Help with supplements: I recently had bloods... - Thyroid UK

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Help with supplements

NicoleHam profile image
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I recently had bloods taken and the doctors has prescribed 100 mcg of levothyroxine which I have started. I had a lot of symptoms and just had a baby but suspected thyroid issues before as it runs in my family & had symptoms.

Based on the results what would be the advice on dose and which supplements to help get me healthy again. I take iron everyday but that’s it. Do you think the levothyroxine dose seems appropriate, I’m a bigger woman although haven’t weighed myself in years and the doctor told me it was based on weight.

serum iron level 16umol/L (5.8 - 34.8)

serum tsh level 9.20mu/L

serum ferritin level 4.14ug/L (30-400)

serum vitamin b12 302 mol/L

Serum folate level 4.0 mol/L

serum free t4 level 11.3pmol/L (11.9-21.6)

any help would be great!

Thank you!

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NicoleHam
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SlowDragon profile image
SlowDragonAdministrator

serum ferritin level 4.14ug/L (30-400)

Is the ferritin really only 4

GP needs to do full iron panel test

Likely need iron supplements

serum vitamin b12 302 mol/L

Serum folate level 4.0 mol/L

Please add ranges

Both look low

You need vitamin D tested too

Which brand of levothyroxine have you started on

Take levothyroxine on empty stomach and then nothing apart from water for an hour

NicoleHam profile image
NicoleHam in reply toSlowDragon

Thank you for your reply! sorry that was a typo

Serum Ferritin 41.4 (30-400)

They did full irons:

Serum iron level 16 umol/L (5.8-34.8)

unsaturated iron binding capacity 46 umol/L

Total iron binding capacity 63 umol/L (30.0-105)

percentage iron saturation 26% (13-45)

Not too sure what any of that means. They didn’t offer any supplements but I’ve been taking liquid iron on an empty stomach for the last 3 months so does that mean it’s not really working?

B12 302mol/L (191-663)

folate 4.0 ug/L (3.9-26.8)

Vitamin D was tested 3 months ago 65mnol/ L (30-200)

The levothyroxine is mercury pharma.

Thanks again!

SlowDragon profile image
SlowDragonAdministrator in reply toNicoleHam

So improving B12, folate and vitamin D by supplements will help improve symptoms and how you tolerate taking levothyroxine

Only add one supplement at a time, then wait 10-14 days to assess before adding another

Suggest you start with B12, then vitamin B complex, then vitamin D

SeasideSusie profile image
SeasideSusieRemembering in reply toNicoleHam

NicoleHam

Serum Ferritin 41.4 (30-400)

They did full irons:

Serum iron level 16 umol/L (5.8-34.8)

unsaturated iron binding capacity 46 umol/L

Total iron binding capacity 63 umol/L (30.0-105)

percentage iron saturation 26% (13-45)

Not too sure what any of that means.

Optimal iron panel levels according to rt3-adrenals.org/Iron_test_... are:

Serum iron: 55 to 70% of the range, higher end for men - yours is 35.17%

Saturation: optimal is 35 to 45%, higher end for men - yours is 26%

Total Iron Binding Capacity (TIBC): Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is 44% through range so just under half way

Unsaturated Iron Binding Capacity (UIBC) - This test measures how much transferrin isn’t attached to iron [whereas TIBC tells how much transferrin (a protein) is free to carry iron through your blood] but unfortunately I've never seen an optimal level for UIBC.

Ferritin - because of the different ranges for ferritin it's difficult to give a percentage to aim for but some experts say the optimal level for thyroid function is 90-110ug/L.

They didn’t offer any supplements

Your GP wont offer prescribed iron for your results because they are all within range and none are even close to the limits to make them borderline.

but I’ve been taking liquid iron on an empty stomach for the last 3 months so does that mean it’s not really working?

It's not possible to say if it's working unless we see results for these tests before you started taking the liquid iron. If you have them can you post them so that we can comment.

