My Medichecks Result - advice please :) - Thyroid UK

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My Medichecks Result - advice please :)

Needleandthread44 profile image

Hi all

I have posted on here previously regarding my Dad and I am eternally grateful for all of the information and advice given.

I am actually hypothyroid myself so decided to do some testing through medichecks. I am 33yrs old, female, and currently take 100mcg levothyroxine. I was on 75mcg before I got pregnant 2 years ago then it increased to 125mcg while pregnant and then I have been on 100mcg since my 18month old was born. I luckily don't really have any symptoms of hypothyroidsm, the only one I would say is my hair falls out quite a bit but not excessively. I am also still breastfeeding my 18month old, not sure if that is relevant but thought i'd mention it in terms of my vitamin results. I don't currently take any supplements but am considering starting some as thinking about trying for second baby.

CRP HS 2.98 (0-5)

Ferritin 52.3 (13-150)

Folate 3.15 (>3.89)

Active b12 141 (37.5 - 150)

Vitamin D 52 (50-200)

TSH 2.01 (0.27 - 4.2)

T3 4.72 (3.1 - 6.8)

T4 16 (12-22)

Thyroglobulin antibodies 87 <115

TPO Antibodies 244 (<34)

I took the test first thing in the morning before any food or my levothyroxine.

Looks like I'll be needing some folate and vitamin D supplementation but any other thoughts please let me know! Had planned to start taking this pregnancy supplement soon equilondon.com/products/pre... just not sure if it will be enough in terms of the requirements for folate and Vitamin D to raise my levels.

Surprised at my TSH being over 2 as in previous tests it had always been <1, could be due to timing of the test. First time I've had T3 tested, how does it look in terms of conversion from T4? I also knew I had TPO antibodies. What does it mean that the other type are normal?

Many thanks in advice for any replies.

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PurpleNails profile image
PurpleNailsAdministrator

FT4: 16 pmol/l (Range 12 - 22) 40.00%

FT3: 4.72 pmol/l (Range 3.1 - 6.8) 43.78%

Vitamin D very far from optimal. you’ll likely need continued supplements to raise it.

Does folate have range? or Is it showing as deficient? 

Ferritin very low & eating iron rich foods will help would be better if over 80, may be cause of hair fall.  

Ask doctor for iron panel or order privately.

 Most feel well with TSH around 1, FT4 top 3rd of range, FT3 at least mid way. 

Your FT3 is slightly higher that FT4 which is unusual it itself but it shows the body is trying to preserve FT3 levels.   

Once your FT4 is at a better level you can assess conversion.  You may find your FT4 rises but FT3 alters. 

Low nutrients can lower TSH.   

Timing can affect TSH it’s highest in morning & lower throughout day.

FT4 results affected by timing of Levo taken prior to draw? How long was levo taken before test? 

The supplement you were considering:

Ingredients - Per daily serving (4 capsules) (*Nutrient Reference Value)

 Vitamin C (calcium ascorbate & acerola cherry) 225mg (281%*), 

calcium (calcium bisglycinate) 200mg (25%*), 

magnesium (magnesium bisglycinate) 150mg (40%*), 

VitaCholine™ (choline) 100mg, pomegranate 100mg, 

rice concentrate 40mg, 

vitamin E (mixed tocopherols) 10iu (55%*), 

vitamin B5 (calcium d-pantothenate) 25mg (416%*), 

co-q-10 (ubiquinone) 20mg, 

iron (Ferrochel® iron bisglycinate) 20mg (142%*), 

zinc (bisglycinate TRAACS® ) 15mg (150%*), 

vitamin B3 (niacinamide) 15mg (106%*), 

vitamin B1 (thiamine Hcl) 10mg (909%*), 

vitamin B2 (riboflavin 5–phosphate) 10mg (714%*), 

vitamin B6 (pyridoxal-5'-phosphate) 10mg (714%*), 

vitamin D3 (cholecalciferol) 25mcg (500%*), 

inositol 10mg,

ginger root extract (10:1) 5mg, 

manganese (bisglycinate TRAACS®) 3mg (150%*), 

beta-carotene (d. salina) 1.3mg, 

copper (TRAACS® bisglycinate) 1mg (100%*), 

folate (5-methyltetrahydrofolate) 400mcg (200%*), 

biotin 200mcg (400%*), 

iodine (potassium iodide) 150mcg (100%*), 

selenium (selenomethionine) 100mcg (181%*), 

vitamin K2 50mcg (66%*), 

molybdenum (sodium molybdate) 50mcg (100%*), 

chromium (polynicotinate) 30mcg (75%*), 

vitamin B12 (methylcobalamin) 20mcg (800%*). 

Capsule shell: vegan cellulose 

The ingredients do contain good forms of nutrients but not all in the quantities you need.

 Multi not recommended as taking in 1 go causes them to bind & not absorb.  

Contain Biotin so would need to leave off around blood tests.   

Extra Iodine can affect those with hypothyroid .  Normal diet & levo includes adequate iodine. 

 Recommended iron panel complete before taking iron.

  Extra calcium not recommended.  If taking D3 and K2 dietary calcium should be adequate.   

Jaydee1507 profile image
Jaydee1507Administrator

What time of day did you previously have your thyroid level checked? Yes having it done at as close to 9am makes sure it is as high as possible which benefits our treatment. That will have made a difference if you had the test earlier this time.

