MORE ADVICE ON RESULTS PLEASE !

[Koababy20]

Hi again kind people,

Further to my last posts-I reduced Levo from 125ug to -100ug from 12/01/24 on Endo’s advice ( previous results as below ,he said ,still showed overmedication)

08/01/24:

TSH 0.02 (0.27-4.3)

FT4 4.2 ( 3.1- 6.8)

FT4 21.9 (12.00-22.00)

My latest blood results taken on 22/02/24 (taken at 9am, fasting, no levo for 24 hrs) :

TSH 0.36

FT4 19.5

FT3 3.9

Folate 14.5 ug/L

Ferritin 45.9 ug/L

B12 908 ng/L marked as high

( Ranges not given )

Vitamin D not checked but I supplement this

I have to get Full blood count repeated in 1 month according to the receptionist??

I suspect I have poor T4 to T3 conversion from these results.

My symptoms now are mainly lack of stamina, bad fatigue, permanently freezing cold, anxiety, low mood, swollen ankles and fingers, muscle pain and weakness. (Sleep improving slightly 6 hrs per night usually interrupted)

I am STILL plagued by difficulty swallowing , pressure in neck area, sore ears even though scan showed thyroid had no enlargement/nodules?? GP says these symptoms are related to acid reflux and has increased Omeprazole to 40mg per day.

I have been gluten free nearly 1 month.

I am seeing Endo again next week , praying he will agree to reintroduce T3 ??

All advice gratefully received!

Many thanks in advance !

[SovietSong]

Hi,it’s advised on here that conversion rate be 4 or under,yours is currently coming in at 5.Your latest test is showing T3 at just 21% through range and that’s what causes symptoms.Your numbers are very similar to what mine were before I added a little T3 about 10 weeks ago.I’m currently 125 levo and 6.25mcg T3 daily and best I’ve felt for two years.I can relate to a lot of those symptoms,Painful swollen fingers,feeling permanently cold and ear pain.Do you allow some time between your levo and omeprazole? as I think it can affect absorption.

[Koababy20 in reply to SovietSong]

Thanks so much for your informative reply, it’s great to know your symptoms have improved, it gives me some hope!

Yes I allow 4 hours between those doses ….

[SovietSong in reply to Koababy20]

One of the symptoms I had was low stomach acid so I’m wondering could the omeprazole be doing more harm than good?GPs tend to not pay any attention to it and instead blame EXCESS stomach acid.Have you had any gastro issues or constipation?

[Koababy20 in reply to SovietSong]

I have many gastro issues unfortunately, never considered low stomach acid being the cause …it’s certainly a symptom of hypothyroidism from what I understand

[SlowDragon Administrator in reply to Koababy20]

Low stomach acid can be a common hypothyroid issue, especially when Ft3 is low

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Web links re low stomach acid and reflux and hypothyroidism

nutritionjersey.com/high-or...

stopthethyroidmadness.com/s...

thyroidpharmacist.com/artic...

How to test your stomach acid levels

healthygut.com/articles/3-t...

meraki-nutrition.co.uk/indi...

huffingtonpost.co.uk/laura-...

lispine.com/blog/10-telling...

Useful post and recipe book

healthunlocked.com/thyroidu...

Ppi like Omeprazole will lower vitamin levels even further

it’s difficult to stop a PPI ….has to be weened off very slowly

gov.uk/drug-safety-update/p...

webmd.com/heartburn-gerd/ne...

pharmacytimes.com/publicati...

PPI and increased risk T2 diabetes

gut.bmj.com/content/early/2...

Iron Deficiency and PPI

medpagetoday.com/resource-c...

futurity.org/anemia-proton-...

onlinelibrary.wiley.com/doi...

sciencedirect.com/science/a...

But never assume you have low stomach acid

healthygut.com/4-common-bet...

[Koababy20 in reply to SlowDragon]

Thanks so much for this ! I’ll get reading!

I really appreciate your help !

[SlowDragon Administrator]

What’s the range on folate

Are you taking a daily vitamin B complex

TSH 0.36

FT4 19.5

FT3 3.9

Obviously Ft3 ridiculously low

Ferritin too low - look at significantly increasing iron rich foods in your diet

You need to test vitamin D

How much vitamin D are you taking

[Koababy20 in reply to SlowDragon]

Hi SlowDragon, thanks for your kind reply, unfortunately no ranges were given for any of the vitamin levels 😩

I currently supplement with B12 1000ug daily (timed release tablet).

I also supplement with Vitamin D3 25ug daily.

My GP said they didn’t test Vitamin D on the NHS. I will look into private testing for this.

I stopped taking multivitamins 3 weeks ago as they contain Iodine which I thought wasn’t good for the thyroid.

I will definitely look into getting T3 prescribed again

[SlowDragon Administrator in reply to Koababy20]

My GP said they didn’t test Vitamin D on the NHS.

That’s rubbish

25ug (1000iu) is low dose ….may not be high enough

Aiming for vitamin D at least over 80nmol

Test twice yearly when supplementing, especially if outdoors a lot in summer.

Can test via NHS private testing service

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...

[Koababy20 in reply to SlowDragon]

Ah thanks so much for all this information, much appreciated! I will definitely increase my dose and get a private test done

[SlowDragon Administrator]

I currently supplement with B12 1000ug daily (timed release tablet).

Folate 14.5 ug/L

B12 908 ng/L marked as high

Instead of a separate B12 look at now moving to a daily vitamin B complex

This can help keep all B vitamins in balance and will help maintain B12

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

Difference between folate and folic acid

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

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

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...

[Koababy20 in reply to SlowDragon]

SlowDragon, this information is so helpful! Thanks so much for taking the time to reply