hello, reaching out to you wonderful wise people again for some advice please- I’m seeing the endo in December for a follow up after increasing my meds to 100mcg levothyroxine for two months, for hashimotos. Sadly I feel worse, zero energy! Anyway, think I read here to not take levothyroxine morning of test at 9am, so last one will be 7am the day before, is that right?
Also should I stop taking B complex vits, which contain biotin and folate & others, a week before? Can I continue to take my magnesium, vit C and D or stop those too? I’d like to see how my body is without them. I’ve asked them to also test my ferritin, folate, vit D and B12, but endo not keen as said they’ve already been tested this year and ‘normal’. ferritin was 32 ng/ml (range 13-150) which i think is low. I eat plenty of red meat so suspect could be absorption issues due to SIBO.
I’m a bit worried there’s nothing more that can be done. Endo wasn’t enthusiastic about prescribing T3 even though mine is bottom of range at 3.1 on the last test this summer (range 3.1-6.8 pmol/L)
Will see what blood results are…
Any advice welcome thank you so much, greatly appreciated.
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Anyway, think I read here to not take levothyroxine morning of test at 9am, so last one will be 7am the day before, is that right?
Yes, we advise 24 hour gap from last dose of Levo.
Also should I stop taking B complex vits, which contain biotin and folate & others, a week before?
Any supplement containing biotin should be left off for 3-7 days before the test, 3 days should be enough for the small amount in a B Complex and 7 days for the much larger amount in a stand alone or hair/nail supplement.
Can I continue to take my magnesium, vit C and D or stop those too?
You can continue with those but take after the test on the day.
ferritin was 32 ng/ml (range 13-150) which i think is low
It's extremely low, just 2 points above what NICE considers to be iron deficiency. You should have a full iron panel to see if you have iron deficiency and a full blood count to see if you have anaemia. You can have iron deficiency with or without anaemia and you can have low ferritin without iron deficiency.
that’s so helpful thank you SeasideSusie, much appreciated. Do you have a link to the NICE anaemia range you mentioned please? Couldn’t find it online and would be useful to show the endo. Might explain why I feel so tired and weak. Thanks again x
Symptoms of hypothyroidism and iron deficiency/low ferritin overlap so testing is the only way. You know your ferritin isn't low and an iron panel will show if you have iron deficiency but with such a high ferritin level iron deficiency is unlikely.
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Thanks so much SlowDragon, I will have a look at the links.
I’m 43, have some form of meat most days and now eat liver once a week also red meat twice a week, plus dark choc, leafy greens, lentils, etc. Have lemony water with every meal - helps with SIBO bloating. And satsumas, lots of fruit and veg.
Pretty sure I’m perimenopausal but still have regular quite heavy periods which doesn’t help with the iron. Is iron shown as HGB on blood tests? If so the same test showed 125 (range 115-157 g/L)
so maybe I don’t absorb enough of what I eat? Really not sure, just desperate to get some energy back!
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