Recommendation re supplements : Hi allI'm fairly... - Thyroid UK

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Recommendation re supplements

Hollybushroad profile image
24 Replies

Hi allI'm fairly new to the forum and I'm finding all your info and wealth of experience extremely helpful. Have learnt that addressing possible nutritional deficiencies is important before Thyroid hormone therapy can be optimally effective. I have Hashimotos and recently posted full thyroid panel results.

Done some futher medichecks tests and I'm looking advice re supplements to optimise my results.

Vit D 121nmol/l (50-200)

I have been taking vitabiotics 3000 iu daily for over a year now but should I increase my dose further or is 121nmol/l ok?

I stopped taking it 6 days before testing as per forum recommendations

Vit B12 (active) 48.1pmol/l

(37.5-150)

Not currently on any B12 supplement

I see this is borderline low so would like a recommendation on best B12 supplement and particular brand ( though not sure if you are allowed to mention particular brands on forum??)

Ferritin 85.9 ug/l (13-150)

Do I need to supplement to further optimise levels

If so any recommendations on supplement please?

Blood Cortisol 607nmol/l

(160-507)

I was expecting Cortisol to be low....not high in hashimotos with all the fatigue that goes with it

but maybe it explains my high levels of anxiety????

Is there any supplement recommended for high cortisol.

When I look at products online they promote as "balancing cortisol levels" but I'm not sure what that actually means in reality?? Surely they either help to lower or increase Cortisol ?? Or is my view too simplistic???

I have since ordered a 4 point saliva cortisol test to confirm findings but in meantime I would really like to go ahead and order supplements for above mentioned vit deficiencies so all recommendations would be greatly appreciated.

PS I was on a gluten free diet a couple of years ago for about 8 months but didn't really notice any improvement in my overall symptoms. (Found it very hard but I did stick to it)

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SeasideSusie profile image
SeasideSusieRemembering

Hollybushroad

Vit D 121nmol/l (50-200)

I have been taking vitabiotics 3000 iu daily for over a year now but should I increase my dose further or is 121nmol/l ok?

I stopped taking it 6 days before testing as per forum recommendations

121nmol/L is fine and as it's now summer you may make Vit D naturally from the sun. Retest at the end of October to check your level and see if you need to adjust your dose for the winter. If all you want to test is Vit D then there is an NHS lab who offer an easy dried blood spot fingrprick test to the general public:

vitamindtest.org.uk/

Vitabiotics isn't a particuarly good brand. I am presuming you are taking the tablet form, this is the least absorbable of all D3, and it's full of added excipients. Best form of D3 is an oil based softgel which has no added ingredients, just D3 and extra virgin olive oil, eg Doctor's Best. D3 needs fat to be absorbed and the oil based softgel provides the fat. With tablets and capsules you need to take them with a fatty meal. Some members use an oral spray but these tend to be more expensive and again have excipients.

Do you also take Vit K2-MK7 and magnesium - two important cofactors when taking D3? Do you take D3 4 hours away from your thyroid meds, magnesium also needs to be 4 huors away from thyroid meds and Vit K2-MK7 two hours away.

There is no recommendation on this forum to leave off D3 for any length of time, certainly not 6 days. All you do is take it after the test on the day instead of before. The test result then reflects the dose you're taking.

Vit B12 (active) 48.1pmol/l (37.5-150)

Not currently on any B12 supplement

I see this is borderline low so would like a recommendation on best B12 supplement and particular brand ( though not sure if you are allowed to mention particular brands on forum??)

An Active B12 level below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:

viapath.co.uk/our-tests/act...

Reference range:>70. *Between 25-70 referred for MMA

There is a link at the bottom of the page to print off the pdf to show your GP.

Do you have any signs of B12 deficiency – check here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

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 then you could start supplementing with a sublingual methylcobalamin such as

Cytoplan cytoplan.co.uk/vitamin-b12-...

or Nature Provides sublingual liquid

amazon.co.uk/Bioactive-METH...?

Note that the Nature Provides supplement contains a much higher dose than the Cytoplan one. Some members have found the taste of Nature Provides too unpleasant and have given up with it, others are fine.

Was folate tested? B12 and folate work together.

