Finally got enough info to post results. The lab says I am ok!
Tests done early morning without taking any medication.
TSH. 1.01 (0.27 - 4.2) 18.83%
Free T3. 4.33. (3.1 - 6.8) 33.24%
Free Thyroxine 20.7 (12 - 22). 87%
Vit D 48nmol (<25nmol/L - >50nmol/L) insufficient
Ferritin 502ug/L. (<12ugl ->300ugl)
Serum TPA 160ku/L (<34.0)
B12 doctor would not do as he said it was obvious from the many other blood tests he had done it was fine.
I have been trying to follow all the instructions you give online and attempt to understand something about ratios.
It looks to me as if the proportion of T4 to T3 is out of kilter. High T4. Low T3?
The TPO confirms Hashimotos?
Ferritin is high. Due to inflammation, probably thyroid itself?
Vit D looks very low compared to level required posted online BUT could that be different units? I forgot to check those online with you before posting. However doc seems to imply I could benefit from supplementing. If it is a conversion issue this could help!?! Initially I read about this and I did supplement for a while but had no idea if it was helping and with so much going on I dropped it, attempting to be more methodical about improvement/worsening or no better.
Please could someone comment?
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The lab is saying OK because results are in range, but that doesn't mean they are at optimal levels for you.
TSH. 1.01 (0.27 - 4.2) - no need for percentage with TSH
Free T3. 4.33. (3.1 - 6.8) 33.24%
Free Thyroxine 20.7 (12 - 22). 87%
It looks to me as if the proportion of T4 to T3 is out of kilter. High T4. Low T3?
Yes, they're not well balanced, they show poor conversion of T4 to T3.
Vit D 48nmol (<25nmol/L - >50nmol/L) insufficient
Vit D looks very low compared to level required posted online BUT could that be different units?
This is low.
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.
You might want to check out a recent post that I wrote about Vit D and supplementing:
and you can check out the link to how to work out the dose you need to increase your current level to the recommended level.
Your current level of 48nmol/L = 19.2ng/ml
On the Vit D Council's website you would scroll down to the 2nd table
My level is between 10-20 ng/ml
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).
So now you look at how much is needed to reach 50ng/ml and you'll see that they suggest 4,900iu daily, nearest is 5,000iu
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.
90-100mcg K2-MK7 is enough for up to 10,000iu D3.
For Vit K2-MK7 I suggest Vitabay, Vegavero or Vitamaze brands which all 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.
Vitabay and Vegavero are either tablets or capsules.
Vitabay does do an oil based liquid.
Vitamaze is an oil based liquid.
With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops.
They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.
If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The K2-MK7 is the All-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.
Right Seaside Susie you have given me plenty of information to be going on with. Re: B12, I get umpteen other blood tests for CHD (which they knew I did not have - finally diagnosed as coronary spasm) for the last 20 years and more. I could off course have it now. Other stuff shows up, type 2 diabetes (but with great effort on my part has been dealt with - now in normal zone) third stage kidney failure which has remained stable for 20 years. High cholesterol, top of range, which has got slightly better through exercise and now the since introduction levothyroxine, liver enzyme stuff I have not taken the time to work out the results on. Doctor deduces that there is nothing to worry about according to what he sees from those tests. However this all sounds pretty devastating on paper BUT I have had no treatment for 15 years other than HBP medication for the last five years. HBP better after starting thyroxine. Many of the drugs I was on are contraindicated for hypothyroidism but I was NEVER tested for that although my symptom picture is pretty blooming clear. 20-20 vision with hindsight. My best symptom improvement has been the virtual disappearance of the coronary spasm of 25 years standing. Although I am so glad you say my levels are still not optimum for me, as I still have all my other hypothyroid symptoms. I can still hopefully improve with the info from yourself and others on this forum. Thank you. I feel like I have ‘skin in the game’, now I have had results to post and received information I can act on!! I can’t help thinking if I had been tested for hypothyroidism all those years ago, the NHS would have been saved a fortune and I would have been able to earn a living, never mind everything else.
Doctor deduces that there is nothing to worry about according to what he sees from those tests.
OK, so I'm not medically trained but I would really like you doctor to explain to me how those other tests prove that my B12 level is fine 🤔
I still have all my other hypothyroid symptoms
Low T3 causes symptoms.
If all nutrients are optimal, ie
Vit D - 100-150nmol/L
B12 - top of range for Total B12 (Active B12 - 100 plus)
Folate - at east half way through range
Ferritin - half way through range although some experts say the optimal level for thyroid function is 90-110ug/L
then if FT4 is still high with low FT3 then consider the addition of T3 to your Levo.
I can’t help thinking if I had been tested for hypothyroidism all those years ago, the NHS would have been saved a fortune and I would have been able to earn a living, never mind everything else.
Amen to that, there's a lot of us here would completely agree with you!
SeasideSusie and SlowDragon. I have discovered I can’t get a B12 test without a proper blood draw, so that remains to be done. My appointment did not go well with my GP, even although I prepared very specifically for it. I wrote to him before my appointment with one specific area of trouble (as they can’t cope with more per appointment) about falling down in the street and not being able to get up again because my muscles are so weak. He agreed there was some degeneration in my spine. He examined a range of other muscles. Apparently it’s my age, my weight and there does not seem to be anything wrong with my muscles. I can’t tell you how frustrating all this is - However I am sure you know! I have to wait another two weeks to discuss the ferritin result, which off course I have done some reading on. I am always on the cusp of type 2 diabetes and already have 3rd stage chronic kidney disease so I am thinking the worst. Anyway I really wanted to ask about my thyroxine meds. I am on 100mcg of levothyroxine and (according to calculations which appear on this forum) and according to my weight (that I can’t shift because I can’t get enough exercise etc etc) I should be on about 150mcgs. Do you think pushing for more levothyroxine should be a goal? I read horror stuff about putting on even more weight taking more levothyroxine, losing hair etc so I am not exactly keen to do that as I have enough problems but ……
It would be a start. NHS at primary level are Total B12 which measures the total of bound and unbound (free/active) B12 and doesn't differentiate. The Active B12 is said to be the better test as it's the free/active B12 that is available for the cells to use.
