I have just re-tested after 9 weeks of 69mg ferrous fumarate, 1 taken alternate days as suggested here, Thorne Basic B & Magnesium supplementation in hope of improving T4/T3 conversion.
I'm on 125g Levothyroxine. I also take Vit D3 w K2 7000, Thorne Basic B, Magnesium 400mg/day, Zinc, Copper. Selenium levels were good at blood test in February.
Folate has improved, but Ferritin & FT3 remain low. D3 & B12 were both already optimal in Feb.
I've struggled with the ferrous fumarate and would like to try another iron supplement that doesn't cause me stomach issues - is 3 Arrows Heme a good one to try? The search function here is tricky but I think some are finding this helpful?
I'm going to try gluten free more conscientiously for 3 months. Have done this before along with going sugar and flour free and felt very well but have slipped.
I wondered what else if anything you'd recommend?
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HotelHurricaine
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Are you taking a separate B12 supplement or injecting? Your B12 level is high and doesn't require supplementing separately, and the 400mcg methylcobalamin in Thorne Basic B wouldn't normally achieve such a level. What was your B12 level before starting the Basic B?
Your iron supplement hasn't helped at all with your ferritin level, but you really should do an iron panel regularly when taking iron to check serum iron and saturation, these shouldn't go too high.
Iron bisglycinate is more gentle on the stomach. I haven't tried 3 Arrows so I'm afraid I can't comment on that.
SeasideSusie for the past 8 weeks I have taken only Thorne Basic B. Before that I was supplementing with a Solgar sublingua B12 2000 with B complex so this was a reduction in dose for past 8 weeks. Previous test in Feb '23 was: Active B12 150 pmol/L (37.5-150).
I have done an iron panel but results not back yet, only Ferritin.
Could B12 be high still from previous supplementation?
Yes, I would think your B12 level is high due to the B12 supplement. Just continue with B Complex only and I expect your level will gradually come down.
I would suggest getting your zinc and copper tested. Hypos are usually high in one and low in the other. So, supplementing the one you are high in is not a good idea.
I tested low in range in copper but couldn’t find a zinc test at Medichecks or anywhere who will do the blood draw (can’t do fingerprint test without a blood bath/fainting!). I will just supplant copper and test again.
Well last dose levothyroxine should be 24 hours before test
So Ft4 is falsely low
So perhaps not room to increase dose
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Look at getting T3 prescribed alongside levothyroxine instead via thyroid specialist
Email Thyroid U.K. for list of thyroid specialist endocrinologists and doctors who will prescribe T3
I'll be honest I don't know - I haven't taken much notice. But I have been on these 2 for the past year or so I think. I'm not lactose intolerant that I know of - is there any other advantage to a particular brand?
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
Accord only make 50mcg and 100mcg tablets
Accord is also boxed as Almus via Boots,
Many patients do NOT get on well with Teva brand of Levothyroxine. Teva is lactose free.
But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
Teva is the only brand that makes 75mcg tablet.
So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Aristo (currently 100mcg only) is lactose free and mannitol free.
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
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