Help with test results including vitamins

[Whateverusername]

I have just had test results from Blue Horizon including vitamins. I take 75 Levothyroxine and 10 t3 self sourced. Levo reduced by doctor due to suppressed TSH I persuaded her not to reduce again which she wanted to do by taking in last blood results with t4 and t3. I always felt well on 100 Levo and 10 t3 for thirty years. Want to ask to go back to 100 but need ammunition any help welcomed if not may go to private specialist. I have put on weight around trunk which I didn’t have before reduction. Any advice on vitamins welcomed I take iCal D3 1000 mg but looks like I need other supplements ?

[SlowDragon Administrator]

Was test done as recommended

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

As your T3 is self sourced GP won’t be happy with suppressed TSH

you will need Thyroid specialist to OK it

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

thyroiduk.org/contact-us/ge...

Folate, B12 and ferritin all too low

[Whateverusername in reply to SlowDragon]

Thank you for reply yes test done as you suggest as I looked at other posts you have replied to

[SlowDragon Administrator in reply to Whateverusername]

Free T4 (fT4) 18 pmol/L (12 - 22) 60.0%

Free T3 (fT3) 4.3 pmol/L (3.1 - 6.8) 32.4%

So you quite likely need to add 3rd 5mcg dose T3 per day

Do you normally split your 10mcg as 2 x 5mcg doses

Alternatively get Levo dose increased back to 100mcg

Which brand is 75mcg levothyroxine

[Whateverusername in reply to SlowDragon]

Brand does vary TEVA this time last time Crescent Pharma and others as well

[SlowDragon Administrator in reply to Whateverusername]

Teva brand Levothyroxine upsets many people

T3 - suggest you try splitting as 2 x 5mcg going forward

[Whateverusername in reply to SlowDragon]

I have always taken as one dose in the morning

[SlowDragon Administrator]

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

Are you vegetarian or vegan?

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...

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...

[SlowDragon Administrator]

High CRP - test for inflammation

Have you recently had cold/covid or virus

Retest again in another 8 weeks

High CRP will falsely raise ferritin levels, so ferritin could actually be lower than 44

lifeblood.com.au/health-pro...

Ferritin is also an acute phase protein and is elevated in inflammation, infection, liver disease and malignancy. This can result in misleading elevated ferritin levels in iron deficient patients with coexisting systemic illness. Markers such as C-reactive protein (CRP) may help identify coexisting inflammation.

Iron deficiency is diagnosed when ferritin is <30μg/L in adults and < 20μg/L in children.

When ferritin is not elevated as an acute phase reactant, a value >30μg/L is normal. Ferritin can be as high as 100μg/L in adults and 150μg/L in children with iron deficiency and inflammation.

Recommend you get FULL iron panel test for anaemia

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Stop iron supplements 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

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

dailyiron.net

[Whateverusername in reply to SlowDragon]

No I have not had any virus or infection. I will get iron panel done and retest CRP in 8 weeks.

[Whateverusername]

I do not eat meat (45years) but do have fish

[SlowDragon Administrator in reply to Whateverusername]

So highly likely low iron or deficient

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...

[greygoose]

Any particular reason for taking calcium?

[Whateverusername in reply to greygoose]

Bone density tested and showed ostopeana so put on them by doctor

[greygoose in reply to Whateverusername]

OK, well, the problem is that doctors know nothing about nutrition or nutrients.

Calcium is neither a treatment nor a cure for osteoporosis. In fact it can make things worse. Excess calcium makes bone brittle. And taking vit D increases your absorption of calcium from food, so you could well be over-dosed on calcium.

Plus, calcium supplements are not very well absorbed and tend to build up in the soft tissues and arteries - and that is a lot of calcium and very little vit D.

Vit D is far more important for bones than calcium, as is magnesium. And, as he prescribed vit D, he should have also prescribed magnesium because the two work together. And taking vit D without magnesium will leave you deficient in magnesium. But I don't suppose he knows about that.

And you should also be taking vit K2-MK7 with vit D, to make sure the extra calcium from food goes into the bones and teeth and doesn't build up in the soft tissues and arteries. But, I don't know if that works with calcium supplements which aren't at all the same thing as calcium from food.

As a general rule, never take nutritional advice from a doctor. Always check here first.

[Whateverusername in reply to greygoose]

Sorry a bit confused are you saying it woul be better to take Vit D and magnesium?

[greygoose in reply to Whateverusername]

Yes, I am.

[Whateverusername in reply to greygoose]

Thank you so Vit D, magnesium and K2-MK have you got advice on which to get?

[greygoose in reply to Whateverusername]

No sorry, I don't know what's available in the uk.