JAmanda profile image
JAmanda

Start with this dose and retest in 8 weeks. If your tsh isn’t responding and say 1 or below and your t4 and T3 higher in range with you feeling a bit better, ask for an increase in dose.

Start taking folate - depending on range it’s likely under or low in range. This as much as anything can make you feel a lot better.

Meanwhile increasing iron rich foods in your diet to improve ferritin level up to around 70

SlowDragon profile image
SlowDragonAdministrator

B12 and folate

Low B12 symptoms

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and a 10-14 days later add a separate vitamin B Complex 

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

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

Thorne Basic B 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

Other options

healthunlocked.com/thyroidu....

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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 until B12 over 500

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator

vitamin D

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is 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...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

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...

waveylines profile image
waveylines

In addition to the great advice already posted. Has your GP checked you for absorption issues.... ie Coeliacs and PA. Both are blood tests the GP can do. It's common with Hypothyroidism for b12, ferritin, folate and vit D to be low but it's really best to get checked out that there isn't another factor involved.

NicoleHam profile image
NicoleHam

Thank you so much for all your helpful advice and suggestions. It really is so helpful and it's taken me a while to read through everything you've sent. When there is no where else to turn this is a great forum to support.

Could you provide some final advice on when to take what. I have purchased: B12, Folate, magnesium, vitamin D and complex B. I already started the Levothyroxine which I take first thing in the morning on an empty stomach and an hour later liquid iron so would just like some guidance on what time of day I should take the others introducing a new one every 14 days as you've suggested.

Also how often should the GP be redoing bloods? I only have a months worth of levothyroxine so I'll need to make a follow up appointment but don't understand why they only prescribed a month when they suggested bloods in a couple months time, does all that sound right?

thank you!

SeasideSusie profile image
SeasideSusieRemembering in reply toNicoleHam

NicoleHam

I have purchased: B12, Folate, magnesium, vitamin D and complex B.

B vits should be 2 hours away from thyroid meds.

Vit D and magnesium should be 4 hours away from thyroid meds.

First of all, don't start all supplements at the same time, start with one, give it two weeks to see if you have any adverse reaction, if all OK add in the second supplement. Again, give it two weeks to see if any adverse reaction and if not add in the third supplement. Continue like this and if you do have any reaction you will know what caused it.

B Vitamins should be taken no later than lunchtime as they can be stimulating so you wouldn't want to take them with your evening meal as they might interfere with your sleep, so B12, folate and B Complex could be taken with breakfast or lunch.

Magnesium is calming so you'd be best taking this in the evening as it may help sleep.

I already started the Levothyroxine which I take first thing in the morning on an empty stomach and an hour later liquid iron

Iron should be taken 4 hours away from any thyroid meds and 2 hours away from any other medication or supplements, this is because it will affect their absorption. I know yours is liquid but it still goes to your stomach (unlike sublingual supplements which are absorbed through the mucous membranes in the oral cavity) so would have the same effect as if it was in tablet or capsule form.

You could perhaps take your iron at lunchtime if you take all the others either with breakfast or evening meal.

NicoleHam profile image
NicoleHam

hi again, I’ve had further bloods taken after all of the above. The doctor refused to do full bloods so only did TSH & vitamin D.

After all of the above I started on 100mg of levothyroxine as well as all the supplements. After 8 weeks I didn’t feel much better so increased to 150mg. I started to get headaches & bad mood swings so reduced it back to 100mgs. The symptoms persisted so I lowered to 50mgs and that seems to be a good dose for me. I have been on 50 for about 3/4 weeks.

My results were

Serum TSH 3.70 (0.27 - 4.2)

Vitamin D 86nmol/l 30.00-200

I am also now pregnant, very early days so just wanted your advice on whether you think these are in good ranges or if I should be pushing the doctor for anything else to be done. They don’t know about my dose changes because it took too long to speak to anyone who actually understood so did it all off my own back. I also continue to take B12, folate, vitamin D, iron and magnesium.

Thank you

Nicole

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