Updated test results: This links to my recent... - Thyroid UK

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Updated test results

Realtiger profile image
2 Replies

This links to my recent post here:

healthunlocked.com/thyroidu...

Recent test showed TSH 4.56 on 50mg Levo.

Requested a dose increase with a GP I hadn’t dealt with before who talked to me about sub-clinical hypothyroidism, increasing dose when TSH goes over 10 and I didn’t have the wit to contradict him and say it’s different when you’re on Levo.

Cue a full panel of tests including Vit D (apparently he has to override a pop up which suggests its not worth testing as all UK adults should be supplementing) and T4 which is a first.

No action required on all but folate for which I have a prescription and am advised to eat dark green leafy veg etc. I eat an entire medium sized box of organic seasonal veg every week along with other folate rich foods inc. chickpeas, brown rice etc. Also eat eggs, small amount of goats dairy and fish, and gluten and sugar free. Aside from eating meat again (am 51 and have been vegetarian/pescatarian since I was 13) I can’t see what other changes I can make to my diet.

Questions:

1. How do I negotiate a Levo increase now? 🤷‍♀️ (TSH was 2.08 at last test in May so its risen significantly and feels like it).

I fear that this T4 result will count against me and that it will be even harder to argue that an increase is indicated. Wondering about going to see a private endo…

2. Do I need to be thinking about PA? B12 and folate levels have been steadily falling since first tested in 2020.

FBC fine apart from hypochromasia 7.60% (normal range: -6) this has come down from 12% in May.

Bone profile also fine.

Hope you can see this picture of my results.

I’ve learnt so much from this forum so greatly appreciate your insight.

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Realtiger
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SlowDragon profile image
SlowDragonAdministrator

Make an appointment with different GP (face to face or phone)

Before consultation …..Email in results and covering letter that you are only taking 50mcg levothyroxine

Request 25mcg dose increase in levothyroxine up to 75mcg per day and a blood test form to retest in 6-8 weeks time

Which brand of levothyroxine are you currently taking?

Ideally stay on same brand as you increase

Also request full iron panel test for anaemia including ferritin as you are vegetarian and hypothyroid patients are frequently vitamin deficient

B12 is far too low, likely mix of vegetarian diet and hypothyroid

Low B12 symptoms 

b12deficiency.info/signs-an...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months.

once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex. (As vegetarian may need to continue separate B12)

B12 drops 

healthunlocked.com/thyroidu...

B12 sublingual lozenges 

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

once you finish prescription folic acid recommend starting daily vitamin B complex too

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12

Realtiger profile image
Realtiger in reply to SlowDragon

Thank you as ever for your response. It’s so helpful to have a plan of action re folate and B12.

Ferritin is 16 ug/L (range 10- 291) but FBC results better than in May with MCHC back in normal rage and haemoglobin better than in years at 136 (120-140) no doubt because I’m entering menopause and haven’t bled for several months now. Ferritin has been consistently low and hasn’t risen much even on iron supplementation. Now it seems I have mild iron deficiency without anaemia but Dr unconcerned. Not sure if I should be taking iron or not.

These results are all via GP so my main concern is that testing T4 has backfired as this and TSH are within range corresponding with the guidelines

“The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.”

I will wait to speak to my usual GP on Monday 🤞

Also I’m supposed to be donating blood next week after a couple of years of not doing so - now wondering if that’s wise?🤔

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