Collagen Supplements

[Mrscat12]

Just a quick question if I may? Is it safe to take a collagen supplement with an under active thyroid? My current TSH last week was 2.3 and have been upped from 50mg to 75mg on alternate days and to be retested in 8 weeks. I’m in constant pain in my shoulders and hand so looking to see if the above product may help.

[SlowDragon Administrator]

Have you had vitamin D, folate, ferritin and B12 levels tested yet

Low vitamin levels are EXTREMELY common when hypothyroid, especially low vitamin D

Rather than starting collagen get vitamins tested via GP

Also …..Have you had thyroid antibodies tested for autoimmune thyroid disease?

You’re going to need several further increases in levothyroxine over coming months

Which brand of levothyroxine are you currently taking for 50mcg and are you taking a 75mcg tablet or adding 25mcg to 50mcg to make 75mcg doses

Many people find different brands are not interchangeable and Teva brand upsets many people

Teva is only brand that makes 75mcg tablets

Frozen shoulder is common hypothyroid symptom

[SlowDragon Administrator]

Just read your profile, so yes you do have autoimmune thyroid disease also called Hashimoto’s

Levothyroxine doesn’t “top up “ failing thyroid, it replaces it

so it’s important to be on high enough dose levothyroxine

Approx how old are you. Starting on only 25mcg is for the very frail or elderly. Standard starter dose of levothyroxine is 50mcg and dose is increased slowly upwards in 25mcg steps as fast as tolerated

Typical eventual daily dose levothyroxine is 1.6mcg per kilo of your weight per day. So unless very petite likely to need to be on at least 100mcg levothyroxine per day

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

[Mrscat12 in reply to SlowDragon]

Slowdragon these are my latest results. Probably not 100% as I wasn’t expecting to have my bloods taken. I’m nearly 54 and weigh around 121 pounds. I currently have the accord brand 50mg and taking 25mg top up of wockhardt as I don’t want the TEVA brand and as you say that’s the only one in 75mg

.

[SlowDragon Administrator in reply to Mrscat12]

How long have you been on 75mcg dose when this test was done

What time was test done

Had you taken levothyroxine before blood test

Folate is deficient and B12 too low

[Mrscat12 in reply to SlowDragon]

Hi I’ve had 3 doses of the 75mg as it’s every alternate day until my next test. I’ve been on 50mg since April 2022.

I’d taken my Levo at 3am and the blood test was at 12.20pm as I was going in for a blood test for hormone levels and the nurse decided to test my thyroid at the same time.

I did query my levels on B12 and folate but the GP said that they were all fine 🙄 Is there anything I can do to improve these with over the counter products?

[SlowDragon Administrator in reply to Mrscat12]

So you had only just increased dose to 67.5mcg daily

Retest after 6-8 weeks

Then push for next increase to 75mcg daily

Retest again in a further 8 weeks

Meanwhile working on improving low vitamins

NHS only tests and treats vitamin deficiencies

Technically they should have picked up low folate

But you’re better off self supplementing a decent quality vitamin B complex anyway

Get coeliac blood test done, before considering trial on strictly gluten free diet

[Mrscat12 in reply to SlowDragon]

Thank you so much for all your help and advice. Very much appreciated x

[SlowDragon Administrator in reply to Mrscat12]

if not supplementing vitamin D, suggest you start

We need vitamin D at least over 80nmol

[SlowDragon Administrator in reply to Mrscat12]

Folate and B12

Low B12 symptoms 

b12deficiency.info/signs-an...

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

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.

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...

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 until it’s over 500

[Mrscat12 in reply to SlowDragon]

I’ve managed to order the B12 complex from hemp outlet. Thank you 😊 They’re currently on offer for £19.99

[SlowDragon Administrator in reply to Mrscat12]

start separate B12 first

Add vitamin B complex after week or so on B12

[Mrscat12 in reply to SlowDragon]

I need to order B12 too. The one I’ve got at the mo is this one. Is this not suitable?

.

[SlowDragon Administrator in reply to Mrscat12]

Just testing TSH is completely inadequate

suggest you spend next 6-8 weeks improving low folate and B12

Then test TSH , Ft4 and Ft3

Test early morning just before 9am and last dose levothyroxine 24 hours before test

cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

thyroiduk.org/getting-a-dia...

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

121pounds = 54kilo

54kg x 1.6mcg levothyroxine = 86.4mcg as likely daily dose levothyroxine required

So that’s 75mcg plus 12.5mcg daily as likely dose required

[SlowDragon Administrator]

Joint pain is most likely low vitamin D

So getting vitamin D tested ASAP …..along with folate, B12 and ferritin

Also request GP do coeliac blood test if not been tested yet (as per NICE guidelines)

Gluten or wheat intolerance can also be cause of pain

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels 

Low vitamin levels affect Thyroid hormone working 

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.

Most common by far is gluten. Dairy is second most common. 

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's test positive for coeliac, but a further 80% find strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link) 

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies 

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first 

Assuming test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.