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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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)
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.
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
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
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 until B12 over 500
Post discussing how biotin can affect test results
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.
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?
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.
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.
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