Referred to private Endo - London; advice and recommendations please

[RuthNelson]

Hi all,

I have just been referred by the GP to an Endo.

I was hoping that someone could privately DM me with recommendations for private endos in central London.

I am also wondering whether I could be suffering from Hashimotos hyperthyroid flare ups:

To recap;

I have hashimotos, and had a hemithyroidectomy for a thy3F nodule just before Xmas. Before the operation I had been described as sub-clinical hypothyroid, with a TSH of around 2.

Since the operation I been suffering from pins and needles and a feeling of slight breathlessness, which mostly comes on in the evening or at night, but can happen during the day too.

In the evening every few days I am assailed by an unnatural and horrible feeling of tiredness and breathlessness, with irregular heartbeats. I then go to sleep early but wake up after a hour feeling breathless, with a very swollen feeling in my throat and ears, feeling anxious and tingling. I try to breath slowly and the worst of this takes a couple of hours to subside, but I am left with a lesser version of the same feelings the next morning. It may or may not repeat the next night.

I am gluten- free and have been taking Vitamin D3 and iron/ B vitamins for the last few weeks. I stopped my iron/b vitamins a week before my blood tests, which were taken at 8.30am after fasting.

I am not taking levothyroxine or other thyroid medication.

Results on 6 March 2024 were:

TSH: 4.22 range 0.3 -4.2 milliunit

Free T 3 4.2 range 2.4 to 6 pmol/l

Free T4 11.3 range 9-23 pmol/l

Folic acid 11.3 range > 2.7 ug/l

Ferritin 34 range 20-300 ug/l

B12 445 Range 160-800 ng/l

Vitamin D 63.7 range 50-150 nmol/l

Thanks in advance for any advice and recommendations.

[greygoose]

I am also wondering whether I could be suffering from Hashimotos hyperthyroid flare ups:

Depends what you mean by a 'Hashi's Flare'. It appears to mean different things to different people.

For me, a Hashi's 'flare' - what I call a Hashi's 'hyper' swing, because that's exactly what it is - is when the thyroid is being attacked by the immune system and the dying cells leak their stock of thyroid hormone into the blood, causing a temporary false-hyper state, with high FTs and therefore very low TSH.

According to your blood test results, this is not what's happening to you. You are hypo, with a TSH over 4. And you should be on thyroid hormone replacement of some kind. Your Frees are far too low for good health.

Also your B12 and vit D are too low. And your ferritin is much, much too low. You need your serum iron tested.

have been taking Vitamin D3 and iron/ B vitamins

So, are you also taking the co-factors for vit D? Magnesium and vit K2-MK7? Vit D on its own won't do much for you except deplete your magnesium, because the two work together.

What are you taking in the way of B vits? A B complex? Does it contain methlycobalamin, rather than cyanocobalamin? And methly folate rather than folic acid?

And, are you taking vit C with your iron to help absorption and protect against constipation? Not really a good idea to supplement iron without getting your serum iron tested first, because that could be high, even though your ferritin is low.

Since the operation I been suffering from pins and needles and a feeling of slight breathlessness,

The pins and needles are probably due to the low B12. Perhaps you need to take a separate sublingual methylcobalamin (B12) as well as your B complex.

The breathlessness could very well be due to that low ferritin.

[RuthNelson in reply to greygoose]

Thank you, Grey Goose, for your comprehensive reply.

1. Iron and B complex

I had my iron tested last summer, and it was low. I started taking the supplements a few weeks ago; iron, plus B vitamins plus Vit C

HealthSpan Elite iron complex: does this look appropriate?

Actives Per tablet % NRV

Iron 14mg 100

Vitamin B2 1.4mg 100

Vitamin B6 1.4mg 100

Vitamin B12 2.5mcg 100

Vitamin C 80mg 100

Copper 1mg 100

NRV = Nutrient Reference Value mcg = micrograms

Bulking Agent: Calcium Carbonate Prep. (Calcium Carbonate, Maltodextrin’), Bulking Agent: Microcrystalline Cellulose, Vitamin C Prep. (Ascorbic Acid, Hypromellose’), Iron Bisglycinate, Coating (Hypromellose, Calcium Carbonate, Polydextrose, Talc, Medium Chain Triglycerides, Iron Oxide’), Magnesium Stearate, Copper Citrate, Anti−Caking Agent: Silicon Dioxide, Pyridoxine Hydrochloride, Riboflavin, Methylcobalamin.

