Results are in - dosage levo / vits - confusion - Thyroid UK

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Results are in - dosage levo / vits - confusion

Moonlight5 profile image
17 Replies

Hey there, following the guidance I thankfully received from this board I had my bloods done.What action should I take?

Anti bodies are positive - what should I doVitamins - how many

Folate - what is this,Where can I buy it?

Levo - daily 75mcg and 100mcg on Sunday

My body aches I'm tired and overweight.

CRP-HS 0.39mg/L

FERRITIN 51.1ug/L

FOLATE SERUM 444 ugl (Range: > 3.88)

B12-ACTIVE 77.7 pm

Vit D 57nmol/L

TSH 3.81 mU/L

FREE T3 4.12 pmol/L

FREE THYROXINE 12.7 pmol/L

THYROGLOBULIN

ANTIBODIES>4000 IU/mL

THYROID PEROXIDASE

ANTIBODIES 329 IU/mL

Any guidance would be appreciated

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Moonlight5
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17 Replies
Jaydee1507 profile image
Jaydee1507Administrator

Can you add ranges for the tests please? They vary from lab to lab.

Also, is your folate really 444?

Moonlight5 profile image
Moonlight5 in reply toJaydee1507

Results

Results
Moonlight5 profile image
Moonlight5 in reply toMoonlight5

I attached the results

Jaydee1507 profile image
Jaydee1507Administrator in reply toMoonlight5

We need to see what the numbers relate to, that just shows the numbers. You can edit your post.

Moonlight5 profile image
Moonlight5

Third time lucky

Results
SlowDragon profile image
SlowDragonAdministrator

Was test done early morning, around 9am and last dose levothyroxine 24 hours before test

FT4: 12.7 pmol/l (Range 12 - 22)

Ft4 only 7.00% through range

FT3: 4.12 pmol/l (Range 3.1 - 6.8)

Ft3 only 27.57% through range

Shows you are extremely under medicated

Request/insist on immediate increase in dose levothyroxine to 100mcg daily

Which brand of levothyroxine are you taking

Do you always get same brand at each prescription

Retest again in 6-8 weeks

You may need further increase

Approximately how much do you weigh in kilo

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Did you not know you have Hashimoto’s

If not had coeliac blood test, GP should test this BEFORE considering trial on strictly gluten free diet

Moonlight5 profile image
Moonlight5 in reply toSlowDragon

yes before 9amYes no levothyroxine for 24 hours prior

Brand always Mercury Pharma - should I change?

73kg weight 160cm height

No, I did not know I had Hadhimotos- what action should I take

Thanks

SlowDragon profile image
SlowDragonAdministrator in reply toMoonlight5

Getting dose levothyroxine increased most important

Initially to 100mcg daily retest again in 6-10 weeks

Your Weight suggests may need small increase after that

Guidelines on dose by weight is 1.6mcg per kilo of your weight per day

73kg x 1.6mcg = 116.8mcg per day

You might find 112.5mcg per day is enough

Or might need a little extra

Hashimoto’s

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)

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

As TSH reduces/levothyroxine increase TG antibodies will reduce

TPO antibodies frequently reduce slowly on gluten free/dairy free diet

GP should have tested for coeliac disease when you were first diagnosed and started on levothyroxine

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. 

 A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

Hashimoto’s and leaky gut often occur together

Both dairy and gluten are inflammatory foods

A 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 may 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.

Similarly few months later perhaps consider trying dairy free too. Approx 50-60% find dairy free beneficial

SlowDragon profile image
SlowDragonAdministrator

What vitamin supplements are you currently taking

Vitamin D needs improving to at least over 80nmol and between 100-125nmol might be better

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.

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

One spray = 1000iu

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

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

Suggest you start on 3 sprays per day

Reduce to 2 sprays after 6 weeks

Retest in 3-4 months

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...

Moonlight5 profile image
Moonlight5

Thanks that's a lot to digest.Which magnesium supplement? I understand there are several types of magnesium ie Threonate, citrate

100 Levothyroxine

Which other brands could I go for?

SlowDragon profile image
SlowDragonAdministrator in reply toMoonlight5

if Mercury Pharma suits you ….make sure you stay on it

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets 

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz 

Only add one vitamin supplement at a time

Wait at least 2 weeks to assess before adding another

Magnesium lots different ones to choose from

Magnesium citrate good if suffer constipation

Eg calm vitality magnesium powder

Thorne Magnesium citramate

uk.iherb.com/pr/thorne-magn...

Or personally I like this as doesn’t affect bowels

You can tip powder into cup of water if capsule too big to swallow

Moonlight5 profile image
Moonlight5 in reply toSlowDragon

Hi SlowDragon do I need to test my adrenal function and where could that be done?

SlowDragon profile image
SlowDragonAdministrator in reply toMoonlight5

no point at moment

Get use to increase in levothyroxine at moment

Moonlight5 profile image
Moonlight5 in reply toSlowDragon

Thanks

SeasideSusie profile image
SeasideSusieRemembering in reply toMoonlight5

Moonlight5

Which magnesium supplement? I understand there are several types of magnesium ie Threonate, citrate

Check the different forms in the links below then choose the one most suited to your needs, it's not possible for anyone to tell you which form is best for you:

naturalnews.com/046401_magn...

The following link is included purely to describe the different forms of magnesium, ignore the fact that it mentions calcium is necessary, calcium is only necessary if you test and found to be deficient and then your GP should address that

explore.globalhealing.com/t...

and ignore the fact that this is a supplement company, the information is relevant:

swansonvitamins.com/blog/ar...

Magnesium should be taken 4 hours away from thyroid meds and as it tends to be calming it's best taken in the evening. Vit D should also be taken 4 hours away from thyroid meds. Vit K2-MK7 should be taken 2 hours away from thyroid meds. Don't take D3 and K2 at the same time unless both are oil based supplements, they both are fat soluble vitamins which require their own fat to be absorbed otherwise they will compete for the fat.

Moonlight5 profile image
Moonlight5

Thank you. I have a lot to read

Moonlight5 profile image
Moonlight5

Thank you all for the invaluable insight.

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