TSH and Vitamin results: Hello everyone, I... - Thyroid UK

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TSH and Vitamin results

sigmoid profile image
7 Replies

Hello everyone, I think it's been nearly a year since I was last on here!

Would like your views on my TSH results

17/1/24 taken before 9.00am no vitamins taken for a week

TSH 2.5 0.27 - 4.2

T4 14 12 - 22 pmol/L

T3 3.5 3.1 - 6.8

I'm taking 100mcg of Levo

Vitamin results..

Iron 143

ferritin 99

TSAT 39

B12 131

folate 7.8

Vit D 58

No ranges were given? MONITOR YOUR HEALTH they said they were all normal.

I've felt so weak and tired for the last 3 months. Have been taking B12, Magnesium and Selenium.

My T4 and T3 are not converting very well!

Appreciate any replies

Thank you.

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sigmoid
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7 Replies
SlowDragon profile image
SlowDragonAdministrator

You need 25mcg dose increase

FT4: 14 pmol/l (Range 12 - 22)

Ft4 only 20.00% through range

FT3: 3.5 pmol/l (Range 3.1 - 6.8)

Ft3 only 10.81% through range

See /contact GP with these results

Get 25mcg dose increase

Which brand of levothyroxine is 100mcg

Instead of taking just B12, instead taking a daily vitamin B complex

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

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

Post discussing different B complex

healthunlocked.com/thyroidu...

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

sigmoid profile image
sigmoid in reply toSlowDragon

Thank you for your reply.

My brand of Levo is Accord

I was taking Thorne B complex, then changed it to Bioactive B12 liquid because of gut absorption?

I feel if I up my dosage of levo...I might be over medicating, especially as I'm not converting very well?

GP not listening when I mention I'm not converting T4 to T3

SlowDragon profile image
SlowDragonAdministrator in reply tosigmoid

When adequately treated Ft4 (levothyroxine) will be at least 60-70% through range

Your Ft4 is only 20% through range

You are currently very under medicated

FancyPants54 profile image
FancyPants54

SlowDragon is right, you are very under medicated and need a dose increase. Judge by the FT numbers not the TSH.

sigmoid profile image
sigmoid in reply toFancyPants54

Thank you ....it's always good to have someone else's judgement.

SlowDragon profile image
SlowDragonAdministrator

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

onlinelibrary.wiley.com/doi...

If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).

guidelines on dose levothyroxine by weight

Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

sigmoid profile image
sigmoid in reply toSlowDragon

That's interesting to know regarding TSH can be slightly below range and T4 within or slightly above. so that's answered me worrying about over medicating.

Thank you SlowDragon

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