Before I spend my hard earned money on going to a private ENDO because the NHS is failing me I wanted to ask what you all thought about the problem of iron deficiency and vitamin D deficiency and how this relates to underactive thyroid . I read a lot here about how these vitamins should be optimal for the thyroid to function well. However I have supplemented them both for years (they constantly slip down if I stop) and my thyroid is still slow. I am on 100mcg T4 every day. I think I either need an increase of T4 or addition of T3, either as NDT or combination therapy but I wonder if the doctors would just say I need to get my vitamins and minerals up before we try that. Or, conversely, if I tried T3 would that improve my vitamin/mineral levels? How are the 2 related? I have never understood.
Thanks for any pointers.
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doingitfordad
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Your doctor, either GP or Endo is unlikely to mention vitamin levels as they don't have the trainign for that. It is us patients that have realised that these things are important.
Iron and vitamin D deficiency are common in the general population anyway. Being hypo reduces your stomach acid and makes the situation worse.
The last blood results you posted 4 months ago only show a TSH result. Have you had a full thyroid panel run recently - TSH, FT4 & FT3? Likely you would need to do this privately and would be good to hve to take a long to your first private Endo appointment.
All that said, if you are thinking of adding T3 then all vitamins should be at OPTIMAL levels to help you tolerate T3.
Do you have recent vitamin results?
What are you taking for iron? Do you take it with orange juice or anything containing Vit C to help it absorb better?
Low thyroid hormone levels will increase the malabsorption effect of vitamins, so adding some T3 (should you need it) will help you retain and absorb vitamins.
So my T4 has dropped a bit from 48% through range to 43% (by my calclulations which might be wrong!) and my T3 in September was 30%. My Ferritin is always low and has sometimes been lower that this and I started taking iron in June (between 400-600mg of Ferrous Fumarate and Ferrous Gluconate, with orange juice daily) with little effect as you can see. I have some loading dose Vitamin D tablets from a previous prescription of 500mcg of which I take 1 a week. I eat a really good diet including meat and lots of green vegetables so don't take much else. My question is with these stats would I be better improving my iron and vitamin D to see if I get more energy or T4/3 go up or go to the private endo now and ask for NDT or T3? Or even an iron infusion. I am lethargic and sometimes need to sleep in the afternoon when I am not working. I can't muster the energy to exercise and I want to lose weight.
I do my tests as advised, in morning not after Levo etc.
BEFORE considering booking any consultation you need to get full thyroid and vitamin testing done
Exactly what vitamin supplements are you taking
Many (most?) thyroid patients need to supplement vitamin D, magnesium and B complex continuously to maintain optimal vitamin levels
Important to get vitamin levels and levothyroxine dose optimal before considering T3
A) you might not then need T3
B) good vitamin levels makes it easier to start on T3 or NDT
C) going to consultation without recent results is waste of time and money
What are your most recent thyroid and vitamin results
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test 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
So my T4 has dropped a bit from 48% through range to 43% (by my calclulations which might be wrong!) and my T3 in September was 30%. My Ferritin is always low and has sometimes been lower that this and I started taking iron in June (between 400-600mg of Ferrous Fumarate and Ferrous Gluconate, with orange juice daily) with little effect as you can see. I have some loading dose Vitamin D tablets from a previous prescription of 500mcg of which I take 1 a week. I eat a really good diet including meat and lots of green vegetables so don't take much else. My question is with these stats would I be better improving my iron and vitamin D to see if I get more energy or T4/3 go up or go to the private endo now and ask for NDT or T3? Or even an iron infusion. I am lethargic and sometimes need to sleep in the afternoon when I am not working. I can't muster the energy to exercise and I want to lose weight.
I do my tests as advised, in morning not after Levo etc.
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and a week 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
Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose
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
Post discussing how biotin can affect test results
Your ferritin has gone up 20 points so I wouldnt say thats little effect. It is notoriously slow to raise ferritin. Keep going with what you are doing. It may take another 6 months but it will be worth it. If you had to pay for an iron infusion it would cost you the best part of £800+, just saying.
I see that SD has replied also now so I won't confuse you by giving too much further advice about vitamins. What I would say is that low B12 inparticular can lower your TSH and conversly if you raise B12 it will raise TSH, so working on getting B12, also folate & ferritin to OPTIMAL will help your cause with your TSH and getting Levo increased.
Low vitamin levels will mean you might struggle to tolerate anything containing T3. Its quite different to Levo.
I would recommend a Levo increase alongside inproving vitamins.
Thank you both for such detailed replies. Have just ordered Vitamin D with K2 spray and a vitamin B12 complex, will continue with iron (not sure I have gone up much as the range was different for each blood test). I need to be more focussed on all this and not let it slide. I weigh about 80kg and am on 100mcg Levo a day which I realise is under the guidance of 1.6x weight in kilos. I doubt my GP will let me go up because my last TSH is under, but what do they know. Also I can't take TEVA and I'm not sure if anyone else does 25mcg? Out of interest do you recommend levo away from food or not? I need to make a plan of which things to take when, keeping iron separate is I think the most important?
I believe Mercury Pharma do a 25 mcg tablet, also Wockhardt who only make a 25 mcg dose (which I take in multiples to make up my dose). Other than that, you could ask for extra 50 mcg tablets of your preferred brand and cut in halve for 25 mcg.
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Should I optimise vitamins and minerals before “tweaking” thyroid medication? 🤔
Thyroid antibodies/vitamins/minerals/complete blood count
Vitamin and mineral advice please - edited and added thyroid results
Vitamin/ mineral advice please!
