Falling apart: Just had my first ever Medichecks... - Thyroid UK

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Falling apart

Jingley profile image
10 Replies

Just had my first ever Medichecks results through and some (most) are pretty bad although all have that lovely green mark!All supplements were stopped about 6 weeks ago - long story but I've only just got round to doing the test. Test taken at 9am with just water beforehand and last dose of Levothyroxine previous morning.

I've been supplementing with Vitamin D for years but obviously not enough.

Do the low vitamin levels just reflect the fact that I've not taken them for so long, or is there an issue?

I'm feeling weary, have slow digestion, put on about 4kg in the last 3 months, have freezing cold feet and my Morton's Neuroma is playing up again. On top of that I have a huge CBA attitude to anything and have trouble falling asleep.

The thing that surprised me was that I have low antibodies. Is this because my thyroid is totally dead so there's nothing to attack anymore, or am I one of those people who just don't have antibodies at all?

All advice very welcome 🙂

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Jingley profile image
Jingley
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10 Replies
Jaydee1507 profile image
Jaydee1507Administrator

Vitamin levels can drop very fast if you aren't supplementing so I suggest retesting them after you have been supplementing regularly in 3-4 months time.

What supplements would you usually be taking?

Ferritin should be around 90 - 100 for best use of thyroid hormone. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc

Antibody levels vary over time so just because they are negative now doesn;t mean they have never been or never will be positive. Some people with autoimmune hypo never have positive antibodies.

Free T4 (fT4) 17.1 pmol/L (12 - 22) 51.0%

Free T3 (fT3) 4.4 pmol/L (3.1 - 6.8) 35.1%

You have plenty of room for an increase in Levo, perhaps ask for a trial increase of 12.5mcgs.

Your TSH is close to top of range so GP may be reluctant to increase. Fixing vitamins may help.

Jingley profile image
Jingley in reply toJaydee1507

Thanks Jaydee. I normally take a b complex and a vitamin D. This was suggested to me by a GP via the receptionist several years ago so I never had a proper conversation about taking vitamin k with vitamin d. Ferritin is always low. I asked a GP last year about it for suggestions as I hate liver and pate with a passion. Can't stomach it at all. The answer was to drink Guinness!! ( Male GP)

Levothyroxine was reduced by this GP a few months ago chasing an in-range TSH.

Jaydee1507 profile image
Jaydee1507Administrator in reply toJingley

Ask/insist on going back on your previous Levo dose.

Refer GP to 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. “

nice.org.uk/guidance/ng145

Thyroid hormone only works well when vitamin levels are optimal. Recommend working on your low ferritin level.

SlowDragon profile image
SlowDragonAdministrator

You need to work on improving low vitamin levels, especially low ferritin

And get dose increase in Levo

Are you still on 75mcg and 100mcg alternate days

Push for trial increase to 100mcg daily

Which brand of levothyroxine are you taking

Jingley profile image
Jingley in reply toSlowDragon

I was on 100mcg per day until last September when it was decreased due to below range TSH. If I knew then what I've gleaned from this forum, I would have refused a decrease.On Accord 100mcg and Teva 75mcg. Don't think I have a bad reaction to either brand.

There is a hypo GP at the surgery who I'll try to see . Appointments with her are as rare as hen's teeth though

SlowDragon profile image
SlowDragonAdministrator in reply toJingley

Essential to get all four vitamins tested and optimal and maintain at GOOD Levels

TSH. If I knew then what I've gleaned from this forum, I would have refused a decrease

If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....

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. "

SlowDragon profile image
SlowDragonAdministrator

Are you vegetarian or vegan

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

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...

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...

SlowDragon profile image
SlowDragonAdministrator

Iron and ferritin

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

Posts discussing Three Arrows as very effective supplement

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Iron patches

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron

healthline.com/nutrition/he...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

healthunlocked.com/thyroidu...

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:

Females 18 ≤ age < 40. 30 to 180

Females 40 ≤ age < 50. 30 to 207

Females 50 ≤ age < 60. 30 to 264l

Females Age ≥ 60. 30 to 332

Males 18 ≤ age < 40 30 to 442

Males Age ≥ 40 30 to 518

The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.

Jingley profile image
Jingley in reply toSlowDragon

Does this look ok from last year? I don't *think* I'm anaemic, just low ferritin

Iron panel result from July 2023

Serum iron level 18.6 umol/L (9.0-30.4 umol/L)

Serum transferring 2.42 g/L (1.95-3.37 g/L)

Unsat iron binding capacity 61 umol/L (49-85 umol/L)

Transferring saturation index 30% (15-40%)

Serum ferritin 27ug/L (10-291 ug/L)

PS not veggie or vegan

SlowDragon profile image
SlowDragonAdministrator in reply toJingley

Test a year ago is too long ago to be relevant

Iron  18.6  (9 - 30.4) 44.9%

Looks pretty low

Work on increasing iron rich foods in your diet

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