I recemtly consulted a nutritionist about improving my gut health, and I wondered if I could ask for anyone's thoughts on what they are recommending please?
For context I am a 40 yr old male, diagnosed in 2020 and still suffer with fatigue mostly. I had a 6 month trial of T3 a year or two back but it did little for me (the private endo was not the most helpful in the end). It's likely I was (and am) undermedicated but also my vitamin levels are not amazing, hence wanting to focus on nutritional health before pushing to try T3 or NDT again.
So, the nutritionist has advised a bunch of tests, which are rather expensive:
CSA+P Comprehensive Stool Analysis With PCR+ Parasitology £325
Adrenal stress test £125
KBMO Fit 132 test (Unseen inflammation with food tests and gut markers ) (don't know how expensive)
Genova Diagnostics - Metabolomix+ (formally called the ONE Test) £305
In addition she has suggested a daily smoothie with specific ingredients (with their reasons why in brackets), which also add up to £130:
Organic Lion's Mane Mushroom (cognitive function, mood, digestion and immune system)
Bodybio Balance Oil (cell structure to hold nutrients)
Sunflower Lecithin Powder (for cell structure)
Basically this is a huge amount of money for me (my partner pays all the bills & rent etc, I only earn ~£200 per month at the moment) and I do want to invest in my health but I don't want to be led up the garden path. I thought I remembered Maca being questionable for hashis but not sure why.
Please, I would really appreciate any thoughts or advice you may have as this is making me quite anxious whether its the right thing to do or not.
Very much appreciated, thanks in advance
M
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I've had a quick look at some of your older posts. Just wondering how close you have ever got to optimally replaced with Levo+ T3 & all key vitamins being optimal also - ferritin, folate, B12 & D3?
It so happens I am seeing a nutritionist myself at the moment. Costs of tests and supplements can certainly add up, so you could just pick out which tests you think might be most relevant for now.
I did the Metabolomix+ test along with a fatty acid test which showed up nutritional deficiencies that so far I hadn't been aware of and I'm glad I did those tests. It will also give an overall picture of your gut health so you would then know if its worth pursuing further gut health testing.
If you did that first its a great starting point and you can then begin working on what issues show up. It turned out that my gut was better than I thought it was but I had worked on gut health a while ago.
As to the smoothie+ expensive ingredients, it does seem like a bit of an indulgence and fine if you have the cash for the ingredients but if counting the pennies I'd spend on the Metabolomix test.
I am very much into alternative, but the amount of stuff being pushed. 😱 How the heck would you know what’s working and what isn’t. I would really look at optimising your vitamin levels and making sure you were on the right dose of levothyroxine in the first instance.
Perhaps the diagnostic that Jaydee1507 has lived experience of and can speak to its benefits.
You can do many things to improve wellness without hand over wadges of cash at this stage.
I have a friend who was being lined up to pay £100’s for all sorts of stuff and they were not even going to look at nutritional deficiencies until a fair way into the process. Somewhat ‘cart before the horse’.
So, how's the view from the garden path? What I would want to know is how much of the profit goes to her! There's got to be something in it for her.
I don't think that Maca is particularly questionable for Hashi's. It is a kind of stimulant but I've never heard anybody that's taken it say that it did anything for them. Waste of time and money seems to be the general view. Certainly did nothing for me - good or bad. There's a lot of hype around the other ingredients, but it seems to me that if they were that good, we would all know about them.
I don't know about any of the tests but seems rather a lot in one go. Maybe just try one or two to see if you get any useful information, and if that doesn't help at all, do the others at a later date.
my vitamin levels are not amazing
Well, I'd start there if it were me. See how amazing you feel when they're optimal. It's got to be cheaper.
Thanks all; kind of confirming the niggling doubt I have in the back of my head.
greygoose - I would love to increase my vitamin levels but not really sure how to do so, for example I'm taking 2000iu Vit D daily and it's not really had an impact. Do I not need to improve my gut health in order to be getting more vitamins into my system? Sorry if that's a dumb question.
2000iu may not be enough to get your Vit D to optimal.
I'd get the basics in first before you go spending a lot of money on more tests.
Have you had ferritin, folate, B12 & D3 tested lately?
You dont need to improve gut health first. Sometimes its a chicken & egg situation with the gut and being hypo. If you raise vitamin levels and get your thyroid hormone levels more optimal then more will fall into place.
Have you had a private blood test done ever to check vitamin levels?
As JayDee says, it's possible that 2000 iµ is not enough to raise your vit D level. But, are you taking magnesium with it? You really do need to because the two work together. You also need to take vit K2-MK7 with it, because taking vit D increases absorption of calcium from food, and the K2 makes sure it gets into the teeth and bones, and doesn't build up in the soft tissues.
Are you taking any other supplements? It can be tricky, I know. But if you post your B12, folate and ferritin blood test results and ranges on here, there are a lot of people that will be glad to help you decide what to take.
As you're hypo, you probably have low stomach acid, and that's why you have trouble absorbing nutrients from food. Have you done the bicarb test to find out your stomach acid level?
The baking soda test
For the test, you'll drink half a glass (4 ounces) of cold water combined with a quarter teaspoon of baking soda, on an empty stomach. Then time how long it takes you to burp. If it takes longer than three to five minutes, the theory goes, you don't have enough stomach acid
I've spent the last couple of years trying to improve my gut health. I started from the point of trying to stop my silent reflux which caused a chronic cough, and resolve my chronic constipation. These have plagued me for decades. The more I read, the more I realised how my gut health affected my thyroid and psoriasis issues, not to mention brain fog etc.I started with an elimination diet to identify foods causing problems. I used this book ' the complete acid reflux diet book' by Nour Zibdeh.
