I’ve got my medicheck results this morning after getting them done on Tuesday 12th September & can you give me advice on them please.
When I had my last blood test with my doctors in May my TSH was 0.09 & they wanted me to reduce my levothyroxine. I said no & they were okay with that for the time being, to concentrate on my vitamin D which was low at the time at 36.
So not sure what to do if on my next blood test & if my doctors in house pharmacy mention about reducing my dose of Levothyroxine to 75mcg. Instead of doing 4 x a week 75mcg & 3 x a week 100mcg. That I’m currently on . I feeling fine So unsure what to do if they say something again about reducing my dose if my TSH come back like it did on my medicheck results
I had my blood drawn at 8.26am & I took my last dose of Levothyroxine with was 75mcg at 8am Sunday morning. & then after my blood test took that day’s levothyroxine
Thyroid hormones
TSH 012 ( 0.27 -4.2 )
T3 4.54 ( 3.1 -6.8 )
T4 18.2 ( 12 -22)
Vitamins
Folate 2.30 ( 3.9 - 19.45)
Vitamin b12 69.5 ( 37.5 - 150)
Vitamin D 67 ( 50 - 200)
Iron status
Ferritin 113 ( 13- 150 )
Inflammation
CRP HS 0.58 ( 1-5)
Autoimmunity
Thyroid peroxide Antibodies 160 ( 0-34)
thyroglobulin antibodies 185 ( 0- 115
Thank you for all your help. 💜
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Bookworm90
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I feeling fine So unsure what to do if they say something again about reducing my dose if my TSH come back like it did on my medicheck results
Easy for me to say this because I've had too many years of doctors ignoring symptoms and not understanding how to treat hypothyroidism and looking only at TSH so I don't care any more and am not afraid to refuse to lower my dose.
If your GP results come back like this then your GP will probably look at the TSH only and say you are overmedicated so then you should say something along the lines of:
But TSH is not a thyroid hormone, it's a pituitary hormone so can't tell you my thyroid status. The FT4 and FT3 are the thyroid hormones and they are both well within range. My FT4 is 62% through it's range and the FT3 is 38.92% through range so you can see that my throid hormones are definitely not showing that I am overmedicated.
I feel fine, I am not prepared to lower my dose of Levo because that will lower my actual thyroid hormone levels and I will very likely become symptomatic. I wish to remain on my current dose.
I haven't looked back at previous posts but did you know you have Hashi's (confirmed by raised antibody levels)?
Obviously if you do have any 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 could supplement with a sublingual B12 (one bottle should be enough) and once level reaches 100 just continue with a B Complex to maintain level. Hopefully by that time your folate will be at a better level and the methylfolate in the B Complex will be enough to maintain it.
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 D3 per day. Nearest is 4,000iu.
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.
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.
Thank you for the all links & explaining how much Vitamin D I would need to take daily to begin with before going on to maintenance levels of Vitamin D As I wondering about that. I didn’t realise about the magnesium. & Vit K2-MK7 & I will look at your recommendation. I do like the idea of combined D3 & K2
No I didn’t know I have got Hashi, doctors just said that I have hypothyroidism
So that is surprise to me. Do I need to change anything within my diet etc because I’ve got hashi
Oh, right, OK. Unless your GP tested your antibodies then he wouldn't know and they don't do it routinely. If he did test them and didn't tell you they were raised then that's rather negligent.
Hashi's (autoimmune thyroid disease) is the most common cause of hypothyroidism. It's where the immune system attacks and gradually destroys the thyroid which leads to hypothyroidism. Hashi's isn't treated, it's the resulting hypothyroidism that's treated.
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. It would be best 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.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies and is possibly the reason for your not particularly good levels.
**
Are those percentages good for T3 38% & T4 62%?
They're good if you feel well with them there. Most hypo patients on Levo only tend to feel best when TSH is 1 or below with FT4 and FT3 in the upper part of their ranges. It's not set in stone so we have to find our sweet spot. Many hypo patients need FT4 and FT3 more balanced than yours are.