[waveylines in reply to greygoose]

It's a difficult one greygoose. I take calcium with vit D (as per bone specislist) I developed osteoporosis as a result of bc treatment. I eat lots of dairy and on top of my magnesium and vit D with k2 so was skeptical. However I was wrong. For some reason it helped my bone density. And taking it has enabled me to stay off Alendronic. I think its probably more compkex or I have a weird body! 😂🤣

[greygoose in reply to waveylines]

Or the improvement was more to do with the vit D and magnesium than the calcium.

[waveylines in reply to greygoose]

No not this time. As I was already maxed out on vit D3, K2 and magnesium before hand. I was skeptical and didn't take calci D but I was wrong. It maybe due to my weird cancer treatment effects Greygoose but just wanted to gently flag it up. I'd always address diet vit D3 k2 and magnesium first.....top priority. Maybe it's the magnesium as I can't take it as a supplement and rely on foods to get my needs met. Luckily I love nuts!

I dont really know. I really think its time nhs medicine addressed the whole area of vits/minerals. Always mystifies me why they are not trained up in this field. Eg new GP stopping my b12 jabs arguing clinical insufficient data. What rubbish...NHS .Professor of Neurology who I was under came to my rescue. He knows about vits/minerals!

There must be many suffering needlessly from vit/min deficiencies.

Apologies for my ramble. I always pay heed to your advice Greygoose and am grateful for yohr posts. 😊😊

[greygoose in reply to waveylines]

I said above I didn't know if vit K2 had any effect on calcium supplements as it does on calcium from food - which is why we take it with vit D. But, maybe it does and your case proves it. But, once again, doctors know nothing about it and so never prescribe it when prescribing calcium. So, maybe they should! Be interesting to hear more about people taking one vs people taking the two together.

It's a constant mystery to me, too, why doctors are taught nothing about the two main staples of life: nutrients and hormones. All they seem to learn about is prescribing drugs. I'm certainly not someone who believes nutrients cure all - far from it! But that doesn't mean to say I don't think they're important, because I know they are. I've had some heated discussions with doctors on the subject, too. Mainly when they tell me to cut out all traces of fat from my diet because I'm over-weight! Such ignorance. Or are they just trying to kill me off?

[waveylines in reply to greygoose]

Flipping heck Greygoose.....cut all the fat out? Are they barking? I found lower carbohydrates but good protein intake helped.....and I never felt hungry or calorie counted. I totally agree with you re vits minerals and for me GF & B12 jabs are key. Ive put weight on because am stuck with the long lingering after effects of Amiodarone which has lowered my thyroid conversion rate.... so Ft3 level is much lower but ft4 top of range.....and sure enough weight has gone on all round my middle.....lol.

[greygoose in reply to waveylines]

Yup, I've had several doctors tell me that. One said just eat soup, and when I said I started my soup by frying the onions she more or less told me I didn't know how to make soup! lol Another suggested I live on boiled rice and carrots. Apparently, neither of the have ever heard of protein! They just haven't got a clue.

My weight is water, so no cutting out fat or counting calories or lowering carbohydrates is going to help that! But, for most of the doctors I've seen I'm fat because I put butter on my bread! 🤣🤣🤣

[waveylines in reply to greygoose]

Goodness me! I think these doctors who recommend effectively cabbage soup should try living on it themselves....they'd soon run out of steam. And its the opposite of what Peatfield said! Lol....

[greygoose in reply to waveylines]

What did Peatfield say? I haven't read his book.

[waveylines in reply to greygoose]

He recommended low carb getting lots through veg with odd high portion of higher carb like rice or potato plus good protein. I'll look his book out to remind myself when I get a moment. I think he measured out but I didnt.

[greygoose in reply to waveylines]

Hmmm... Well, I'm not sure you can generalise about food. Once again, I think it's a very personal thing. My daughter once lost a hell of a lot of weight whilst eating a whole baguette a day! lol

[waveylines in reply to greygoose]

We are all different......a baguette a day would blow me up! Guess it's all about what each body needs & how we process or not different food types. I was always slim, never put weight on, no matter what I ate until hypothyroidism hit!

[greygoose in reply to waveylines]

Well, same here - except it hit me at about 8 years old! Since then I've had skinny periods and periods of beached whale. And during the skinny periods people - including doctors - have said 'there you are! see what you can do when you try?' Only I hadn't tried. It had just happened. And I had no idea why!

[waveylines in reply to greygoose]

When hypothyroidism really kicked in, I lost one stone in one week, next week I put a stone back on! I ate the same both weeks. I agree the metabolism is overlooked by the medical profession. The idea its all in what u eat is heavily over relied on.....yet again the medical profession assume we all have the same fully functioning metabolism.....but we dont!

[greygoose in reply to waveylines]

Whatever way you look at it, the medical profession is pretty useless. And, once they get an idea in their heads there's no budging them! Sigh.