Advice on latest lab please?

[BC99]

Just wondering if you could give advice on my last bloods?

I feel ok, not swelling, but can not loose weight at all. I stop feel always cold, but my heart rate increase to 85/min

I used NDT 3 years, was great, but the factory was closed, and I can not buy anymore lacto free NDT (without prescription) after 1 year with Levothyroxine only, I discovered T3

I have Hashimoto and taking levothyroxine from 12 years.

From 6 weeks I am on 100mcg levothyroxine Teva (lacto free)

And 50mcg T3 (I am taking 5am - 25mg and 4pm - 25mg)

I am gluten and dairy free from 4 years, eat a lot of vegetables/fruits/nuts, meat/fish sometimes only, do not take any vitamin/supplements.

My test was done early morning 24hrs from levothyroxine and 16hrs from T3

I am losing a lot of hair and can not loose weight.

I have problem with guts, too quick digest and do not take vitamins/ minerals from foods

Any advice please?

Why T4 is so low? And looks as T3 I should reduce 12.5 less?

FT3 level 8.6 pmol/L (3.1 - 6.8 pmol/L)Serum TSH level 0.01 mu/L [0.3 - 4.2]Serum free T4 level 11.8 pmol/L [12.0 - 22.0]

Serum ferritin level 32 ug/L [30.0 - 400.0]

VITDT 56 nmol/L

Vitamin D <30nmol/L indicates Vitamin D deficiency Vitamin D >50nmol/L indicates adequate Vit D levels

Serum vitamin B12 level 324 pg/mL [197.0 - 771.0]

Serum folate level > 19.5 ug/L [> 3.0]

Serum testosterone level 1.3 nmol/L [0.2 - 3.0]

Serum urea level 1.5 mmol/L [2.5 - 7.8]

Serum C reactive protein level < 1 mg/L [< 5.0]

Serum calcium level 2.27 mmol/L [2.12 - 2.62]

Serum albumin level 43 g/L [35.0 - 50.0]

Serum adjusted calcium concentration 2.31 mmol/L [2.2 - 2.6]

Serum electrolyte levels Creatinine and Electrolytes

Serum sodium level 140 mmol/L [133.0 - 146.0]

Serum potassium level 3.8 mmol/L [3.5 - 5.3]

Serum creatinine level 47 umol/L [45.0 - 84.0]

Serum chloride level 105 mmol/L [95.0 - 108.0]

Serum cholesterol level 3.9 mmol/L

Serum triglyceride levels 0.6 mmol/L [< 2.0]

Serum HDL cholesterol level 1.5 mmol/L

Serum LDL cholesterol level 2.1 mmol/L

Serum non high density lipoprotein cholesterol level 2.4 mmol/L

Serum alkaline phosphatase level 64 u/L [30.0 - 130.0]

Serum albumin level 43 g/L [35.0 - 50.0]

Serum total bilirubin level 7 umol/L [< 21.0]

Serum alanine aminotransferase level 23 u/L [10.0 - 60.0]

Plasma total protein level 65 g/L [60.0 - 80.0]

[SlowDragon Administrator]

That’s a very high dose of T3 if you really mean 2 x 25mcg tablets….having only started 6 weeks ago

It’s always recommended to start T3 very SLOWLY

Typically starting on 5mcg ……wait a week or so…..add a 2nd 5mcg

Then wait 6-8 weeks before testing

Your Ft3 is too high

Suggest you cautiously reduce dose by 1/4 of a tablet ……wait 4 weeks, then reduce again by 1/4 tablet

Hold at that and retest 6-8 weeks later

You may need to increase dose levothyroxine a little after next test. But only change one thing at a time

Meanwhile vitamin levels are all low and need improving apart from folate

Serum ferritin level 32 ug/L [30.0 - 400.0]

VITDT 56 nmol/L

Serum vitamin B12 level 324 pg/mL [197.0 - 771.0]

Optimal vitamin levels are

B12 at least over 500

Vitamin D at least around 80nmol and around 100nmol maybe better

Ferritin at least half way through range

Are you male or female?

Pre or post menopause

Vegetarian or vegan

What vitamin supplements are you currently taking

Extremely common when hypothyroid to have low vitamin levels

Many, many people need to supplement virtually continuously to maintain optimal vitamin levels

[BC99 in reply to SlowDragon]

Hi SlowDragon,Thank you for replay.

I will reduce T3 slowly.

I am female 42years old

Do not take any vitamin/ supplements

I am 100% dairy free, meat/fish I eat maybe twice a month.

I was thinking about iron supplements but my GP said that the level of ferritin is correct...

Can you advice any good supplements, or just buy multivitamin?

Thank you

[SlowDragon Administrator in reply to BC99]

Multivitamins are never recommended on here, too little of what we do need, usually poorly absorbed cheap ingredients and most contain iodine not recommended for anyone on replacement thyroid hormones unless tested and deficient and under care of iodine specialist

Ferritin is only 2 points above deficiency

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Suggest you get FULL iron panel test for anaemia done

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

GP should test, but here’s

Medichecks iron panel test

medichecks.com/products/iro...

Meanwhile working on increasing iron rich foods in your diet

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat daily , pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

An article that explains why Low ferritin and low thyroid levels are often linked

preventmiscarriage.com/iron...

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Good explanations of iron

theironclinic.com/iron-defi...

theironclinic.com/ironc/wp/...

Recommend Reading the many posts and replies by humanbean on low iron and ferritin

[SlowDragon Administrator in reply to BC99]

Only start one vitamin supplement at a time and wait at least 10-14 days to assess before adding another

Low vitamin D

GP will often only prescribe to bring vitamin D levels to 50nmol. Some CCG areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7. One spray = 1000iu

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

Another member recommended this one recently

Vitamin D with k2

amazon.co.uk/Strength-Subli...

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Suggest you start with 2000iu or 3000iu per day and retest in 2-4 months

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine or T3

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Great article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[SlowDragon Administrator in reply to BC99]

Low B12 symptoms

b12deficiency.info/signs-an...

With 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.

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...

Vitamin B complex 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

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...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and separate B12

How other member saw how effective improving low B vitamins has been

healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to BC99]

Majority of Hashimoto’s patients on levothyroxine plus T3 end up on between 10mcg - 30mcg T3 per day…..frequently as divided dose every 8 hours

Plus enough levothyroxine to bring Ft4 to at least 50-60% through range

Extremely important to have GOOD vitamin levels for good conversion of Ft4 to ft3

Many members find conversion improves enormously once vitamin levels are optimal

Always recommended on here to get vitamins optimal BEFORE considering adding T3

Nether levothyroxine or T3 will work when vitamin levels are low

[BC99 in reply to SlowDragon]

Thank you for all information 🙏😊I would like start from increase ferritin level.

Now I know that I need to do full iron test,

I tryed take iron tablets few weeks ago but after 1 tablets I have huge stomach upset.

It could be better after few days?

I do not eat meat(only some times)

I don't know how I could increase ferritin..?

Is it any spray as vitamin d?

[SlowDragon Administrator in reply to BC99]

Recommend reading posts and replies by humanbean on improving low iron and ferritin

There’s lots of different iron supplements

There is an iron spray, but I don’t think many (any?) members have had good results with iron spray