latest blood test results Graves’ disease

[Yoga54]

Hope everyone is enjoying the new year and your valuable thoughts on my latest blood tests would be appreciated, I have Graves’ disease and been on medication for 20 months now on block and replace with carbimazole reduced from 40mg to 20mg 3 months ago. Next appointment with endocrinologist in April. Thank you for taking the time to read my results, hopefully clear enough photos as I’m a bit of a computer dinosaur unfortunately.

[Forestgarden]

Hi there, how are you feeling on this dose? Your t4 is towards the top of the range

[Yoga54 in reply to Forestgarden]

I feel fine most days although my feet ache and sometimes feel a bit low and stressed out but that’s not too often thankfully

[Forestgarden in reply to Yoga54]

I think ideally your free t4 would be a little lower, and your free t3 a bit higher, but obviously you don't want to rock the boat too much if you're generally feeling ok. It is essential that your vitamins and minerals are 'optimal' so that your cells can convert t4 to t3, so this may be an area you need to investigate

[Yoga54 in reply to Forestgarden]

Thank you I will investigate further, I hadn’t thought much about vitamins before as I was so busy concentrating on feeling better, felt fantastic on carbimazole alone and probably 90% on block and replace, radioactive iodine was mentioned at my last appointment but I said I wasn’t happy about taking it and they said that was absolutely fine

[Forestgarden in reply to Yoga54]

Resist RAI as long as possible! Thats another can of worms...

[Yoga54 in reply to Forestgarden]

I know I really don’t want to go down that road if I can help it

[pennyannie in reply to Yoga54]

Hey there Yoga - I think I've written to you before - haven't I ?

I may have already sent you these research papers but please read and copy so you have some medical facts to defend your stance on not wanting RAI thyroid ablation if the subject of definitive treatment comes round again :

pubmed.ncbi.nlm.nih.gov/338...

ncbi.nlm.nih.gov/pubmed/306...

All things Graves Disease - elaine-moore.com

[PurpleNails Administrator]

Had you taken Levo prior to test?

FT4 high in range & FT3 quite low.

Have you had folate, ferritin, B12 & vitamin D tested?

[Yoga54 in reply to PurpleNails]

yes I took levothyroxine 4 hours before, not sure if that was the right thing to do. I’m not aware of being tested for folate, ferritin or B12 and D

[SlowDragon Administrator in reply to Yoga54]

other post

healthunlocked.com/thyroidu...

Vitamin D must have been tested and found to be deficient (under 25nmol) as you are now prescribed LOADING dose vitamin D

That means 300,000iu of vitamin D over 6-8 weeks

Important to retest vitamin D at end of prescription

And you will need ongoing maintenance dose vitamin D going forward

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

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...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

ESSENTIAL to also test folate, B12 and ferritin

Test privately if NHS won’t test

[PurpleNails Administrator in reply to Yoga54]

If taking levo even as block & replace it's important to test as recommended.

Close to 09:00, fast overnight, delay replacement until after draw. Stop biotin supplements 3 days before.

Showing a peak FT4. Your block & replacement might need adjusting.