I had posted previously about my Dad. He is 72 and around 8 weeks ago his GP had increased his dose from 75mcg Levothyroxine to 100mcg. in April his results were TSH: 4.68 (0.27 - 4.2) T4: 16.7
On the advise of the helpful people on this forum we got some private testing done through medichecks. I just got the results through.
Any advice would be greatly appreciated:
TSH: 1.2 (0.27 - 4.2)
FT4: 15.6 (12-22)
FT3: 4.47 (3.1-6.8)
Thyroglobulin antibodies: 412 (<115)
TPO Antibodies: 188 (<34)
Folate: 19.8 (>3.89) note he has been on 5mg Folic Acid for last 4 months
Active B12: >150 (37.5 - 150) back as too high probably because he was having B12 injections in May/June
Vitamin D: 61 (50-200)
Ferritin: 197 (30-400)
CRP HS Inflammation marker: 0.63 (0-5)
Many thanks in advance for any feedback/advice on the above set of results. We've never had his T3 tested before so would be keen to understand what that means/ how his conversion is.
Clare
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Needleandthread44
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Well his TSH is certainly looking a lot better. Can't comment on how FT4 might have changed because there's no range for the GP test, but with the Medichecks test it's low in range and there's plenty of room for an increase of 25mcg Levo to try to bring his FT4 to at least half way through range, FT3 should follow as conversion is good.
Raised antibodies confirm autoimmune thyroid disease (Hashimoto's) which is the most common cause of hypothyroidism.
Fluctuations in symptoms and test results are common with Hashi's.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
Folate level now good and I expect the prescription for folic acid may stop now or soon. He could go onto a good quality bioavailable B Complex to maintain his level. My suggestion would be Thorne Basic B. 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).
B12 - forget this as he's having injections. Are his injections going to continue?
Vit D: 61nmol/L
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 61nmol/L = 24.4ng/ml
On the Vit D Council's website you would scroll down to the 3rd table
My level is between 20-30 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 3,700iu per day. Nearest is 4,000iu.
Retest after 3 months.
Once he'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
Magnesium should be taken 4 hours away from thyroid meds and as it tends to be calming it's best taken in the evening. Vit D should also be taken 4 hours away from thyroid meds. Vit K2-MK7 should be taken 2 hours away from thyroid meds. Don't take D3 and K2 at the same time unless both are oil based supplements, they both are fat soluble vitamins which require their own fat to be absorbed otherwise they will compete for the fat.
CRP is good and shows no inflammation.
Is he still taking PPIs and steroids? Keep these well away from his thyroid meds. PPIs affect Levothyroxine's absorption so may result in a higher dose required.
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