After your advice last time when I posted, I spoke to a new doctor, who actually has an underactive thyroid and was brilliant. She understands my symptoms and isn't as concerned about TSH. She even surprisingly increased my thyroxine from 100/75 alternatively to 100 each day.
She agreed I could have the blood tests requested, I had then done on Thursday at 9am (I haven't ever taken supliments prior or ever had them taken before)
Just wondering if I can have some advice on the results. I think it shows I do need supplements, but unsure whay and where to go next. So any help is appreciated!
Just to recap from my last post, my latest thyroid levels are as follows (Taken pre 9am no thyroxine taken for 24 hours)
8th August - Monitor My Health
TSH: 0.3mu/L (0.27- 4.2mu/L)
FT4: 20.1 pmol/L(12-22 pmol/L)
FT3 4.1pmol/L3.1 -6.8 pmol/L)
8th August - GP
TSH - 0.42 mu/L (0.35 - 5.5 mu/L)
I've attached my results below for my vitamins.
Thank you all again for your help the other week, feel like im slowly getting somewhere
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Caro719
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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 48.4nmol/L = 19.36ng/ml
On the Vit D Council's website you would scroll down to the 3rd 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. Nearest you can buy 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.
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.
B12: 363ng/L (211-911) - ng/L is the same as pg/ml below
This is low. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Some people with a level in the 300s have been found to need B12 injections.
Do you have any signs of B12 deficiency – check here:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do 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 and if you have B12 deficiency is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.
If you don't then you'd be OK to supplement with a sublingual B12 until your level reaches over 550ng/L along with a B Complex to keep all the B vitamins balanced.
Once you've reached 550n g/L you can stop the B12 sublingual and just continue with the B Complex as maintenance.
Folate: 4.6 (>4)
This is low although just inside their "range". When there is no proper range with an upper and lower limit we suggest aiming for double figures.
Eating folate rich foods and a good quality, bioavailable B Complex will help raise your folate level.
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).
Do not start B Complex if you have symptoms of B12 deficiency, testing for B12 deficiency and starting B12 injections or supplements must be done first.
Ferritin: 39 (10-291)
This is dire, below 30 suggests iron deficiency according to NICE and you're not much over that so this is a very low ferritin result, it's recommended to be half way through range although some experts say the optimal level for thyroid function is 90-110ug/L.
You should ask your GP to do an iron panel to see if you do have iron deficiency, and a full blood count to see if you have anaemia. You can have anaemia with or without iron deficiency.
Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
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.
Your poor nutrient levels may be the cause of your poor conversion so you should optimise these as a priority. Once optimal if your conversion remains poor then you may benefit from the addition of T3 to your Levo.
My thyroid results were on my dose of 100/75 alternatively on 8th August she upped them since then.
In that case I think the increase might possibly push your FT4 over range but wont do much for your FT3 level.
If you discuss your Vit D level with your GP she may offer prescription D3 but it wont be anywhere near the dose you need, possibly 800iu or 1,600iu and you need more of that. Also, doctors aren't taught much (if anything) about nutrients so wont know about the importance of Vit K2-MK7 or magnesium and why they're needed when supplementing with D3, which is why I said you're better off addressing this yourself 😊
I'll sort the Vitamin D out and the K2-mk7 and magnesium.
Honestly before this forum I thought I was going mental, its only because of here I tested my t3 and realised my t4 wasn't converting very well at all!
Everywhere I researched suggested that ferritin needs to be at least over 70 for any thyroid hormone replacement to work well and assist in the conversion to T4 into T3.
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