Hi there,
You guys have been so helpful to me, would you mind commenting on my daughters 18 year old blood test results, taken 7am no meds, takes no multi-vitamins. We got her tested because my results show autoimmune thyroid and we wanted a baseline for her at 18 to understand her own levels. She is mostly vegetarian (flexi/pesci) and we can see she will need to supplement. Anything else we should consider? She is on and off symptomatic for hypothyroid.
Regenalotment
Ferritin is very low but not surprising if she is mostly veggie. Ferritin is recommended to be half way through range (around 82 with that range) although some experts say that the optimal level for thyroid function is 90-110ug/L. She should consider if she can eat red meat, particularly liver or liver pate, for health reasons, or look into iron rich foods she is willing to eat and keep an eye on her level.
bda.uk.com/resource/iron-ri...
everydayhealth.com/pictures...
She shouldn't consider taking an iron supplement unless she does an iron panel, if she already has a decent level of serum iron and a good saturation percentage then taking iron tablets can push her iron level even higher, too much iron is as bad as too little.
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Folate is very low, the range is 3.89-19.45 and folate is recommended to be at least half way through range. Do nothing about this until B12 has been investigated.
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Active B12 at 55.6 needs investigating.
Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
viapath.co.uk/our-tests/act...
Reference range:>70. *Between 25-70 referred for MMA
There is a link at the bottom of the page to print off the pdf to show her GP.
Does she have any signs of B12 deficiency – check here:
b12deficiency.info/signs-an...
b12d.org/submit/document?id=46
If she does then list them to discuss with her GP and ask for testing for B12 deficiency and Pernicious Anaemia. She should not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
She may need B12 injections or supplements and these should be started before supplementing for the low folate level. Once B12 has been started she could take a good quality B Complex which will help raise her folate level, plus lots of folate rich foods.
I have used Thorne Basic B for a long time and always been happy.
If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.
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).
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Vit D: 36nmol/L = 14.4ng/ml
This is very 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:
healthunlocked.com/thyroidu...
and you can check out the link to how to work out the dose she needs to increase her current level to the recommended level.
Her current level of 36nmol/L = 14.4ng/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 per day, the nearest available dose to buy is 5,000iu.
Retest after 3 months.
Once she's 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 my suggestions are 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
natureprovides.com/products...
It may also be available on Amazon.
One member recently gave excellent feedback on this particular product here:
Here is what she said (also read the following replies):
healthunlocked.com/thyroidu...
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.
naturalnews.com/046401_magn...
drjockers.com/best-magnesiu...
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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.
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As for her thyroid results, a normal healthy person with no thyroid condition would generally have a TSH of no more than 2, often around 1, with FT4 around mid-range. her TSH is very close to the top of the range and FT4 is close to the bottom of the range.
I would suggest that she retests in a couple of months' time and it might be better to do the test at 9am when TSH is slightly higher than at 7am according to the first graph here (remembering to stop the B Complex 3-7 days before testing):
healthunlocked.com/thyroidu...
Thanks so much for all this wonderful advice. We will get to work!
Her numbers are fine except for vitamin D which should be higher, especially at this time of year. Prudent sun exposure (without sunblock) is the best way of getting vitamin D and as she eats fish she could choose ones with good vitamin D content. Otherwise she will need vitamin D supplements.
Her TSH is a little high and fT4 marginal but these can fluctate, so it's good you have a baseline in case she gets worse.
I'd beware of worrying too much about minor problems (I assume they are), these things happen and the best way to good health is to not worry and get plenty of exercise.
Thanks, she is super active (plays hockey a few times a week) works out, and we are very outdoorsy. Have a very healthy grow your own diet, she eats masses of varied veggies and fruit, fish twice a week and just recently has agreed to eat grass fed beef. I agree it’s easy to over medicalise but personally at 48 I’m now living with the consequences of a very similar picture not being picked up when I was 18. So I’m delighted we can help her have agency over her health through adulthood, she’s a science boffin so will absolutely do her own research and thanks to forums like this she’s well informed!
That's really good which makes the low vitamin D a bit weird. I'd supplement for a while to see if it helps. Sometimes thyroid symptoms can come on before the bloods go abnormal (who knows why) so having a benchmark is useful, you can see if they get worse over time.
I plan to do the same thing with my children. I'm the first in my family to have a thyroid issue so I can be fairly confident it's not a genetic thing. I also had significant amounts of stress in my life from age 5 up to probably about 28 so I think that is most likely the cause for me.
I've been reading about the link between gut health and autoimmune disease but also the impact of processed food. So it's empowering to know that if we tweak our diet we can help keep the children healthy.
I think it's great to test while she feels well. I wish I'd had that baseline information!
Yeah, same, we are sending son’s (20) off too to see what that shows up. All three of us have had lots of antibiotics in the past, plus tick loads of other boxes for history and triggers. Talking to 84 year old Mum about it and she thinks my Dad has been symptomatic hyper most of his life. Aunty (Dad’s sister) had a goitre removed. So plenty of possibilities for genetic predisposition. Listened to a US podcast today about contraceptive pill, hypo symptoms and nutrition, fascinating. I wish I’d known more when I was younger. At least we can arm the next generation 🤗🙏🤗
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