Recent results following increase in Levothyrox... - Thyroid UK

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Recent results following increase in Levothyroxine dose.Anything of note?

Pebble23 profile image
7 Replies

HiFollowing advice on the forum I asked GP for screening for Vit D etc at my recent review of increased dose.

I have generalised osteoarthritis and a family rich in autoimmune diseases.

Please see my results.

The only comment made by GP is that Vit D a bit low and to take over the counter supplement.

Results

TTG abs (lgA) 0.5 U/ml

Range - 0 - 10 U/ml

Immunoglobulin A 1.56g/L

Range 0.7 - 4

CCP abs 0.9 U/ml

Range 0 - 7

Folate serum 6ug/L

Range 2.4 - 20

B12 339ng/L

Range 197 - 771

TSH 1.72 mlU/L

Range 197 - 771

Ferritin 58ng/ml

Range 13-150 ng/ml

Rheumatoid Factor 11.6iu/ml

Range. 0-30

Vit D 46nmol/L

Range 25 - 125

Calcium corrected for serum/plasma 2.39 mmol/L

Range 2.2 - 2.6

Phosphate 1.16 mmol/L

Range 0.8 - 15 mmol

Albumin 42g/L

Range 35 - 50.

Unfortunately no T4 or T3.

Other than Vit D,is there anything else I should be acting on ?

Thank you.

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Pebble23
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SlowDragon profile image
SlowDragonAdministrator

So looking at previous post

healthunlocked.com/thyroidu...

After a fight you got Levo increased to 75mcg daily 2 months ago

Which brand of levothyroxine are you taking

Just testing TSH is completely inadequate but frequently all NHS will test

You will need to test TSH, Ft4 and Ft3 together yourself privately

All your vitamins are on low side, suggesting you’re still in need of further increase in levothyroxine

Recommended that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Cheapest for just TSH is Monitor my health at £32

Plus 10% off with code from Thyroid U.K.

monitormyhealth.org.uk/thyr...

Suggest you Order test kit

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Meanwhile start working on improving low vitamin levels by supplementing as this will improve conversion rate of Ft4 (levothyroxine) to Ft3 (active hormone)

SlowDragon profile image
SlowDragonAdministrator

Folate serum 6ug/L Range 2.4 - 20

Optimal at least over 15-18

B12 339ng/L Range 197 - 771

Optimal at least over 500

Ferritin 58ng/ml Range 13-150 ng/ml

Aim to maintain over 70

Vit D 46nmol/L Range 25 - 125

Vitamin D at least over 75nmol and between 100-125nmol may be better

Pebble23 profile image
Pebble23 in reply to SlowDragon

Thank you Slow DragonI am now well versed at not taking the Levothyroxine before blood test and my test was at 8 am.

I even have my 90 year old mother following this practice!

To make up the 75 mg I have prescribed 25mg....Teva UK and 50mg Accord.

Sounds like I need to get a private test and take some supplements and re test a couple of times a year.

Thank you for the links.

Plenty of bedtime reading for me.

SlowDragon profile image
SlowDragonAdministrator in reply to Pebble23

Teva brand levothyroxine upsets many people

Next time try Mercury Pharma or Wockhardt

We recommend getting FULL thyroid including thyroid antibodies and vitamins at least once a year

Then just TSH, Ft4 and Ft3 Approx 6-8 weeks after any dose change or brand change in levothyroxine or starting or stopping HRT of after any lifestyle change eg going gluten or dairy free or significant weight change

SlowDragon profile image
SlowDragonAdministrator in reply to Pebble23

Vitamin D

Suggest you try Vitamin D mouth spray by Better You

It’s 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...

Taking 3 sprays per day = 3000iu

Retest in 3-4 months

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

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...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

SeasideSusie profile image
SeasideSusieRemembering

Pebble23

The only comment made by GP is that Vit D a bit low and to take over the counter supplement.

Vit D 46nmol/L (= 18.4ng/ml)

Did he tell you how much to take and the important cofactors needed when taking D3? No, I expect not.

You might want to check out a recent post that I wrote about Vit D and supplementing:

healthunlocked.com/thyroidu...

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 46nmol/L = 18.4ng/ml

On the Vit D Council's website

web.archive.org/web/2019070...

you would scroll down to the 2nd table

My level is between 10-20 ng/ml

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).

So now you look at how much is needed to reach 50ng/ml and you'll see that they suggest 4,900iu per day (nearest is 5,000iu).

Retest after 3 months.

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:

vitamindtest.org.uk/

Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.

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.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.

For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.

For Vit K2-MK7 my suggestions are Vitabay, Vegavero or Vitamaze brands which all contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.

Vitabay and Vegavero are either tablets or capsules.

Vitabay does do an oil based liquid.

Vitamaze is an oil based liquid.

With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops.

They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.

Another "all trans" one worth considering if the others aren't availaable:

amazon.co.uk/Vitality-Biore...?

Another important cofactor is Magnesium which helps the body convert D3 into it's usable form.

There are many types of magnesium so we have to check to see which one is most suitable for our own needs:

naturalnews.com/046401_magn...

explore.globalhealing.com/t...

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

swansonvitamins.com/blog/ar...

Folate serum 6ug/L Range 2.4 - 20

This is on the low side. Folate is recommended to be at least half way through it's range. A good quality B Complex will help here, eg Thorne Basic B, Vitablossom Liposomal, Yipmai Liposomal or Pink Tribe Liposomal are all good ones used by members here. B Complex needs to be stopped 3-7 days before any blood test as it causes false results.

B12 339ng/L Range 197 - 771

This is rather low and some people with B12 in the 300s have been found to need B12 injections.

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 don't have any you could supplement with a sublingual methylcobalamin B12, one bottle may be enough, also take B Complex with B12 to keep all B vits in balance. Once your B12 has reached 500 plus you could drop the separate B12 and just continue with the BComplex.

TSH 1.72 mlU/L Range 197 - 771 - that's the range for B12 not TSH.

TSH is still rather high for someone taking Levo. Most Hypo patients tend to feel best when TSH is 1 or lower.

Without FT4 and FT3 we can't get a full picture of thyroid status. These are the actual thyroid hormones, TSH is a pituitary hormone and not much use once diagnosed and should not be used to determine thyroid status or to adjust dose.

Ferritin 58ng/ml Range 13-150 ng/ml

This is low, some experts say the optimal ferritin level for thyroid function is 90-110ug/L.

It would be worth doing a full iron panel to include

Serum iron

Saturation percentage

Total Iron Binding Capacity

Ferritin

to see if you have low iron as well as low ferritin. Don't self supplement with iron tablets unless you do an iron panel first, if your serum iron and saturation are already good then you risk raising them to toxicity level if you take iron tablets.

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

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

Pebble23 profile image
Pebble23 in reply to SeasideSusie

Thank yo so much for this information Seaside Susie....you are quite right,there was no advice as to dose of Vit D or other considerations.Coincidentally,my opthalmologist has advised me to trial 4 capsules of Omega Eye.

This dose,as stated on the bottle,states is equivalent to Vit D(as D3 Cholecalciferol). 25ug.

I will certainly do the calculation you suggested.

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