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Is they anything I can do to improve my T3 & T4 if they are not good percentages.
Optimal nutrient levels are needed for thyroid hormone to work properly and good conversion to take place. We suggest that the levels to aim for are:
Vit D: 100-150nmol/L (recommended by the Vit D Council, Vit D Society and Grassroots Health.
B12: top of range for Total B12, for Active B12 over 100.
Folate: at least half way through range.
Ferritin: half way through range.
**
Would I have to increase my dose of levothyroxine for it to rise in percentages?
Increasing Levo will increase your FT4 level and your FT3 level should rise correspondingly (depending on how well you convert T4 to T3).
But don't get stuck on numbers alone, take into account how you feel.
What is the Best way to take folic acid in tablet or spray form
When buying it ourselves, I contacted my doctor surgery & they won’t test my folate at the moment because my blood test form has already been sent out to me.
I don't know but this is really something that you should be sorting with your GP. I'm afraid I'd be making a fuss, asking for another form. Prescribed folic acid is high dose for a short course with, hopefully, another test at the end of it.
Standard "supermarket" folic acid is typically 400 micrograms. Less than one twelfth as much.
Excess folic acid can be as bad as too little. That is why higher doses are restricted to being on prescription. And, if you are prescribed them, you should only take them for a limited time, typically two months, then get re-tested and your need re-assessed.
1.1.1 Offer serological testing for coeliac disease to:people with any of the following:
persistent unexplained abdominal or gastrointestinal symptoms
faltering growth
prolonged fatigue
unexpected weight loss
severe or persistent mouth ulcers
unexplained iron, vitamin B12 or folate deficiency
type 1 diabetes, at diagnosis
autoimmune thyroid disease, at diagnosis
irritable bowel syndrome (in adults)
first‑degree relatives of people with coeliac disease.
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
I also always refused to let them lower my dose. "If you lower my dose I won't be functional." My GP couldn't understand why I couldn't get out of bed when he lowered my dose to 75mcg. Well, first of all it states that a patient should be given 1.6 mcg per kg of body weight but the full dosing guidelines also state that the bioavailability of Levothyroxine is only 80% You're not absorbing 100% and I've taken Levo in liquid and capsule form, which is near 100% absorbed, and can confirm that the absorption of Levo in tablet form is not the best. I used to weigh 47 kg which is 75 mcg but I took 88 mcg to compensate. I've since gained 9 kg and now take 112 mcg. Even then 1.6 mcg per kg of body weight is only a guideline. They never take this into consideration but it's on the dosing instructions.
thank you, I didn’t realise that you don’t actually absorb the full amount of the tablet form. Will mention it too them. Can the doctors or anyone within the surgery reduce my medication dose without consulting me first?
The reason I’m asking they did this once, ( it was in house pharmacy team within my doctors & they look at blood test ) because they said they tried to contact me & they automatically reduced my dose. Because of my TSH was low. I wasn’t happy about, but went with it, This was at the start of my journey & didn’t know much about thyroid health etc.
My doctor tried that with me one time and within a few days I couldn't get out of bed and was non functional, couldn't work. I called and demanded they put me back on my previous dose and explained because of their actions I missed a week of work and that they needed to fill out a form for my work explaining why I was gone. I'm in the US though and I'm not sure how it works in Uk but I assume you can refuse to agree with their decision. They reduced me from 88mcg to 75mcg! I have no functioning thyroid either. I was surprised how poor the absorption in pill form is and only realized this after a trial of liquid/capsule in the same dose of Levo turned out to be too much. I think it's ridiculous that the pharmaceutical companies get away with saying you're getting X amount of Levo when you're not, so of course doctors under dose people not taking into account the bioavailabilty. I should only be on something like an estimated 90-95mcg but I'm taking 112mcg daily to compensate for the fact that not 100% is absorbed. I complained about this on another post LOL.
If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "
Comprehensive list of references for needing LOW TSH on levothyroxine
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