Ferritin 85.9 ug/l (13-150)

Do I need to supplement to further optimise levels

This is more difficult. First of all you'd need CRP testing to see if you have any inflammation, ferritin rises with inflammation. If CRP isn't tested you wont know if you have a true measure of your ferritin level. You shouldn't supplement with iron unless you do a full iron panel which includes

Serum iron

Saturation percentage

Total Iron Binding Capacity

Ferritin

If you already have a good level of serum iron and saturation then taking iron supplements will take these too high and can lead to toxicity.

Medichecks do an iron test which includes the above plus CRP, I think it's £49 for the fingerprick test.

Some experts say the optimal ferritin level for thyroid function is 90-110ug/L.

Blood Cortisol 607nmol/l (160-507)

A 24 hour saliva cortisol plus DHEA test is said to be better than a blood test. My serum cortisol with my annual full thyroid/vitamin panel comes back high but my 24 hour saliva test shows lowish cortisol throughout the day.

If you want to do a saliva test then Regenerus do cortisol plus DHEA

thyroiduk.org/help-and-supp...

Don't choose a cortisol only test and certainly not Medichecks as they have a couple of their ranges which start at zero and if anyone does have a zero cortisol level they would either be very ill or in the morgue.

When I look at products online they promote as "balancing cortisol levels" but I'm not sure what that actually means in reality?? Surely they either help to lower or increase Cortisol ?? Or is my view too simplistic???

Adaptogens are said to be balancing which you would think they would lower a high cortisol level and increase a high cortisol level but in reality it doesn't always work out like this and some seem to only do one job or the other not both.

I certainly wouldn't suggest you supplement anything for cortisol unless you do a 24 hour saliva test.

Hollybushroad profile image
Hollybushroad in reply to SeasideSusie

Hi SeasideSusieThank you so much for your very helpful and detailed reply.

Please forgive me but I am not very tech savvy (bit of a dinosaur really 🦖)

I have no idea how to highlight the points you raised. I only have my mobile phone and don't have access to a computer so again please forgive me if I just respond in paragraph format.

Re Vit D:

I think I got mixed up about stopping Vit D a few days before test ....maybe I was thinking about other tests. It's a minefield all this really. But wudnt imagine 6 days without vit D3 would greatly affect the result. (Although I am aware of not taking Levothyroxine 24 hrs prior to Thyroid blood test)I will order Drs best in my next order. I just assumed Vitabiotics was a well known brand and would be good but like I said when my supply runs out I will order Drs Best as per your recommendation.

I don't think I can take K2 along with my vit D3 as I am on clopidogrel (blood thinner)

Would I be correct in saying that??

I currently don't take a magnesium supplement.

Would it be worth getting my magnesium levels checked??

Re Vit B12:

I really would prefer to arrange all my blood tests privately as I do not have a good relationship nor much confidence in my GP (but I will not rant). She is the only permenant doctor in my surgery and rest are locums who are quite inexperienced Unfortunately I had a great former GP who retired last year. I really need to change my surgery.

Medichecks in their comments section suggested further MMA testing but I wasn't sure about pursuing it but I think I should after reading your comments. In hindsight

My late mother had pernicious anaemia and was taking B12 injections so yes definitely worth investigating further. Thankfully after reading your commentI hadn't ordered any B12 supplements yet.

I actually forgot to check folate . It was only after writing my earlier post I realised and have ordered anaemia test kit from Monitor My Health.

Re Ferritin test:

I will get CRP checked as you advised prior to considering supplementation. I supposed my anaemia test will give me a clearer picture about all that. In hindsight I shud have done this initially instead of ordering only ferritin test. Will post my results later in week.

Unfortunately after writing my earlier post I ordered a cortisol saliva test from medichecks so it's paid for and dispatched.

(I'm just so impatient and desperately looking for answers)

You are perhaps thinking I'm being very extreme doing all this private testing but as I mentioned earlier I do not have a good relationship with my GP (and that's being diplomatic lol). I find it extremely stressful dealing with her and I no longer have the will nor patience to do it anymore.

Yes ....this private testing will cost me a small fortune but after years of illness with little quality of life I have learnt that you can't put a price on your health as I'm sure alot of members on this forum would agree. Thank you so much again for all your very help. This forum really is a godsend. Wish I had known about it years ago

SeasideSusie profile image
SeasideSusieRemembering in reply to Hollybushroad

Hollybushroad

I don't think I can take K2 along with my vit D3 as I am on clopidogrel (blood thinner)

There are differing opinions about K2 and blood clotting.

