Hi, I was diagnosed with under active thyroid around 5 years ago, and I’m taking 100 mg of Levothyroxine daily ( I take this around 6 in the morning at least 2 hours before coffee or breakfast) I do not take any other medication.
my symptoms have never gone away ( tiredness, lethargic, brain fog, muscle aches, cold hands and feet)
My GP checks bloods every year and he is happy with my TSH and the levo dose (100 mg)
I have paid to have a private test (medichecks) as I was wanting to know what my FT3 levels are ( my GP does not test for these)
I received the results earlier and all my thyroid levels are with in range so I’m not sure what to do next, I have increased thyroglobulin levels which may suggest Hashimoto’s so was wondering if changing my diet to gluten free may help with my symptoms?
I took my bloods at 09:45 AM and had only had water and my Levothyroxine at 06:00 the morning before the test.
Test results:
CRP HS 3.9 (<3 ) High
Ferritin 131 (30-400)
B12 52 (37.5 - 188)
Vitamin D 65 (50 - 250)
Folate serum 7.4 (8.83 - 60.8) Low
TSH 2.73 (0.27 - 4.2)
FT3 4.2 (3.1 - 6.8)
FT4 21.4 (12 - 22)
Thyroglobulin 282.3 (0 - 115) High
Thyroid peroxidase 24.6 (0 - 34)
If my thyroid results were abnormal I was thinking of paying to go private with a view to T3 or NDT meditation but as they seem ok I’m not sure now!
thanks in advance
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Bluecat77
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thanks for your quick reply it’s really appreciated.
I am not vegan or vegetarian, I normally take a centrum for men multivitamin daily but did not take for a few days before blood test as it contains b12.
I weigh 85 kg and I’m 6ft tall.
I’ll book an appointment with my GP to discuss but was thinking of paying to see a private GP that specialised with Thyroid conditions and maybe try a different medication if that’s what they advise. Thanks again
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 or two
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
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 folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
How other member saw how effective improving low B vitamins has been
Sorry missed your question in first response, I took my Levothyroxine at 6am on the same morning of the test (09:45) thanks for the advice about not taking for 24 hours before I will do this next time.
I always get the same brand of Levothyroxine (Teva uk)
I will stop the multi vits and start with separate supplements once I have have seen the GP and hopefully had a new blood test.
With ref to B12 symptoms I never have much energy and always seem tired even after sleep. I will try some supplements once my new bloods are sorted (hopefully!)
Many people find Levothyroxine brands are not interchangeable.
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 start/ 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
Request a blood test to check your B12 level, the reason being that you could have Pernicious Anaemia which means you'd have to have regular B12 injections.
I have a B12 injection every month and I think the regular is usually every 3 months. My mother also had Pernicious Anaemia.
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Over range CRP suggests inflammation somewhere, but as a non-specific marker it can't tell us where the inflammation is. As your raised antibodies suggest Hashimoto's this could be the cause.
Ferritin 131 (30-400)
Ferritin can be raised when inflammation is present, as your CRP is raised it's very likely that your ferritin result is falsely raised and your normal ferritin level will be lower than this.
Ferritin is said to be recommended to be half way through range, although some say a level of around 130ug/L is OK for a male. With your natural level likely to be lower than measured with this test it's hard to say whether your level is too low but it is likely to be.
You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
If you want to do a full iron panel Medichecks offer a iron panel for £49 less discount of 10%, details of discount 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.
Vitamin D 65 (50 - 250)
This is low. You might want to check out a recent post that I wrote about Vit D and supplementing:
and you can check out the link to how to work out the dose you need to increase your current level to the recommended level.
Your current level of 65nmol/L = 26ng/ml
On the Vit D Council's website they suggest supplementing at 3,700iu D3 daily, nearest to buy is 4,000iu, cheapest is to buy 5,000iu and take 6 days a week rather than 7.
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).
Retest after 3 months and adjust dose if necessary.
Read up about the important cofactors needed when taking D3, these are magnesium and Vit K2-MK7. I can give suggestions for brands if you like, just ask.
Folate serum 7.4 (8.83 - 60.8) Low
This is below range and very close to possibly folate deficiency, it is in the "indeterminate" category according to NICE and you should discuss with your GP:
◦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.
Do not start folic acid or anything for your low folate until further testing of B12 has been carried out and supplements or B12 injections commenced (the reason for this is explained above in the comments about your B12 level).
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