What I should have done first is test my vitamin and mineral levels and optimise these.
The more I read, the more I realised I needed to reduce inflammation and heal my gut lining - bone broth, turmeric, fish oil tablets, a low histamine diet (as much as possible) for me, are key. I am also dairy and gluten free. Stress reduction is key - not just externally (work, home, dealing with dr's etc), but internal too. Reducing cortisol levels, yoga, mindfulness etc. I hardly drink and alcohol or caffeine. Might sound hard going, but I'd rather give up these things if I can actually function day to day. I have tried maca, but not convinced by it. I think the question mark about if it affects the thyroid is because its a brassica which can be goitrogens?? But I have read that as quantities are so small, its fine to take if you have thyroid issues.
I found it really useful to write down all my issues on separate pieces of paper and do some mind mapping. Its amazing the overlap I started to see between quite different problems. Inflammation for me stood out.... brain, gut, joints, thyroid of course... so that became my focus.
Good luck on your journey and spend your money wisely!
and test folate, B12 and ferritin at least annually
Exactly what vitamin supplements are you taking
How much levothyroxine/T3 are you currently taking
And are these always same brands
first (and cheapest) thing is to test thyroid and vitamins
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)
On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
I agree with comments that the nutritionist has overloaded on tests and supplements, particularly at 1st consultation. A better one would likely focus on diet first with 1 or 2 supplements. Was he/she qualified and BANT-approved?
Note: Ive had the expensive gut tests and found useful in various areas.
Yes, they are Bant approved, also IFM and CNHC, used to be a pediatric nurse then worked with MSF before retraining as a nutritionist. So I thought they would be coming from a broad range of experience but quite able to reference it within conventional medical practice. In the hour and a half session they waffled a lot, never saying things concisely. I basically spent a months wages on that first consultation but I felt I had done my research and that this person should be well qualified.Are there good nutritionists out there? This is the second I've seen and the first didn't fill me with confidence either.
Yes there are very good ones out there including one I had that's now retired. I can send you a link to options but only if you ask in view of your bad experience.
Maybe the one you had was in fact "spoiled" by past medical experience with limited appreciation of people's budgets? Just guessing.
Finding the right nutritionist for you (and your budget) isn't easy.
I'm on my second nutritionist. First only did a breath test and stoll analysis that didnt help much even once I tried the supplements. Put me on a multivitamin.
Second one I have more of an idea what I needed to know so doing better with this one.
You dont have to accept their suggestions and do make clear that your budget is limited.
Suspect you will feel a lot better optimising ferritin, folate, B12 & d3 to start with then take it from there.
I, with hindsight, I would never do anything to my body without knowing a ‘why’. It might not even be a correct ‘why’ but I would have an expected outcome to measure. It’s impossible with that list to have any control over what’s happening. It’s tempting to hand ourselves over to ‘experts’ but honestly, finding a true expert is fraught with difficulty. I would doubt very much that this ‘prescriber’ would have a clue what’s happening. Good or bad!
112.5mcg levo, reduced from 125 in May (I'm 6'2, 12 stone for reference) - always Accord
2000IU Vit D
3.75g magnesium malate
125 mcg vit k2
vitablossom liposomal b complex (400mcg folate, 500mcg b12 among others)
Haven't done the baking soda test yet although the nutritionist did suggest I do it... It's just it's supposed to be done on an empty stomach and not eat for an hour after (right?), trying to fit that in with taking levo in the morning and not pass out from not eating is stressing me out. I've started eating larger meals in the mornings so possibly could do it one evening if I ever got it together enough to think about it...
You would benefit from a Levo dose increase as you do have some room.
Optimal D3 is said to be 100-150 so try 3,000iu even 4,000iu vit D a day.
Your ferritin isnt terrible but if you could add in more liver each week it would help raise it to more optimal of around 100.
Are these results after you have been supplementing with the Vitablossom? If so then you need a separate B12 (1000iu) & also separate methylfolate (400mcgs).
You could take your levo at bedtime which many do and this works well.
I'm not familiar with the baking soda test but I'm sure google could help with details.
Yes I keep arguing for an increase in levo but am currently being reduced (the NHS endo I've just been referred to following moving is threatening a further reduction pending new blood tests).I have been using vitablossom for maybe a year or two now. Does anyone have a B12/methylfolate supplement they would recommend?
I have tried taking levo at bedtime previously but it didn't really work for me, I guess I could swap it around for a day or two though.
If your Levo is being reduced then thats not good. You need to make a case for a dose increase to get your FT3 level up a little more.
You can accept responsibility for a lower TSH with this evidence from the NICE guidelines. The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility”
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "
I'm no expert, but your vits are very low. Have you been tested for pernicious anaemia? It's the route I'm heading down now... when I can get an appointment with my gp
I think the Nutritionist should have at least taken your personal circumstances into account especially when recommending those ingredients. I don’t know what conversation you’ve had with her but your priorities and budget should have been made clear. Or she should have got that information from you.
As for the tests, I’ve recently done a Genova Metabolomix, Adrenal Stress Profile, SIBO and GI effects. They’re really expensive but I feel the investment was worth it. I feel I’m getting the help I should have received years ago. I hope you’re able to get the relief you need. Supporting and sorting out the gut is key for thyroid issues.
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