Hello everyone,I would really appreciate any advice regarding my latest fasting blood tests, done before taking my Levothyroxine tablet.
I am still on 75mcg Levothyroxine since diagnosed with Hashimoto's in 2010. After my latest post, around Nov 2022, I followed the advice I was given and started taking Basic B Complex and Vit D drops and I remember actually feeling better for a while. Can't remember why or when I stopped taking Vit D... but kept up with Complex B until a few weeks ago before the blood tests.
Have not done any blood tests in between. During the last couple of years there have been long periods when my parents health has been worrying and required my care and I have been through periods of intense stress and activity as well as poor sleep and diet. Seem to manage somehow but afterwards I always feel exhausted, anxious and unable to function properly. Brain fog, confusion and extreme difficulty in looking after the house and worse... preparing healthy nourishing meals for me and my husband, who has health issues of his own. I am constantly aware of this and it makes me feel so guilty.Sorry to go on and I know that nobody can help with this but it helps to share and I feel that I can be understood here.
These are the results of the blood tests I have just done (in Portugal). Don't know why but the reference ranges have changed since last time...
TSH: 3,22 µUI/ml (Range 0.27- 4.20)
FT4: 1,29 ng/dl (Range 0,93 -1,70)
16.6 pmol/l (Range 12,0 - 22.0)
FT3: 2.02 pg/ml (Range 2.0 - 4.4)
Ferritin 96,10µg (Range 20-280)
Vitamin B12 357,4 pg/ml (Range 191-663)
Vitamin D 12,06 ng/ml (Deficiency <20 , Sufficiency 30 -100)
And don't know if anybody knows about the relevance of cortisol but as I have been feeling so stressed that I asked for the test privately and it came 16,58 ug/dL (Range 5,26 - 22,42). This, and Ferritin I didn't tell my GP about as he didn't request them.
His response to the other results was that Vit D seemed a bit low, maybe we could consider a supplement if I wanted... Said yes of course and he sent me a prescription for pills.
Colecalciferol (Molinar) 22400 U.I - 3 pils/box. 1 a month to be taken for 4 months.
Previously I had got Colecalciferol in drops (1ml - 30 drops - equivalent to 20.000 of vit D3) and with your help, regarding the amount advisable then, I worked out how many drops/week. Does anyone have advice/experience regarding taking a monthly pill vs. drops of D3?
As ever, any advice/information would be really appreciated.
Thank you so much and best of health to everyone.
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Griffin43
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Thank you so much SlowDragon. Sitting here taking what you wrote in, my heart just sank. On the one hand it is so important to me to believe that there's hope and that I am not just imagining how bad I feel. Knowledge is power and gives me hope and I really trust your knowledge and experience. On the other hand from my Dr's brief response and lack of interest I don't know what understanding and help I am going to get from him. But will definitely try. Meanwhile... do you think having suspended Thorne's B Complex for the weeks waiting to do the blood test could have made a significant difference? Or, as I just read on the bottle, I better take 2 or even 3 a day?
And your views regarding the vit D supplement? The monthly tablet or liquid drops? And dosage?
I'm sorry to ask for more information and trouble you but any input would be so much appreciated. Thank you again.
Meanwhile... do you think having suspended Thorne's B Complex for the weeks waiting to do the blood test could have made a significant difference? Or, as I just read on the bottle, I better take 2 or even 3 a day?
No folate test result?
I would take one Thorne per day PLUS separate B12
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement as well as 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
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 can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
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
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
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.
TSH should be under 2 as an absolute maximum when on levothyroxine
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).
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
"In part your vitamin levels are poor because you are not on high enough dose levothyroxineBeing hypothyroid results in low stomach acid, then poor nutrient absorption as direct result
(Had forgotten about reading about your information above...)
Approximately how much do you weigh in kilo"
45kg - used to be a bit more before the diagnosis.
Can't thank you enough for the comprehensive and helpful answers.
With the excess stress over many years and the symptoms you are having, you should check the Reverse T3 also. In chronic illness and stress, the conversion to bioavailable FT3 can be disrupted and create an excess of inactive RT3 which takes place on the thyroid receptor sites and blocks the thyroid hormone, causing hypo symptoms, even with lab tests showing within normal limits on the reference interval and without stress relief or reversal of RT3, this can continue for decades without being acknowledge, leaving you in a chronic hypo state.
Usually, RT3 is only a concern when a person is critically ill or in chronic stress because it is the way the body makes you rest so it can heal. The problem in our society now, is we don't rest to heal and continue in chronic stress. It is not normally checked in someone who appears to be normal and walking in the real world.
But we are seeing this in those with chronic illnesses, autoimmune and chronic stress without relief. The body is only trying to save you by creating these symptoms.
The thyroid is a hormone that revs us up and gives us energy. If the body is not at the correct temperature, we don't make proper enzymes, and the RT3 is a sign to the body to begin shutting down things we dont need right now to preserve the things we do need.
The fatigue is a sign of needing to rest, the low temp/cold feelings are a sign to cover up and get warm (raising the temp), brain fog means needing to slow down and let the brain rest. Insomnia, again the body trying to make you rest.
The treatment should be a resetting protocol of T3 only, which will suppress the T4 and RT3 allowing the cells to again accept FT3. The Levo will give you more T4 which will continue to convert improperly to RT3, but you should absolutely speak to your physician or a provider who can help you through this program.
The resetting cycle can take 3-6 months of titrating up and then weaning off of T3 only supplement. A way you can confirm this is to check your temperature several times per day and average. If your body temp is not 98.5-98.6, you are not making the correct enzymes to convert thyroid hormone correctly.
We should be 98.6 F which is the perfect temperature where our body can do its normal processes correctly. Outside of 98.6, we begin to create misshapen enzymes which are necessary to convert thyroid properly. We observe this normally with a fever above a certain degree, the enzymes necessary for brain function are destroyed leading to cognitive issues. RT3 is the same in reverse, the enzymes are misshapen when the temp is too low and prevents proper function across the body and these symptoms.
The low Vitamin D goes right along with that and can create an immune catastrophe into multiple autoimmune disorders.
Thank you Elily. It's quite a lot to take in this evening but will try to get my head around the information. And will certainly bring this up with the Endocrinologist that I will have to see as my GP, despite my request, and the clear info by SlowDragon that I shared with him, refused to change my treatment as my results "are fine". But admitted he doesn't have enough knowledge and advised me to consult an Endocrinologist. Best wishes.
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Blood test results??
