I was diagnosed with hypothyroidism in October 2022; and with Hashimotos in January 2023. I also have fibromyalgia (diagnosed in 2011) and am peri menopausal (since 2021). In October 2022 I was out on 50mg of levothyroxine and in January 2023 this was increased to 150mg after my TPO was tested. After my recent blood tests my levothyroxine has been dropped to 125mg as my dr is concerned my TSH is very low. My blood test was done at 8:50am and my last dose of levothyroxine was 24 hours before. My main symptom is exhaustion (this is ruling my life). I struggle to hold a conversation sometimes and actually fell asleep at my desk last week!
Here are my blood results - do I need to take any supplements?
I’m desperate to feel less tired
TSH. 0.08 mu/L range 0.40-4.50
TPO. 310 iu/mL range 0-9.00
Free T3. 6.1 pmol/L range 3.90-6.90
Free T4. 16.8pmol/L range 7.00-17.00
Vit.D. 66.3nmol/L range 50.00-250
Vit B12. 362ng/L range 145.00-910.00
Ferritin 70 ug/L range 11.00-307.00
Folate. 3.6 ug/L range 3.10-19.90
Any advice will be gratefully received, thank you
Written by
Charliebing
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◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.
◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.
So although your result does not indicate deficiency it does come under the "should be interpreted as suggestive of deficiency" part of the guidelines. I would discuss this with your GP and he may prescribe a course of folic acid.
Apart from that
Vit.D. 66.3nmol/L range 50.00-250
You might want to check out a recent post that I wrote about Vit D and supplementing:
you'll see that they suggest supplementing with 3,700iu D3 daily (nearest is 4,000iu).
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).
Once you've reached the recommended level then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
If you do supplement with D3 then you will also need it's important cofactors - magnesium and Vit K2-MK7.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
Magnesium helps the body convert D3 into it's usable form. There are many types of magnesium each helps in different ways, you'll need to check to see which form is right for you:
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Do you have any signs of B12 deficiency – check here:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results and if you have B12 deficiency and it is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.
If you do not have any signs/symptoms then you could supplement with B12 sublingual methylcobalamin plus a good quality B Complex. One bottle of B12 should be enough then just continue with the B Complex.
Suggestions for good quality B Complex supplements are:
Thorne Basic B but this can be expensive and hard to obtain, in which case consider the following which are all almost identical:
Thank you for your reply. Could the big increase account for my tiredness?
The brand for my 100mg & 50mg is accord. I’m still taking the 150mg dose as it was only changed on Friday afternoon and I’ve not got my new tablets. If accord don’t do a 25mg then I’ll contact the surgery and ask for the same brand 100mg tablets to use with the 25mg tablets.
Do you think I need to take any supplements? I feel like I’m clutching at straws in the hope that something needs adding so I’ll feel better 😞
SeasideSusie apologies I didn’t realise you’d messaged - thank you very much for such a comprehensive response. I will read through the links you have posted. I will definitely add folate - I’ll look at previous posts for guidance.
okay thank you. I’ll will cut up my 50mg and add in supplements as suggested. Should folate be added at some point as well?
My dr hasn’t tested for coeliac- should I ask for this? I have tried to cut down on gluten but really struggling to cut it out completely. I will make a concerted effort to eliminate gluten. Thank you
Thorne Basic B complex 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-£25. iherb.com often have in stock. Or try ebay
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
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
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and add a separate vitamin B Complex after a week
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
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