Can I get some advice on my latest results, please?

[BookLover2020]

Hello Everyone,

I hope everyone is looking forward to their Christmas and New Year break!

I would like to get some advice before my next appointment with my endocrinologist.

Below are the subset of my latest blood test results (17 December 2022).

I am currently on 100mcg Levothyroxine and 5mcg T3 (Thybon Henning)

Fasting blood sample taken in the morning. Levo and 5mcg T3 taken after the blood draw.

CREATININE * 119 umol/L 66 - 112

IRON 15.3 umol/L 10.6 - 28.3

25 OH Vitamin D 79 nmol/L 50 - 200

HDL CHOLESTEROL * 0.8 mmol/L 0.9 - 1.5

THYROID STIMULATING HORMONE 0 .84 mIU/L 0.27 - 4.2

FREE THYROXINE 17.3 pmol/l 12.0 - 22.0

FREE T3 4.3 pmol/L 3.1 - 6.8

FASTING BLOOD GLUCOSE 5.6 mmol/L 3.9 - 5.8

FASTING CHOLESTEROL * 6.2 mmol/L Optimum <5.0

HDL % of total * 13 % 20 and over

LDL CHOLESTEROL * 4.2 mmol/L Up to 3.0

FASTING TRIGLYCERIDES * 2.6 mmol/L < 2.3

Fasting Insulin * 13.3 mIU/L Less than 10

Non-HDL Cholesterol * 5.4 mmol/L < 3.8

Last couple of months, I haven't been watching my diet but I do still regularly go to the gym.

Of late, I have been feeling low on energy during the day and had been eating a lot of sugary foods . I don't know if that's connected to the Fasting insulin being outside of the range.

My sleep is also not so great.

I understand the T3 dosage that I am currently on is v low, so I plan to increase dosage slowly

from 5mcg to 15mcg.

Any suggestions or advice welcome!

[Jaydee1507 Administrator]

When was your last dose of T3 before the test? If it was 24hrs it will be too long and the results invalid.

Do you have results for ferritin, B12 and folate?

[BookLover2020 in reply to Jaydee1507]

I take my T3 and levo at the same in the morning. The test was done before my T3 or Levo intake. So it's more than 24 hours since my last dose.

[Jaydee1507 Administrator in reply to BookLover2020]

In that case your FT3 result will be lower than it should be and this test is invalid.

When taking T3 you need to take your last dose 8-12 hours before the test, so for you, the day before the test take your T3 dose at 11pm or so.

[SlowDragon Administrator in reply to BookLover2020]

So the Ft3 result is falsely low

Day before test split T3 dose, even if you don’t usually

[BookLover2020 in reply to SlowDragon]

Thank you, will do. Endo recommended T3 dose about 5 hours before the test.

[tattybogle in reply to BookLover2020]

Testing approx 2-6 hours after the dose of T3 is the way to measure the maximum peak in daily level for fT3 (when its absorbed via the gut, all in one go).

BUT you don't have that level of fT3 all day.

Endo may use a 5 hr result to limit/ or reduce dose of T3 , leaving your body without enough for a large part of each day. The best idea really is to get a more 'middle' level ,, ie not the highest @5 hrs .. not the lowest @ 24hrs ( if taken in one daily dose) but inth middle ie 8-12 hrs after last dose T3.

make sure you know your endo's intentions/ understanding of this , when they are asking for a 5hr test.

[SlowDragon Administrator in reply to BookLover2020]

many of us end up 3 doses per day…..that’s roughly 8 hour intervals

Endo might not think it “necessary “ to split the dose …….but you might find it preferable

See how you get on with single dose

Day before test, always split the dose and last dose 8-12 hours before test

[BookLover2020 in reply to SlowDragon]

Thank you for the tip!

[SlowDragon Administrator]

What vitamin supplements are you currently taking

Vitamin D is on low side

Last dose T3 should be approx 8-12 hours before test

[BookLover2020 in reply to SlowDragon]

Thank you.

I take Vitamin-D and selenium supplements from Cytoplan. I also take Magesnium L-Threonate and Vitamin C separately. But to be honest, I do skip a day or two in a week.

[BookLover2020 in reply to SlowDragon]

Endo has now prescribed 10mcg T3 to be taken along with the 100mcg T4 in the morning. He mentioned, not necessary to split the dose. I prefer taking it as a single dose rather than a split dose. I will give it a go and see how it goes.

Also, his concern was of the elevated fasting insulin. In a previous blood test, a year ago, I had elevated fasting insulin which went down after a few months of diet and exercise.

Last couple of months my diet (late night snacking etc) was not great. I hope I can bring it down in a few months before the next blood test.

Any thoughts?

[BookLover2020]

I find it hard to get Vitamin-D on the high side, do you recommend any high dose Vitamin-D supplements?

[SlowDragon Administrator in reply to BookLover2020]

With thyroid disease we frequently need higher dose than average

It’s trial and error what dose vitamin D each person needs

2000iu - 4000iu per day not unusual

Likely to need higher dose in winter than summer

Vitamin D tablets must be at least 4 hours away from levothyroxine and best with food that has highish fat content to improve absorption

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.

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

One spray = 1000iu

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...

[SeasideSusie Remembering]

How much Vit D are you taking ?

What form - oil based drops, tablets, capsules?

[BookLover2020 in reply to SeasideSusie]

Apologies for the late response.

This is the one that I use: cytoplan.co.uk/catalogsearc...

[SeasideSusie Remembering in reply to BookLover2020]

Which one are you taking - the 50ug or the 100ug - and total daily amount?

[BookLover2020 in reply to SeasideSusie]

The 100ug. Approximately, once a day.

By the way, I ordered Vitamin D mentioned by SlowDragon above.

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

[SeasideSusie Remembering in reply to BookLover2020]

Sorry, I'm confused now. You said you're taking the Cytoplan D3/K2 and now you're saying you're taking the Nature Provides one?

If you're finding it hard to raise your Vit D level it wont hurt to take more during the winter months. The 100mcg Cytoplan = 4,000iu D3. You could add an extra one or two doses in the week, or aim to take an average of 5,000iu daily.

You might find you'll do better on the Nature Provides, it may be absorbed better than the Cytoplan capsules.

[BookLover2020 in reply to SeasideSusie]

Sorry, I just ordered the Nature Provides a few days ago. Before that I was taking the Cytoplan D3/K2.