Can I get some advice on my latest results, please?

[BookLover2020]

Hello Everyone ,

I hope everyone is enjoying the sunshine!

Below are the latest blood test results from GP (12 April 2024).

I am currently on 100mcg Levothyroxine and 10 mcg T3 (Thybon Henning)

Fasting blood sample taken in the morning (10:20am) . Levo and T3 (last T3 taken 24 hours before) taken after the blood draw.

1. TSH 0 .18 mIU/L (0.35 - 4.94)

2. Free T4 14.0 pmol/L (9.0 - 19.1)

3. HBA1C 32 mmol/mol - [20.0 - 41.0]

FULL LIPID PROFILE:

Serum cholesterol level 5.4 mmol/L; For primary prevention refer to a cardiovascular

risk calculator if FH unlikely. For statin treated

patients refer to Non-HDL Cholesterol.

Serum HDL cholesterol level 0.81 mmol/L [1.0 - 5.0]; Below low reference limit

Serum triglyceride levels 1.3 mmol/L [0.0 - 1.7]

Serum cholesterol/HDL ratio 6.7

Serum LDL cholesterol level 4.0 mmol/L

Serum non high density lipoprotein cholesterol level 4.6 mmol/L; On statin therapyaim for decrease of greater than

40 % in Non-HDL Cholesterol from baseline (NICE)

to an absolute target of < 2.5 mmol/L (JBS3).

Around 2 weeks ago I started on a new supplement from Cytoplan called

Blood Glucose support ( cytoplan.co.uk/blood-glucos... )

I am due for an appointment with my endo in June or July 2024 before that I may have to do

fasting insulin and other tests.

Can someone please comment on my TSH being too low? The GP practice has marked

TSH test and T4 test result as abnormal and I am about to have a call with them this week or next week.

Supplements that I take:

1. Cytoplan Vitamin D3 and K2

2. Cytoplan Selenium

3. Cytoplan Magnesium Threonate ( Will discontinue after the current stock finishes)

4. Cytoplan Fish Oil Capsules

5. Cytoplan Blood Glucose Support ( Started in April 204 )

In terms of how I feel, I still feel my I want to close my eyes.

After going for a run, I feel better. I go to gym 2-3 times a week, mostly on the treadmill and some weights.

I also feel better after eating sugary foods perhaps explains why I put on weight in the last few years especially during the pandemic.

Currently, I am 83 Kg and 177cm tall.

Recently, I started to reduce or eliminate sugar from my diet ( No sugar in coffee/tea, no biscuits/cakes/ ice-creams or sweets).

It's hard but we will see if I feel better.

Apologies for the long post.

Thank you.

[SlowDragon Administrator]

How do you feel?

GP should not be meddling with your dose, as you are under care of endocrinologist

When taking any dose of T3 it’s almost inevitable that TSH will be below range or suppressed

The most important results are always Ft4 and Ft3

Plus vitamin D, folate, ferritin and B12

There’s no Ft3 result or vitamin levels

What vitamin supplements are you taking

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

is this how you did your test

Free T4 (fT4) 14 pmol/L (9 - 19) 50.0%

Ft4 possibly too low

No Ft3

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[BookLover2020 in reply to SlowDragon]

Thank you SlowDragon .

I have updated my post with the supplement details and other information.

[BookLover2020 in reply to BookLover2020]

SlowDragon

Should I ask my GP to test Vitamin B12, Vitamin D and Folate?

I'm pretty sure my Vitamin D is low. It's hard to get it high.

[SlowDragon Administrator in reply to BookLover2020]

You can ask

They might oblige

If not test vitamin levels privately as you need to test TSH, Ft4 and Ft3 together

How much levothyroxine were you taking before T3 was added

Looking at your weight ….you probably need 25mcg dose INCREASE in Levo …..or at least increase by 12.5mcg daily as first step

GP will probably want to REDUCE Levo based erroneously on low TSH.

Do you always get same brand Levo at each prescription

how much vitamin D are you taking

not taking any B12 or vitamin B complex?

[BookLover2020 in reply to SlowDragon]

I was taking 100mcg T4 (Teva brand. I always get this brand) before T3 was added.

I am due for my blood test before my endo appointment in June/July 2024. So I could do the tests for Vitamins then.

I take 4,000i.u. of vitamin D3. I must admit I am not consistent with them.

Can you recommend a good Vitamin B complex or B12 please?

I prefer Cytoplan as I can get some rewards.

Any thoughts on this: cytoplan.co.uk/vitamin-b12-...

[SlowDragon Administrator in reply to BookLover2020]

So guidelines on dose by weight when ONLY on levothyroxine is approximately 1.6mcg per kilo

At your current weight of 83 kilo that’s approximately 132mcg per day

Typically when T3 is added dose levothyroxine is reduced by 25mcg per day (which is often too much)

Many, many members on Levo plus T3 find they need both Ft4 and Ft3 at least 70% through range

I would test B12 and folate BEFORE starting any supplements

[SlowDragon Administrator]

If 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

Cytoplan

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

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

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

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

Post discussing different B complex

healthunlocked.com/thyroidu...

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

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...

[BookLover2020 in reply to SlowDragon]

Thank you v much for your suggestions.

[greygoose]

3. Cytoplan Magnesium Threonate ( Will discontinue after the current stock finishes)

Why? If you're still taking vit D, you need to continue to take magnesium. The two work together. And you are probably deficient in magnesium, anyway. Most people are.

[BookLover2020 in reply to greygoose]

I recently started taking Cytoplan Blood Glucose Support which contains Magnesium Biglycinate. So I thought I could stop Magnesium Threonate.

[greygoose in reply to BookLover2020]

It only contains 60 mg magnesium. That's not enough. You need more like 350 mg.

Another thing about that supplement, it contains zinc and copper. Whilst zinc and copper need to be kept balanced, hypos usually have one high and therefore the other one low. And it's not a good idea to take more of the one that is high. So, you should really have these tested before taking any.

[BookLover2020 in reply to greygoose]

Thank you @Greygoose.

Let me have a think.