Vitamin D3 and Levothyroxine: In October I had... - Thyroid UK

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Vitamin D3 and Levothyroxine

JigsawJill profile image
9 Replies

In October I had blood tests from Blue Horizon which picked up that My Vitamin D level was low at 46 (Optimal 75-200).

My TSH was 1.71 (0.27-4.20), T4 Total 96,7 (66-181) Free T4 16.6 (12.0-22.0) and Free T3 4.71 (3.1-6.8)

Ferritin high at 279.0 (13-150) Vitamin B12 high at 580 (145-569), Cortisol High at 650.0 (166-507).

My GP did follow up blood tests. Last week I was prescribed Stexerol-D3 1000 iu. I started taking them on Sunday at breakfast time (2 hours after Teva Levothyroxine 75mg). Tuesday night I started to feel jittery, unable to relax and 'hyped' up. I then woke early Wednesday morning feeling the same way. I wondered if the D3 was affecting me so I did not take it yesterday nor today. I feel better now. The chemist advised me yesterday that there should be no reaction with Levothyroxine and 2 hours was a sufficient delay.

Has anyone else had a similar experience? I am wondering how to proceed - whether to take D3 later in the day, or start again having one tablet every other day? Or do you think it is unconnected?

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9 Replies
Jaydee1507 profile image
Jaydee1507Administrator

Looks like you need a Levo dose raise of 25mcgs with a TSH of 1.7, that's way too high.

SeasideSusie profile image
SeasideSusieRemembering

JigsawJill

Vit D is actually a hormone, not a vitamin, it's one of the supplements that should be taken 4 hours away from Levo so that absorption of Levo is not affected. Whether or not taking it too close to Levo has caused the problem I don't know but I think possibly not, maybe more like a reaction to the tablet itself.

Did you read the patient information leaflet (PIL) that came with it, the online PIL shows section 4 listing possible side effects and section 6 gives a very long list of excipients, you could be reacting to any of those excipients.

You might be better with a clean supplement containing no excipients at all, I take Doctors Best softgels which just contain D3 and extra virgin olive oil, nothing else.

To be honest, although your GP is probably following guidelines and prescribing the dose which the guidelines state, it will take a very long time for your Vit D level to reach optimal with the dose given.

You might be interested in 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 46nmol/L = 18.4ng/ml

When you work out how much they suggest to reach the recommended level you will see it is 4,900iu D3 daily so the nearest you'd get to that is 5,000iu. Then, of course, there are the important cofactors needed when taking D3 - magnesium and Vit K2-MK7.

I agree with Jaydee that your thyroid results suggest that you are undermedicated and may benefit from an increase in your dose of Levo.

Your B12 is slightly over range but not considered too high. I expect that measurement is pmol/L and if converted to pg/ml it is 785pg/ml and 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."

so I wouldn't worry too much about that.

Your cortisol is high so I hope your GP is investigating that.

As for your high ferritin, looking at your previous post your CRP was near the top of the range which suggests some inflammation. Ferritin rises with inflammation so it could be connected (with the caveat that I am not medically trained). Your TPO antibodies are also positive for autoimmune thyroid disease (Hashimoto's) and this causes inflammation.

SlowDragon profile image
SlowDragonAdministrator

75mcg levothyroxine is only one step up from starter dose

Approx how much do you weigh in kilo

Free T4 (fT4) 16.6 pmol/L (12 - 22) 

Ft4 only 46.0% through range

Free T3 (fT3) 4.71 pmol/L (3.1 - 6.8)

Ft3 only  43.5% through range

Most people when adequately treated will have Ft3 at least 50-60% through range if not higher

Results Suggest you need next dose increase in levothyroxine

Request increase to 100mcg and 75mcg on alternate days

Retest in 6-8 weeks

No folate result?

Aiming for vitamin D at least around 80nmol minimum

Likely to need much higher dose to make progress

Even NHS guidelines recommend 1600iu daily for 6 months

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

Doesn’t need to be 4 hours away from levothyroxine as it’s absorbed in mouth

There’s a version made that also contains vitamin K2 Mk7. 

One spray = 1000iu

Suggest you try 3 sprays per day

amazon.co.uk/BetterYou-Dlux...

Another member recommended this one recently

Vitamin D with k2

amazon.co.uk/Strength-Subli...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease 

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease 

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Great article by Dr Malcolm Kendrick on magnesium 

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Lulu2607 profile image
Lulu2607 in reply toSlowDragon

Hi. Thank you for the extensive advice. A Dr recently told me in passing that my vit D reading is currently 30, so 'just get some vit D from the chemist'. I'm not happy with that vague advice but he wouldn't discuss it. I've read your advice with interest thanks. Having looked at vit D tablets in supermarkets and pharmacies in the past they appear to be poor quality/low dose and probably a waste of money. It's impossible to make an informed choice when you have underlying health conditions already so the advice on here is invaluable.

SlowDragon profile image
SlowDragonAdministrator in reply toLulu2607

Suggest you try mouth spray vitamin D. An hour away from levothyroxine is fine

Vitamin D tablets or gels you swallow should be at least 4 hours away from levothyroxine

Lulu2607 profile image
Lulu2607 in reply toSlowDragon

Thank you.

SlowDragon profile image
SlowDragonAdministrator in reply toLulu2607

Did you get dose increase in levothyroxine yet

Initially 75mcg and 100mcg on alternate days

Retest 6-8 weeks later

Or even straight up to 100mcg daily

Approx how much do you weigh in kilo

Teva brand levothyroxine upsets many people

Have you always had Teva

Are you lactose intolerant

Teva is only brand that makes 75mcg tablets

Lulu2607 profile image
Lulu2607 in reply toSlowDragon

Your reply above may be meant for the poster JigsawJill ?

SlowDragon profile image
SlowDragonAdministrator in reply toLulu2607

yes it was

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