Have also just started taking liquid B12 from Nature Provides Liquid Vitamin B12 (Bioactive B12, 3000 mcg):

Reverse osmosis water, Vitamin B12 (as Methylcobalamin and Adenosylcobalamin)

2. Vitamin D

Was taking D3 Healthspan elite 400 iu x 1 tablet, but have recently upped this to take 5 tablets a day i.e. 2000 iu; not sure hw much I should be taking? GP said 1000 iu, but I have also heard higher,

I have been wary about taking K2 with it, as I have Factor v Leiden (clotting disorder), and am trying to find literature about whether I should avoid K2 in this instance or not?

3. Magnesium

I have not been taking magnesium, but have just bought a Welleco hot chocolate bedtime drink that has half the recommended daily quantity of magnesium. Not sure what amount of magnesium is good; is there a specific supplement / dosage that is widely recommended?

Welleco hot chocolate.

Each serve (5 g) contains: Alkalised Cocoa Powder, Magnesium Citrate, Cacao Powder, Dried Acerola Cherry Powder (Malpighia emarginata), Medium-Chain Triglycerides (MCT from Coconut), Chamomile Flower Extract (Matricaria chamomilla), Flavouring, Dried Shiitake Mushroom (Lentinus edodes), Lemon Balm Leaf Extract (Melissa officinalis), Passionflower Extract (Passiflora incarnata), Lavender Flower Extract (Lavandula angustifolia), Pomegranate Peel Extract (Punica granatum), Sweetener: Steviol Glycosides from Stevia, Nicotinamide.

4. Selenium

Eating a couple of brazil nuts a day

Thank you once again for your help.

[greygoose in reply to RuthNelson]

HealthSpan Elite iron complex: does this look appropriate?

No, it doesn't. The iron will block the absorption of the B vits. You need a B complex with just Bs in it, nothing else, and take it at least two hours away from iron.

Iron should be taken at least two hours away from everything else except vit C.

Also, the copper is inappropriate. Copper should be balanced with zinc. However, when you are hypo you usually have on high, and therefore the other one low. Usually it's the zinc that is low, but could be copper, so both should be tested before supplementing. Taking more copper if your copper is already high will make you quite ill.

Have also just started taking liquid B12 from Nature Provides Liquid Vitamin B12 (Bioactive B12, 3000 mcg):

That's a very high dose, and you'd be unlikely to be able to absorb it all in one go. So, what your achieving there is just expensive pee!

Vit D - not sure hw much I should be taking? GP said 1000 iu, but I have also heard higher,

Depends on your level. I'm afraid I can't help you with that as I'm not well up on vit D.

I have been wary about taking K2 with it, as I have Factor v Leiden (clotting disorder)

Ah, yes, that's a tricky one. And I've never been able to find a definitive answer. Let me know if you find one! Because that affects so many people.

The thing is, taking vit D increases absorption of calcium from food. And the K2 makes sure it goes into the teeth and bones, rather than building up in the arteries and soft tissues. I've never found out how to get round that one. So, best to avoid it until you know for sure.

is there a specific supplement / dosage that is widely recommended?

The recommended dose of supplement magnesium is between 350 and 400 mg. But magnesium comes in many different forms and it depends what you want it to do for you:

Magnesium citrate: mild laxative, best for constipation.

Magnesium taurate: best for cardiovascular health.

Magnesium malate: best for fatigue – helps make ATP energy.

Magnesium glycinate: most bioavailable and absorbable form,non-laxative.

Magnesium chloride: for detoxing the cells and tissues, aids kidney function and can boost a sluggish metabolism.

Magnesium carbonate: good for people suffering with indigestion and acid reflux as it contains antacid properties.

Worst forms of magnesium: oxide, sulphate, glutamate and aspartate.

Or, you can buy a magnesium complex that contains several different forms.

That sounds like a great chocolate drink BUT, I'm not sure about Sweetener: Steviol Glycosides from Stevia. That's not something I would personnally want to ingest.

Eating a couple of brazil nuts a day

Are you sure that your Brazil nuts were grown in selenium-rich soils? It usually says on the packet. If not, no point in eating them - unless you like them, of course.