I saw the endo last week. Told her all my symptoms but she didn’t seem interested just that my TSH and ft3&ft4 were in limits. She said a lot of my symptoms could be from something else or age related. I said about vitamins and she said she would do them so that I could take some to see if that helped. She said about a good B complex but something about if magnesium was in had to be careful as I might take too much but I don’t know what my vitamins are. She took my bloods at 1.30 after I had had my tablet in the morning!!! She advised dr to put my tablets up from 100 daily to 125/100 mcg alternate days. How do I know which vitamins and how much I should be taking. These are my results
New results: I saw the endo last week. Told her... - Thyroid UK
New results
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Judyrabbit
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SlowDragonAdministrator
which brand Levothyroxine is your 100mcg
Ideally get same brand for 25mcg
Do you should get test results for vitamin D, folate, ferritin and B12
What vitamin supplements you currently taking
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common on Levothyroxine
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)
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
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...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
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
SlowDragonAdministrator
vitamin D needs improving to at least 80nmol and around 100nmol maybe better
GP will often only prescribe to bring vitamin D levels to 50nmol.
Some areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Test twice yearly when supplementing
Can test via NHS private testing service
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...
Recipe ideas
bbc.co.uk/food/articles/mag...
Interesting article by Dr Malcolm Kendrick on magnesium
drmalcolmkendrick.org/categ...
Vitamin K2 mk7
SlowDragonAdministrator
if endocrinologist didn’t test B12, folate and ferritin get these tested via GP or via private testing
Medichecks or Monitor My Health or BH
Do NOT start B vitamins until tested
Ferritin test - early morning and only water to drink between waking and test
Come back with new post once you get results
these are m results from March
W
Ferritin is low
Want to aim to maintain at least over 70
Around 100 may be better
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.
Look at increasing iron rich foods in diet
Retest in another 3-4 months
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
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
If taking iron supplements Stop 5-7 days before testing
Medichecks iron panel test
medichecks.com/products/iro...
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...
If you need supplements
Posts discussing Three Arrows as very effective supplement
Great replies from @FallingInReverse
re ferritin and Three arrows
healthunlocked.com/thyroidu......
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great reply by @fallinginreverse
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...
Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue
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.
She said a lot of my symptoms could be from something else or age related.
They rarely are interested in symptoms because - as she said - they are non-specific: i.e. they could all be due to 'something else'.
However, aske her which scenario is the more likely: a) you have 36 diseases with one symptom each or b) you have one disease with 36 symptoms?
As for age related, getting old is not a disease and should not cause a bunch of symptoms.
She said about a good B complex but something about if magnesium was in had to be careful as I might take too much
Hardly likely. Magnesium is water soluble, so any excess is excreted. Besides, most of the population is magnesium deficient because soils are depleted and they're not getting it in their food any more. Being hypo will make that worse. And, if you are going to take vit D, you must take magnesium because the two work together.
The nutrients you have to be careful not to over-dose on are: vit D, vit A, vit E and iron. Because they are fat soluble so build up in fatty tissues and excess is not excreted.
But, as a general rule, never take nutritional advice from a doctor because they just know nothing about it. They don't 'do' it in med school. 
So should I take a vitamin B complex tablet and if so could you advise a good one
With your level of B12 it's usually suggested that you start by taking a sublingual methylcobalamin (B12) tablet of 1000 mcg for a week or so, and then add in a B complex. Take the two together until the sublingual B12 is all gone, and then continue with the B complex as a maintenance dose.
A good B complex contains methylcobalamin and methylfolate, rather than cyanocobalamin and folic acid. Two I can recommend from personal experience are Thorne Basic B, and Igennus B complex. There are others but I don't know them.
Oh, and that comment about magnesium in a B complex... I've never seen a B complex with magnesium, so I think your doctor was getting confused with multi-vits and B complexes. Multi-vits are definitely not recommended - not because of the magnesium but for a whole host of other short-comings.
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...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements
thyroidpharmacist.com/artic...
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
greygoose
However, aske her which scenario is the more likely: a) you have 36 diseases with one symptom each or b) you have one disease with 36 symptoms?
As for age related, getting old is not a disease and should not cause a bunch of symptoms.
here here!!!!
😭😭😭😭😭😭😭
Annoys me so much when doctors say it could be "something else" but don't actually know what that something else could be
Or just blame it on age
Or the ever dreaded "depression" label......
I had all this before going private. I genuinely thought I had a serious mental illness but it was just hypo!!
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