Hi all, I've just had my latest Blue Horizon results (see image) which I would welcome comments on, particularly regarding the vitamins and minerals I might need to supplement. All blood tests were done no later than 9.30am, no levo for 24 hours before. I've worked really hard this year on my diet, but my Free T3 has barely shifted. I eat loads of veg, nuts and seeds, meat, no gluten (finally committed to it), no dairy (many years). The only supplements I take daily (with evening meal) are fish oil capsules (2000mg), and vitamin D3 (10mcg). I take my levo at 7am with water, nothing else for at least an hour. I think I've reached my upper limit with the levo. I have been feeling much improved, so I was probably very low previously in some vit/min (unfortunately didn't get that tested at beginning of year 🙄).
So my next steps will be to supplement vit/minerals as necessary, and then see a private endo to get a prescription to trial some T3. Any suggestions who (Scotland)?? Please message me direct. Thank you in advance for all your advice. This forum is a life saver!
Diagnosed with Graves 2014
RAI 2019 : 100mcg levothyroxine since then
Jan 23 results : 100mcg levothyroxine
TSH 0.8 (0.27-4.20)
FreeT4 19.9 (12-22)
FreeT3 3.66 (3.1-6.8)pmol/L
magnesium 1.04 (0.7-1.0)
cortisol 8am 512 (166-507)
Feb 23 results :
Retest cortisol 342 (133-537)
Levothyroxine increased from Feb 23 : 112.5mcg
June 23 results:
Magnesium 1.14 (0.7-1.0)
Cortisol 270 (166-507)
TSH 0.18 (0.27-4.20)
FreeT4 21.8 (12.0-22.0)
FreeT3 3.82 (3.1-6.8)
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Forestgarden
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Your Vitamins do look on the low side. It's not enough for those of us with hypothyroidism to scrape into the bottom of the range we need to be at least mid way.
SlowDragon as loads of links to information on vitamins and minerals to help with this. She has shared on many posts. If you ever want to read information you can click on the person's icon and it will go to their profile. Here you can see their bio, their posts and their replies. This is a really knowledge dense forum if you work out how to navigate it - can take a while!🤗😉
I would read around the introduction of supplements - the key is one at a time and bioavailable forms. I and many others here would not reccommend multivitamins as they counter each other (cancelling out) and are often the cheapest preparations, not necessarily the most effective or bioavailable. In other words what goes in comes out the other end with very little benefit.
Once vitamins are optimised and having been on them for a while you can then see if your conversion improves. Everything has to be not just in range but ooptimal, vitamins, minerals and thyroid hormone work in concert.
Your FT4 is slightly over range and your FT3 is lower than one would hope. Have you come across percentagersz within range? I have a post discussing how it can be calculated for your results and it takes away the number bias whern a range starts above 0 it can be difficult to see just from the numbers where in the range one sits but a percentage makes more sense of it.
I will go and have a dig in my profile and find try to link this for you.
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.
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
SlowDragon has provided you with the ultimate bundle of info links on vitamins and minerals. Amazing resource! 😀👍Just work through slowly - so worth it!
Thanks all. This is just what I needed. My weekend reading! I won't be bothering going to the gp, after all my results are 'within range' , plus I don't want my levo reduced!
Edit: will ask gp to test for pernicious anaemia though (just won't share my tsh)
Your active B12 is low so I'd definitely get tested for PA before taking any forms of B12. You probably won't be offered all of the tests for PA on the NHS but they are available privately. Head over to the PAS forum for further info and advice.
Vitamin deficiencies tend to come in little groups, especially if absorption is the issue. Lack of screening and an understanding of deficiencies is the problem as we can be deficient for years and not realise until symptoms appear. More Pandora's box in my case. We learn the hard way sadly ☹️
Hi Forestgarden. In scotland you are entitled to a 3 month trial of t3 if you have unresolved symptoms on t4 only. The tricky bit is getting endocrinology to accept the referral. My gp wrote 3 times and it was knocked back 3 times. I saw a private Dr, noted trial successful then raised a complaint with my nhs healthboard. My surgery wouldn't accept the recommendation from private to prescribe t3. It had to come from nhs endo. Yours might! Also, they altered my dose, so I refused to end the trial until I felt better. My three month trial lasted about 9 months. I am more than happy to share the details of private Dr but I am having a brain fart and can't remember how to private message! Good luck.
I'm also in Scotland. After the trail, did you continue with T3? I've been on extended release T3 only (started in the USA) but my GP left and the new one would not continue with what has worked well for over 23 years. My new prescription will be 125 mcg T4 an 20 mcg T3 when I collect it in about a week. However, I am going to see a private Endo to consider Erfa, as my sister is using that a feels really good. I'm curious if the T3 was a temporary thing. Many thanks.
HiYes, the endocrinologist wrote to gp to continue prescribing. I have a bit less flexibility within the nhs but I don't have to pay for t3 so for that I'm grateful!
Thats interesting. Did you get all your vitamins and minerals optimised before asking for T3 trial? I feel like its a one barrier after another ... first take the t4 and see how you feel, then improve your diet and see, then check your vitamins and minerals, supplement, and see how you feel... then, still feeling exhausted with limbs of lead, and not prepared to put up with it? Ok, if you kick up enough of a fuss, we might consider t3
It does feel like you have many hoops to jump through! But yes, I had found this forum by then and realised that my gp was keeping me woefully undermedicated. I had b12, folate and vit d all at good levels by then. The private endo asked about them but none of the nhs medics did. One gp told me to improve my health by improving my diet but knowing what I know now, I don't think that would happen. I had a healthier diet then than now. Fatigue feeds my biscuit habit now. Most other health conditions come with choices. I find it baffling that thyroid treatment is handled the way it is. If you didn't experience it yourself, you'd think folk were making it up! The way they make you feel it's you whose not eating right or exercising right or taking the tablets right is unbelievable! If you want the private endo details pm me! It was a real turning point for me!
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Results - don't know what to make of them
Vitamin and mineral advice please - edited and added thyroid results
My latest blood results
Vitamin, mineral results 
