Endo appointment later in the week, any advice? - Thyroid UK

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Endo appointment later in the week, any advice?

Bluevitd profile image
5 Replies

I'm currently on 50 teva after a lot of stomach trouble with other brands after diagnosis of subclinical hypothyroid, I seem to get on with the lactose free ones better. I am still absolutely cream-crackered all the time, my feet are always freezing, hair is in a terrible state and having trouble with constipation.

I have an appointment with the endo at the end of the week and based on results below, I am anticipating dose will be gradually stepped up again, but is there anything else I should raise?

Tests were taken at 8.30am, 24 hours after last meds. My last vit d in October was down at 34, and have been supplementing to increase.

For some reason doc didn't test folate, but based on the advice I've seen here I need to improve all the vits to the optimal ranges?

TSH 4.01 mIU/L (0.27 - 4.2) 95.2%

Free T4 (fT4) 16.5 pmol/L (12 - 22) 45.0%

Free T3 (fT3) 4.1 pmol/L (3.1 - 6.8) 27.0%

T4:T3 Ratio 4.024 

Thyroid Peroxidase Antibodies (TPO) 327 IU/mL (≤ 49)

C-Reactive Protein (CRP) 5 mg/L (≤ 7) - down from 10mg/l 6 months ago

Vitamin B12 (active) 289 nmol/L (130 - 800) 23.7%

Vitamin D 60 nmol/L (30 - 300) 11.1%

Ferritin 55 ug/L (30 - 150) 20.8%

Appreciate any thoughts/advice - thanks!

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5 Replies
Hedgeree profile image
Hedgeree

Hi Bluevitd,

Welcome to the forum 🙂

As no one has replied to your post yet my comment will bring it into the recently active feed. Hopefully then others can make suggestions and comment on your results for you.

Best wishes.

SlowDragon profile image
SlowDragonAdministrator

obviously you need next dose increase in levothyroxine up to 75mcg daily

Have you had coeliac blood test done yet

That’s not Active B12 it’s serum B12 and is far too low

Aiming to improve Serum B12 to at least over 500

Low B12 symptoms 

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

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...

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)

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.

Vitamin B complex

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) 

Thorne currently difficult to find at reasonable price, should be around £20 

If you want to try a different brand in the meantime, one with virtually identical doses of the ingredients, and bioavailable too, then take a look at Vitablossom Liposomal B Complex. Amazon sometimes has it branded Vitablossom but it's also available there branded as Yipmai, it's the same supplement

amazon.co.uk/Yipmai-Liposom...

or available as Vitablossom brand here

hempoutlet.co.uk/vitablosso... &description=true

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

SlowDragon profile image
SlowDragonAdministrator

vitamin D, keep supplementing

Aiming for vitamin D at least over 80nmol and between 100-125nmol might be better

Are you currently taking any magnesium supplement

Once you Improve vitamin D level, 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.

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...

Interesting article by Dr Malcolm Kendrick on magnesium 

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

SlowDragon profile image
SlowDragonAdministrator

Ferritin is too low

Look at increasing iron rich foods in your diet

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

List of iron rich foods

dailyiron.net

drhedberg.com/ferritin-hypo...

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.

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron 

healthline.com/nutrition/he...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator

Guidelines on dose levothyroxine eventually likely to be on is approx 1.6mcg per kilo of your weight per day

So unless very petite likely to need at least one more increase in dose after retesting levels on 75mcg levothyroxine in 6-8 weeks after increasing

Always worth trying strictly gluten free diet, but get coeliac blood test done before considering trial

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