blood results advice

[Thyroid36]

hi everyone, I am so tired in the evening still brain foggy. I’m on 100mcg Levo and 10mcg 2x a day Liothyronine. Bloods were done 24hrs last dose of t4 and 12hrs after dose of t3 and didn’t eat or drink anything before bloods which were done at 9.30am. My bloods in October were a lot better don’t know why it’s changed as I Haven’t changed anything . What’s your thoughts?

[SlowDragon Administrator]

what vitamin supplements are you taking

B12 is far, far too low

No folate, ferritin or vitamin D results

How much levothyroxine were you taking BEFORE T3 was added

[Thyroid36 in reply to SlowDragon]

hey, I am still waiting for vitamin D to come back, I have been on t3 for a year now, my t4 was lowered to 75mcg from 100mcg when t3 was first introduced and then after about 2months my t4 was increased again to 100mcg as it dropped to low.

[SlowDragon Administrator in reply to Thyroid36]

So are you currently taking any B vitamins

[Thyroid36 in reply to SlowDragon]

No not taking a vitamin, I take magnesium, vitamin d, omega, lions mane, cq10, aswaganda, tumeric! I will get some b12 and I will have some b12 injections I didn’t realise how low it was! 🤦🏼‍♀️

[SlowDragon Administrator in reply to Thyroid36]

are you vegetarian or vegan

Do you have Low B12 symptoms

If you do……your GP should test for Pernicious Anaemia before starting any B12

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

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

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

Low folate

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) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

[Thyroid36 in reply to SlowDragon]

Oh wow really so it’s possible I have MTHFR gene . I was tested for pernicious anaemia last year which was normal, should I get tested again? Is my B12 really badly low ?

[SlowDragon Administrator in reply to Thyroid36]

No …if been tested …just start B12

You might initially look at B12 injections

Then try daily B12 supplements

[Thyroid36 in reply to SlowDragon]

Ok amazing thank you, do you think GP

Will offer b12?

[Thyroid36 in reply to Thyroid36]

Will gp offer B12 injections u think?

[SlowDragon Administrator in reply to Thyroid36]

ask GP if they will do so

[SlowDragon Administrator]

FT4: 16.7 pmol/l (Range 12 - 22)

Ft4 only 47.00% through range

FT3: 5.3 pmol/l (Range 3.1 - 6.8)

Ft3 59.46% through range

Request 12.5mcg increase in levothyroxine per day

100mcg and 125mcg on alternate days

What brand is 100mcg tablet

[Thyroid36 in reply to SlowDragon]

Brand is TEVO, I have been feeling pretty crap so this is clearly why, thank goodness it’s not just in my head and when I feel rubbish shows in my bloods!

[Thyroid36 in reply to Thyroid36]

Sorry brand name is wrong !

[Thyroid36 in reply to SlowDragon]

Sorry brand name was wrong this is the Levo I’m on.

T4

[SlowDragon Administrator in reply to Thyroid36]

Almus is Accord boxed by Boots

Do you always get Accord/Almus

[Thyroid36 in reply to SlowDragon]

yeah that always seems to be the brand they give me. I can request a different if u think it’s better for another brand.

[SlowDragon Administrator in reply to Thyroid36]

The main thing is to stay on same brand at each prescription

[Thyroid36 in reply to SlowDragon]

Oh ok so I will stick with it then

[Thyroid36 in reply to SlowDragon]

Hi so I spoke to endo and he suggested increasing t4 to 125mcg per day and change t3 to 5mcg 3x a day . What’s your thoughts on that?

[SlowDragon Administrator in reply to Thyroid36]

We only ever advise changing one thing at a time

Are you currently taking 10mcg T3 per day

or

20mcg per day (2 x 10mcg)

[Thyroid36 in reply to SlowDragon]

Hey, I am on 20mcg per day (10mcg x2 day).

