Advise me, please, on NDT dose/vitamins optimisation. Functional but at sea... Latest results

[ZeilaJee]

Please would you review these blood results and advise me? On EVERYTHING?

I’m on Armour 1 grain and I stopped taking all vitamins (B complex Igennus) 3 weeks in advance of the test. Last dose NDT 9am, 24 hours before testing at 9am.

I see that I’m undermedicated but would like a plan: how/by how much to raise over time. Cortisol, ferritin, B12 and antibodies are all high. What does this mean? I'm confused over Vitamins, especially B12 being high, as I was advised to take a good B complex. I'm not taking anything now except the Armour. What vitamins should I take?

Reading advice here, I tried dividing doses and tried taking more: 1 ¼ grains but my heart raced at night when trying to sleep and made it impossible to drop off. It seems to beat faster at night anyway. Is the balance of T3 and T4 in Armour right for me or do I need referral to endo? What endo would understand this/NDT (the Thyroid UK referral list is not that helpful)? I have been self-medicating for at least 2 years, importing Armour from the USA, and am happy to continue with some guidance.

Symptoms: my hair thickness has reduced by ½ to 2/3. Hairloss seemed worse with higher dose. I feel depressed, aimless and have little energy, though this miraculously comes back to some extent when I’m on holiday, I am struggling. My skin is dry, ageing (I’m 67) and without bloom. I have had an awful year with crisis after crisis (moved house, husband heart op, son’s wedding at home, dog dying, mother dying, other son’s wedding and his relocation abroad) and confidence is at very low ebb. I am gluten free and have a good diet and don't take much exercise, which I should/does good; I am not overweight but I have flab. Otherwise I don't have any problems😬. Oh yes, I have quite large nodules on my thyroid too. They didn't seem concerned about these but said I should be retested in 6 months about 6 months ago.

Your advice would be much appreciated!

[SlowDragon Administrator]

Sorry you haven’t had a reply

You only need to stop vitamin B complex 5-7 days before test

Folate result is far too low

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

You could experiment with taking a vitamin B complex that doesn’t contain B12 say 4 days week and Igennus the remaining 3 days

Your thyroid results suggest you are under medicated

Many people on NDT need to split the dose ……only increase by 1/4 gain at a time,

Alternatively you could try adding some levothyroxine. 25mcg

Retest 6-8 weeks after any dose change or brand change

As you have Hashimoto’s are you on dairy free diet too

High ferritin can be deceiving

Ferritin often high with inflammation of Hashimoto’s

Higher levels common after menopause

Because you are loosing hair

Suggest you get full iron panel test

Medichecks iron panel test 

medichecks.com/products/iro...

Ferritin range on Medichecks 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

If you are over 60 …..ferritin over 150 is “normal “

Often ferritin rises after menopause

[Strongerme23 in reply to SlowDragon]

This was really good advice, particularly on splitting the NDT dose. Or taking the 1 grain in the morning, and maybe 1/5 or 1/6 of a grain in the afternoon. Cortisol being high is not good. Too much cortisol reduces TSH, which means you won't produce as much T4, and that could be why your T4 is low, though your T3 is fine. I recently got a similar result. You need to increase T4, so I agree with the above recommendation about adding some levothyroxine.

[SlowDragon Administrator in reply to Strongerme23]

High cortisol is common when under medicated

Adrenals try to compensate for lack of thyroid hormones

Cortisol levels should improve as dose of NDT/levothyroxine is increased

[meme]

if you took your last NDT 24 hours before test you will have false low t3 and 4 readings. It’s 12 hours before testing with for NDT.