I wrote to him before my appointment with one specific area of trouble (as they can’t cope with more per appointment) about falling down in the street and not being able to get up again because my muscles are so weak. He agreed there was some degeneration in my spine. He examined a range of other muscles. Apparently it’s my age, my weight and there does not seem to be anything wrong with my muscles.
I don't know how much you weigh nor how old you are, I am over 70 but I have never seen ladies of any age or weight just down in the street, and neither have I or my friends of a similar age. So all I can deduce from this is that he doesn't have a clue, isn't interested in finding out, will find any excuse to fob you off and is talking out of an orifice other than his mouth.
Anyway I really wanted to ask about my thyroxine meds. I am on 100mcg of levothyroxine and (according to calculations which appear on this forum) and according to my weight (that I can’t shift because I can’t get enough exercise etc etc) I should be on about 150mcgs.
Please don't get hung up on "I should take X amount of Levo because I weigh Y".
Yes, the dose by weight is in the new guidelines but as an estimated starter dose for some people with recommendation to adjust dose where necessary. It is not set in stone that you need to dose by weight. We need what we need and it's how we feel that should be our guide.
Do you think pushing for more levothyroxine should be a goal?
Free T3. 4.33. (3.1 - 6.8) 33.24%
Free Thyroxine 20.7 (12 - 22). 87%
In my opinion - no. Taking more Levo will push up your FT4 level and possibly take it over range. Your problem is low T3 so if/once all nutrient levels are optimal (levels given above) if you still have such a low FT3 compared with your very decent FT4 level then it would be T3 that you need.
I read horror stuff about putting on even more weight taking more levothyroxine, losing hair etc so I am not exactly keen to do that as I have enough problems but ……
It may have happened to some people but it's not a given that it will happen to everyone. I've been on as much as 200mcg Levo and I did not gain wait nor did I lose hair, but as I've said it's not more Levo that you need.
OK SeasideSusie thank you again for getting back to me, giving me support when frankly I have been feeling a bit alone again with my problems. Glad about your opinion on the levothyroxine because my experience is that I have felt no improvement since being put on 50mcgs and only felt improvement for two weeks. Same with the 25mcgs. Started very low at my request because of my heart symptoms - did not want to make them worse. Although as I have said they are the one thing that have greatly improved! I see that Medichecks test now - don’t know how I missed it. I have started the Vit D and the K2? you mentioned and Magnesium. I have not started the B vits because of the B12 testing I intended to get. I do see that other people are intimidated by this situation with the medics, not just me. In the bigger picture I am sure it would be better for them, just to get on treating us better! Thanks again for getting back to me, especially so blooming quickly.
Thank you SlowDragon. It’s so good to have a distinct direction now. Ah yes no folate test. At the moment no supplements at all. I have tried a gluten free diet but did not see any difference to my usual level of discomfort. I do try to keep bread etc to a minimum (except when I can’t - fatigue, the worst time I should be eating it). IBS of the looser kind for too many years to mention and I do feel, constipated or not, that my intestines are constantly being ‘scourged’ so I know there is inflammation there too. Bowel cancer tests clear.
Thank you again SlowDragon. At the moment I have no idea what this high level of ferritin could mean. Something else I will study. Timing has been organised. I see GP on Monday. I wonder how much of this I will be able to get through with him? Probably very little. I have primed him as to a specific symptom group to discuss, as I am sick of being ‘unable/disabled’. I am concentrating on muscle pain, lack of flexibility and weakness. It’s bad enough getting around but falling (2x) in the last fortnight and can’t get up under my own steam has scared me a lot. However I will order the tests myself if if we can’t cover that.
I remember now why I was looking at the B12 via a blood draw. I was going to get the folate done and the ferritin rechecked against the NHS ferritin result. I am not taking the B vits recommended here yet. They are purchased but not started due to too many things happening and don’t want to lose what little control I have. Anyway not had the discussion with doc re the ferritin results yet. Telecon next Friday. Medichecks B12 result is ‘normal’! 118 (37.5 - 150). Your thoughts/comments on this would be useful as they are often different from the more orthodox view.
B12 Test was done 9.30am. Non fasting. Folate still not done because I was confused. The ferritin result is uppermost in my mind and I have a telecon consultation this week with GP to discuss it. So GP has the chance to check/comment - if I am not distracted. I intend to get a full thyroid panel next time which has the folate. I am not going to bother the GP again for tests unless he offers. I just can’t be bothered with the hassle.
Can I ask one more thing? Do You know if I need a GP referral to go to a private GP? The ThyroidUK list provided a name/organisation which appeals. I don’t want to waste time trying to get an NHS endo as I have heard what the two ‘experts’ in my local hospital think about T3 (in their own words) etc and it is so utterly patronising. A rumour which is a bit unsettling is that the GP Surgery can excommunicate you for doing this and your hospital can also refuse to treat you. I think the latter is unlikely but it is a consideration.
Thank you I realise I am getting a bit ahead of myself. It’s just it takes me so looong to do anything, I need to plan quite a bit in advance. I am in the North East of England. Yes vitamins need to be optimal. I can start taking the Bs now that the B12 is out of the way. Whew. Thanks for getting back to me so promptly and helping set my mind at rest.
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