There are two main forms of vitamin K:

Vitamin K1 (phylloquinone): Found in plant foods like leafy greens.

This is the blood clotting form, the one they give newborn babies to prevent a now rare bleeding disorder called 'vitamin K deficiency bleeding' (or 'haemorrhagic disease of the newborn'.

Vitamin K2 (menaquinone): Found in animal foods (high-fat dairy products from grass-fed cows, egg yolks, as well as liver and other organ meats) and fermented foods such as natto and sauerkraut.

This is the form that directs calcium to bones and teeth and away from soft tissues and arteries

Difference between different forms of K2 article:

healthline.com/nutrition/vi...

orawellness.com/whats-best-...

So really it's a case of doing a bit of research then making your mind up.

I currently don't take a magnesium supplement.

Would it be worth getting my magnesium levels checked??

Probably not, certainly not a serum magnesium test. Testing serum magnesium is unreliable. About 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood. So testing what's in the blood isn't giving an accurate picture of our magnesium status.

A red cell magnesium test is said to be the better indicator of magnesium status, not the standard serum magnesium test. The red cell test is expensive and requires phlebotomy which is why it's not included in these bundles.

Most hypo patients are low in magnesium.

As your mother had PA then for peace of mind it might be best to pursue further B12 testing. I've not had to do it so can't recommend any particular lab nor do I know if there's more involved than just testing MMA. Medichecks do MMA and the link to Viapath above has a tab with "Ordering info" so that might be worth looking at. You could always pop over to the PA forum here on HealthUnlocked as they might be able to give you further help:

healthunlocked.com/pasoc

CRP needs to be tested from the same blood draw as ferritin. Medichecks do this in their iron test

medichecks.com/products/iro...

You are perhaps thinking I'm being very extreme doing all this private testing

Not at all, I tested far more when I made the decision to stop messing around and get to the bottom of the problem!

I just hope my GP acknowledges private lab results should there be any problems detected ( but hopefully not)

It can sometimes be a problem getting GPs to accept private results, they have all kinds of excuses for not accepting them. However, as Monitor My Health is an NHS lab (Exeter hospital) I would imagine it would be difficult for them to argue about that one. If results from any private tests are a cause for concern and the GP wont accept them, then use that opening to say that if they're not happy then will they do the tests themselves.

Hollybushroad profile image
Hollybushroad in reply to SeasideSusie

Sorry to bother you again Seaside Susie but I meant to ask you what lab would you recommend using to get MMA test done? (Don't want to make anymore rash decisions lol....I just look for cheapest but I'm learning that is not always the best idea) also CRP testing?I just hope my GP acknowledges private lab results should there be any problems detected ( but hopefully not)

Hollybushroad profile image
Hollybushroad in reply to Hollybushroad

Hi again SeasideSusieThank you so much for your helpful reply. I'm still getting used to how this forum all works ( as I previously mentioned I'm really not up to date with technology and no computer)

After msg Slow Dragon re no answers to a question I put on forum a few days ago he said I wasnt clicking reply button underneath the members comment and that's why I didn't get a response. ( Although I did get responses when I initially joined the forum a couple of weeks ago.) Not sure if you can see my initial posts.

Could you clarify for me when I press reply underneath this post does everyone on the forum read it or just you?

Obviously I want all members input but just not sure I'm doing it right.

ReCortisol saliva test:

I was able to cancel my saliva cortisol test from medichecks first thing this morning as they hadn't yet tested the samples so thankfully they are providing me with a full refund ( very impressed with their customer services)

I will order saliva cortisol/ DHEA from Regenerus as you recommended.

Re B12 resting

I am definitely going to pursue further investigations re possible B12 deficiency with MMA testing esp with my mum having had pernicious anaemia. I do seem to have alot of symptoms esp neurological which is quite scarey .But suppose it cud be my thyroid....hard to know as obviously they are all inextricably linked.

Mum also had coeliac but I got checked a few years ago for it and result was negative (that's when I had a good caring GP)

Re CRP

Think I have made another big boob 😂 ....I just sent of my anaemia panel to monitor my health this morning so won't be from same blood draw as CRP test kit from Medichecks when it arrives Is it really essential that both tests come from same blood draw I really should stick to one lab for all tests but unfortunately not all tests available on Monitor my Health.(I have Terrible brain fog and so much info to absorb). I actually do feel like I have early onset dementia sometimes and it's scarey how my cognitive abilities are gradually declining.