[SlowDragon Administrator in reply to Thyroid36]

FT4: 16.7 pmol/l (Range 12 - 22)

Ft4 only 47.00% through range

FT3: 5.3 pmol/l (Range 3.1 - 6.8)

Ft3 59.46% through range

So endo suggesting reduction in T3 to 15mcg

And increase levothyroxine by 25mcg

Worth trying

Increase in Ft4 (levothyroxine) should push Ft3 back up…..wether it’s enough for you ……only by experimenting can you see which mix suits you best

[Thyroid36 in reply to SlowDragon]

Ah yes ok I wonder, don’t know how I’m gonna get in the habit of taking t3 three times a day lol 😂. I got my new meds today and they have given me 100mcg of the normal brand I use and then 25mcg of a different brand is that ok or not really?

[SlowDragon Administrator in reply to Thyroid36]

don’t know how I’m gonna get in the habit of taking t3 three times a day lol

That’s easy

Early morning around 6am (alarm on and go back to sleep)

Mid afternoon - put on alarm to remind you

Bedtime or …..if keeps you awake….early evening

Do you take Levo waking or bedtime

I got my new meds today and they have given me 100mcg of the normal brand I use and then 25mcg of a different brand is that ok or not really?

Almus (Accord ) doesn’t make 25mcg tablets

So what brand is 25mcg

Mercury Pharma (Advanz)

Wockhardt

Teva (lactose free)

[Thyroid36 in reply to SlowDragon]

The 25mcg is mercury

[SlowDragon Administrator in reply to Thyroid36]

So see how you get on with it

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets 

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz

[Thyroid36 in reply to SlowDragon]

Ah ok amazing thank you so next time I tell

Them to make 100mcg as mercury as well . Thank you 🙏

[SlowDragon Administrator in reply to Thyroid36]

If you find the 25mcg is ok

[SlowDragon Administrator]

Accord don’t make 25mcg

So you need 50mcg …..cut into 1/4’s to get 12.5mcg

[Katherine1234]

I would feel poorly with B12 that low. Salt is low too, wonder if the low B12 is taking your adrenals down somewhat. I use to have a mug of boiled water with a 1/4 teaspoon of the unbleached grey sea salt, got use to drinking it. Like a weak cup of soup. That would perk my energy. Do you know why your B12 would be that low? You need folate tested too. B12 cannot work properly without a good folate.

[Thyroid36 in reply to Katherine1234]

Oh wow is it really low then 🤦🏼‍♀️ I dull get on to GP now thank you

[Katherine1234 in reply to Thyroid36]

Yes, it is low, it is just scraping in at the bottom of their lab ranges. I would ask your GP to go by symptoms not the lab range and ask for a therapeutic trail of B12 injections, which is every other day injections until symptoms improve. And get your folate tested. You need optimum folate too for the B12 to work properly. When having injections always pay attention to your electrolytes because it can take them down fast whilst you are healing. B12 injections brings down my potassium and magnesium pretty quick.

If you are vegan you may get away with high dose sublingual B12 tablets 5000 mcg, once or twice a day. If you have tummy problems low acid, heartburn, gripes etc this may not cut it.

[waveylines]

If it's not diet related ie you are not vegetarian and have red meat regularly in your diet, your GP need to do an Intrinsic Factor test first. This still misses about 50% of PA. However if you are positive then they eill give you a loading period of B12 injections and then a B12 injection every 2-3months.If you have neurological symptoms but your B12 is low but in range, negative for Intrinsic Factor then your GP can refer you to a neurologist who may then agree B12 injections if they believe B12 deficiency is the cause. This what happened to me and then I go my B12 injections which I chose to self administer on the NHS.

Neurological symptoms are quite varied but often include tremors, tingling, numbness, coordination difficulties, You can do a B12 symptom checker on B12d. Org.

[Brightness14]

Your FT3 from six months ago was 6.1 now it's 5.3 I have no thyroid and always need my FT3 at around 6 + to feel well. What were you taking then Levo and T3?

[Thyroid36 in reply to Brightness14]

Hey yes was taking same dose and same meds. I have felt exhausted lately horrible feeling

[Brightness14 in reply to Thyroid36]

I would think that it's your low B12 then.