Your ferritin is also not optimal. You should be aiming for around 100.

Folate (in the form of methylfolate, NOT folic acid) is the active and best form. A good B complex such as Thorne Basic B contains all the B's you need.

The pregnancy multivit may look like a good idea, but for many reasons multi's aren't recommended here. The product you mention contains iron which will affect the absorption of other vitamins including your thyroid hormone if taken too close together. You really only need to supplement things you have tested and found deficient. That product would be a waste of money.

On that blood result you need a dose increase of Levo. Once you do get pregnant you need to get your levels rechecked as your requirement for more hormone will increase.

SeasideSusie profile image
SeasideSusieRemembering

Needleandthread44

Thyroglobulin antibodies 87 <115

TPO Antibodies 244 (<34)

Your raised antibodies confirm autoimmune thyroid disease, known to patients as Hashimoto's. I don't know if you already knew this. Hashi's is the most common cause of hypothyroidism, it is where the immune system attacks and gradually destroys the thyroid.

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.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

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.

TSH 2.01 (0.27 - 4.2)

T3 4.72 (3.1 - 6.8)

T4 16 (12-22)

The aim of a treated hypo patient on Levo only, generally, would feel best when TSH is 1 or below with FT4 and FT3 are in the upper part of their reference ranges.. Your TSH may be too high for you, FT4 is only 40% through range and FT3 is 43.78% through range. These results suggest that you may benefit from an increase in your dose of Levo, maybe 25mcg now and retest in 6-8 weeks.

CRP HS 2.98 (0-5)

As an inflammation marker then the lower the better with this test. It's within range but might be showing some signs of inflammation.

Ferritin 52.3 (13-150)

As your CRP might possibly be showing some inflammation, it's possible that your ferritin level is showing higher than your normal level (ferritin rises with inflammation). Even if it's your normal level it's on the low side. Ferritin is recommended to be half way through range.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

Obviously you can't eat liver if you do become pregnant.

Folate 3.15 (>3.89)

According to

cks.nice.org.uk/anaemia-b12...

Folate level

◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.

◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.

So this needs to be discussed with your GP as it might be folate deficiency.

Active b12 141 (37.5 - 150)

This is a good result.

Continued in new post below.

SeasideSusie profile image
SeasideSusieRemembering in reply to SeasideSusie

Vitamin D 52 (50-200)

This is not Vit D deficiency. Vit D deficiency is a level below 25nmol/L. Your result of 52nmol/L is classed as "sufficient" according to the NHS although some doctors might possibly give a small dose of D3 to achieve a level of 75.

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 you need to increase your current level to the recommended level.

Your current level of 52nmol/L = 20.8ng/ml

On the Vit D Council's website

web.archive.org/web/2019070...

you would scroll down to the 3rd table

My level is between20-30 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.

Bearing in mind that your only 20.8 you could also look at the 2nd table for current level between 10-20ng/ml and you'll see that one suggests 4,900iu D3 daily.

You should be perfectly OK to supplement with 4,000-5,000iu D3 daily.

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:

vitamindtest.org.uk/

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

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...

Another important cofactor is Magnesium which helps the body convert D3 into it's usable form.

There are many types of magnesium so we have to check to see which one is most suitable for our own needs:

naturalnews.com/046401_magn...

explore.globalhealing.com/t...

and ignore the fact that this is a supplement company, the information is relevant:

swansonvitamins.com/blog/ar...

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.

Needleandthread44 profile image
Needleandthread44 in reply to SeasideSusie

Thank you SeasideSusie The doctor has recommended taking 5mg folic acid to get folate levels up. I had planned to take methylfolate but when I suggested this he said he didn't know about it and recommended just taking the folic acid. Do you think there would be an issue with taking the 5mg folic acid for a few months while also taking Thorne Basic B complex?

SeasideSusie profile image
SeasideSusieRemembering in reply to Needleandthread44

Do you think there would be an issue with taking the 5mg folic acid for a few months while also taking Thorne Basic B complex?

I've never done it so can't answer from experience. However, the Thorne Basic B contains only 400mcg methylfolate so you'd be increase your folate intake by a relatively small amount. However, you might want to consider taking just the folic acid for now, once your folate level is up (you'll probably be on it for about 3 months or so) the prescribed folic acid will stop and you could then go on to the Thorne Basic B as a maintenance dose.

when I suggested this he said he didn't know about it and recommended just taking the folic acid

I think this just goes to show how little they know about these things. With folic acid your body has to convert it to folate. Taking methylfolate is taking the converted form.

Needleandthread44 profile image
Needleandthread44 in reply to SeasideSusie

Many thanks for your reply. Yes I also just wondered whether to take a higher dose Methylfolate rather than the 5mg folic acid. Just while I am here - can I just ask, when do people normal take their Thorne basic b complex during the day? Would it be ok after breakfast and then vitamin D with dinner?

SeasideSusie profile image
SeasideSusieRemembering in reply to Needleandthread44

B Vitamins can be stimulating so it's best to take them no later than lunchtime. I take mine with breakfast.

Vit D is fine with your evening dinner but keep a watch out for if it interferes with your sleep, apparently it does with some people. I take mine with breakfast along with B Complex and a couple of others. Just keep Vit D 4 hours away from your thyroid meds, and B vits 2 hours away from thyroid meds.

Needleandthread44 profile image
Needleandthread44 in reply to SeasideSusie

thank you!!

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