Yes I had same thought re GP possibly not accepting private lab results and asking them to do it....good minds think alike!

PS could I possibly ask one last question....I have noticed a very gradual swelling of my neck over past year.... probably a lot longer actually. I feel like I've developed a double chin which is not in keeping with my general body mass as I'm a fairly slim build. Also feel my face is getting puffier. I don't feel any lumps as such but my gland does feel quite tender to touch...not painful just tender. I done the swallowing water while looking in mirror with head tilted back check but not really sure if there anything significant. As I said neck just feels tender and swollen but no bumps as such. I avoid eating lumps of meat as I do find it quite hard to swallow and always afraid of choking. haven't even approached my GP about it...I just would imagine her saying ....sure u have hashimotos and nothing to worry about.

Do you think I could possibly need athyroid ultrasound ?

I appreciate it's hard for you to know with not actually seeing me but it's been on mind for a while now.

Once again thanks so much for all your very helpful info

Jaydee1507 profile image
Jaydee1507Administrator in reply to Hollybushroad

You will see if you have replied correctly for someone to get an alert at the top of your reply when published.

In this case you pressed the reply button under your own response so SeasideSusie won't get an alert.

Use the reply button directly under the persons reply that you want to respond to.

I have 'tagged' SeasideSusie by typing @andthenhername You can see the text light up so now she will get an alert.

reply to self
Hollybushroad profile image
Hollybushroad in reply to Jaydee1507

Hi Jaydee1507 Thanks so much for trying to clarifying my issue. but I'm still confused... I'm terrible with technology. I have pressed reply under your post but surely I need to also press reply under my own post as well in order to send it to u??? Does everyone else on forum see this or just you???

Please let me know if u get this post so I know if I'm doing it right

humanbean profile image
humanbean in reply to Hollybushroad

You (and me) are currently typing in the public forum and every member of this forum can read everything that we've typed. The point is that only you will get an alert about this - nobody else will. Note that above this reply it says "Reply to Hollybushroad".

But people who haven't got an alert about this will still be able to see what is written in this thread by anyone. But they have to choose to look and read, they don't get a "nudge" which is all that an alert is.

If you want to send private messages that only you and the person you are writing to you can read then you have to use the private messaging system which you'll find when you click on "Chat" at the head of the page. It takes you here :

healthunlocked.com/messages

I should point out that anyone sending a private message might offer suggestions that are incorrect and nobody will know and correct the mistake (because the only people who read this incorrect suggestion are you as the sender/recipient and the author of the mistake). If something is written on the public forum then mistakes are much more likely to be corrected.

Also, the members and administrators cannot be assumed to be doctors. This is a patient-to-patient forum and people make suggestions based on their own experience and reading. None of it can be guaranteed to be right.

Obviously if you want to write to a specific individual about something extremely private then the Chat system is the thing to use because the forum members and the general public can't read what the chat was about.

Hollybushroad profile image
Hollybushroad in reply to humanbean

Hi HumanbeanThanks for your help. If everyone else can see this they will think I'm a complete idiot😂 but sure I'm anonymous thank goodness!

But yes my aim is to put my questions to all members on forum ( not just private msg to one member) so as to get as much feedback as possible . I'm really finding this forum fascinating. Have learnt so much about thyroid.

Now if only I could learn how to actually send MSG's to everyone 😂

humanbean profile image
humanbean in reply to Hollybushroad

Well your message that starts "Hi Humanbean" can be read by any members who choose to read this thread. But that is what a public forum is all about. :)

And don't forget - we were all new once. You aren't doing any worse than other people do when they first start using the forum.

Hollybushroad profile image
Hollybushroad in reply to humanbean

Thank you that's very reassuring. Appreciate everyone's patience 😊

tattybogle profile image
tattybogle in reply to Hollybushroad

Jaydee will see your reply .. and she will also get an 'alert' because you used the reply box directly underneath her comment (we can see you used the right reply biox because it says " Hollybushroad~ in reply to Jaydee1507 " above your reply(

The rest of us can all read your comment to jaydee, if we happen to look at this post , but we don't get an 'alert' that you made a reply , because your reply wasn't directed to us.

So yes , you first click on the reply box directly underneath the persons comment you are answering ~ which opens up a new box to write in .. you write your reply in the box which opens up .... and then click reply again (at the bottom of that new box) to post it... the person you replied to will then get an alert .

