, bioavailable B Complex containing methylfolate and methylcobalamin (B12). My choice is Thorne Basic B which contains 400mcg each of methylfolate and methylcobalamin. I would take both the methylfolate and the B Complex. Once folate level is at least half way through range I would stop the methylfolate and just carry on with the B Complex which will then maintain both folate and B12 levels.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
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).
thank you this is great. Got a dr's appt on monday. Not sure they will be happy with me asking to retest. The one I'm seeing is more up on hrt then thyroid meds. . I'll try and if not get tests done myself. Can you advise on where to look for testiong please
Cheapest for jut TSH, FT4 and FT3 is Monitor My Health which is an NHS at Exeter hospital which offers this test to the general public for £26.10 with code here:
one last question if I may. What sort of figures should I be looking for in my t3 /t4. I'm just trying to work out if I'm converting the t4 or not. Knowing how to look at the figures would help me be prepared for tomorrow afternoons drs appt.
What sort of figures should I be looking for in my t3 /t4. I'm just trying to work out if I'm converting the t4 or not.
TSH below 1 to give highest possible FT4. Last dose of Levo 24 hours before test to give accurate FT4 level. TSH, FT4 and FT3 must be tested at same time from same blood draw.
If FT4 is high in range and FT3 low in range = poor conversion
eg FT4: 20 (12-22) = 80% through range
FT3: 4 (3.1-6.8) = 23.32% through range
If FT4 and FT3 reasonably well balanced = good conversion
Also, you can divide FT4 by FT3 (as long as units of measurement are the same). Good conversion generally is below 4:1, poor conversion is generally above 4:1, eg
FT4: 20 : FT3: 4
20 divided by 4 ratio is 5:1 = poor conversion
FT4: 20 : FT3: 5.7
20 divided by 5.7 ratio is 3.5:1 = good conversion
Don't expect your doctor to know anything about this or even accept it. All they know is that results should be in range and as far as they're concerned that's anywhere in range.
This is great thanks for your help. Not checked my figures yet but just out of interest when drs arent helpful what do people do if they have conversation etc
If we have optimal nutrient levels, test to see if they are, if they need improving then do this as we need optimal nutrient levels for any thyroid hormone to work properly.
Vit D - 100-150nmol/L
B12 - top of range for Total B12, over 100 for Active B12
Folate - at least half way through range
Ferritin - half way through range although some experts say that the optimal level for thyroid functin is 90-110ug/L
If these are all optimal and still poor conversion then adding T3 is likely to be beneficial.
Those of us who can't get T3 on the NHS we self source.
Something to consider if you are not already gluten free:-
"Determine whether there is an underlying cause for the vitamin B12 or folate deficiency — this may require specialist referral.
If folate levels are low, assess dietary folic acid intake, and if history suggests malabsorption, check for coeliac disease by testing for antiendomysial or antitransglutaminase antibodies (depending on the local laboratory).
The main cause of folate malabsorption is gluten-induced enteropathy. "
Folate deficiency + autoimmune thyroid disease should trigger coeliac testing, but sadly it doesn't. More & more people are being dx coeliac due to Iron deficiency because unexplained Iron deficiency requires referral to Gastro for further testing, wheres a +++ positive coeliac dx under age 55 does not (so, saving money). Folate deficiency..........they are only required to prescribe folic acid for a couple of months, then re-test, and tend to ignore the above advice from NICE.
Been gluten free for years as I was diagnosed with coeliac disease and being gf changed my life. I was so skinny it was terrible. I was deficient in nearly everything and mal nourished.
I can't remember the last time these were tested. The trust I'm with are really tight so will do the bare minimum tests unfortunately . I will check and see if I can get them added next time
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Some help and advice please with my results.
My latest thyroid test results
New Blue Horizon Results & Iron Improvement
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