The other person who gets an alert when someone answers anywhere on their post is the person who wrote the original post.. but in this case , that person is also you , because this is your post ... hope that makes sense :)

Hollybushroad profile image
Hollybushroad in reply to tattybogle

Awh thank you so much for your clarification. Ur step by step instructions have really helped. The penny has finally dropped 😂 and it makes total senseBetter late than never 😊

Jaydee1507 profile image
Jaydee1507Administrator in reply to Hollybushroad

You clicked the correct reply button then and I got a notification. You can also see once its published that it says "in reply to Jaydee1507".

You only need to click reply under the persons response that you are replying to.

Everyone in this forum can see this post or on the HealthUnlocked forum. You have an anonymous name though so nothing can be traced back to you personally. 🙂

Hollybushroad profile image
Hollybushroad in reply to Jaydee1507

Thank you for all your help and patience

SeasideSusie profile image
SeasideSusieRemembering in reply to Hollybushroad

Hollybushroad

I've been out for a few hours and I see others have answered your queries about replies :)

Think I have made another big boob 😂 ....I just sent of my anaemia panel to monitor my health this morning so won't be from same blood draw as CRP test kit from Medichecks when it arrives Is it really essential that both tests come from same blood draw

Yes, because if you have any inflammation showing on your CRP then ferritin will be raised as well, the elevated CRP will alert you to the inflammation and that your ferritin level will not be your normal level. If you test ferritin without CRP you wont know if it's a true ferritin result because you wont know if you have any inflammation.

If GP did a ferritin test chances are they wouldn't do a CRP test as well unless they were specifically looking for inflammation. There's an awful lack of joining the dots where tests are concerned.

Have you actually been diagnosed with Hashi's? An ultrasound is one way of identifying Hashi's, the other of course is raised antibody levels. This is not something I have experience of so I really don't know if you would benefit from an ultrasound.

Hollybushroad profile image
Hollybushroad in reply to SeasideSusie

Yes another boob I fear I've made with CRP and ferritin testing separately😂Thanks for that....I will do retest combining the 2. Ur explanation makes total sense.

(Medichecks will b making a fortune out of me 😂)

Oh yes I have known for years I have hashimotos. I have raised TPO antibodies. 489 iu/ml on my last test on 16th may. I posted my private TFT results on this forum a couple of weeks ago. I don't know if you can read my previous posts.I don't think I'm being adequately treated with Levothyroxine as my TSh and T4 are within range???..... As per GP but I've learned from this forum that meanings nothing so that's why I got full thyroid panel done privately.

Long story but I have various physical symptoms....too numerous to mention here but the most debilitating symptom for me has been severe treatment resistant depression which has cost me my career, my marriage and loss of friendships.

I sent a post to slow dragon about a week ago thinking it was to open forum but only he/she replied but he/she explained to me the error I had made. My post basically summarises my current problem and possibly being misdiagnosed with bipolar??? I'm not sure if you can access the post but feel free to check as any input from others is greatly appreciated

Many thanks again for all your help

Hollybushroad profile image
Hollybushroad in reply to SeasideSusie

I can't seem to find the combined iron and CRP test u recommended on medichecks. They appear to b 2 separate test kits. Can't find the combined test on any other labs either

SeasideSusie profile image
SeasideSusieRemembering in reply to Hollybushroad

I ready linked to the full iron panel with Medichecks inone of my replies above. Here it is again.

Iron test:

medichecks.com/products/iro...

Hollybushroad profile image
Hollybushroad in reply to SeasideSusie

Sorry bout this but that test only checks iron not CRP as well. as I was looking at it myself.I'm really confused. I thought you meant it was a combined test for both iron and CRP???

SeasideSusie profile image
SeasideSusieRemembering in reply to Hollybushroad

No, it has 5 biomarkers as mentioned here:

Now see next reply.

SeasideSusie profile image
SeasideSusieRemembering in reply to SeasideSusie

CRP

Click on "Iron Status" below the word "Inflammation" and you'll see what's in the next reply.

SeasideSusie profile image
SeasideSusieRemembering in reply to SeasideSusie

The other 4 tests.

All make up the full iron panel as I described.

I do this test myself quite regularly.

Hollybushroad profile image
Hollybushroad in reply to SeasideSusie

Sorry about that....Yes of course I can see now CRP is mentioned.

Thanks again for all your help. Will post results next week

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