Confused 😕 Thyroid or PMR

[Blodders2]

Hi all, I have been prescribed prednisolone (June 2024) for suspected PMR I felt good for a few days but still had pains so medication increased then decreased slowly over the past weeks still not feeling well having pains in calf muscles, tired, aching, I saw my GP last Friday 22nd I discussed with her that I think it could be me still undermedicated on my thyroxine, I had blood tests in July results were TSH 4.7 Range 0.27-4.5 FT4 15.4 Range 11-23 thyroxine was then increased from 125mcg to 150mcg, plan from appointment with GP 22/8 taper of prednisolone quickly over next few weeks ie 15mcg one week, 10mcg one week and then 5mcg. blood tests this Thursday TSH, FT4, (FT3 if Labs will do), Antibodies, CRP, ESR and HBA1, hopefully medication will be sorted after results. Apologies if this post is a bit long and confusing but my head is not in the right space at the moment. Your comments and input would be much appreciated.

Diagnosed Hypothyroid 1991

[TiggerMe]

Not surprising that you feel awful...

TSH 4.7 mIU/L (0.27 - 4.5) 104.7%

Free T4 (fT4) 15.4 pmol/L (11 - 23) 36.7%

You really need another increase in T4, let's hope they test fT3 this time 🤞

[TiggerMe in reply to TiggerMe]

Sorry should have said welcome aboard

Remember to NOT take your levothyroxine the morning of the test, water only before

Have they tested your B12, Vit D, folate and ferritin levels?

[Blodders2 in reply to TiggerMe]

Thank you so much your prompt reply and advice.

My last test results for: B12 909 Range 197-771

Vit D 60nmol no range,

Folate 4.4 Range 2-18.7

Ferritin 150.4 Range 20-260

[TiggerMe in reply to Blodders2]

Vit D range is around 50-200 with optimal being 100-150 ... grassrootshealth.net/projec...

Folate ideally into double figures

[Blodders2 in reply to TiggerMe]

How do I increase Vit D and Folate, will taking supplements be enough or do I need medication?

[TiggerMe in reply to Blodders2]

Supplements do the trick, most of us take a B complex but then we tend to struggle with low B12 which you are high on which raises slight suspicion and it would be good to know your active B12 level... this is a really useful comparison as not all B complex's are good so these have been cherry picked... Or you can go for a separate folate something around 400mcg

healthunlocked.com/thyroidu...

Vit D wants to include K2 (also magnesium helps uptake) I like a sublingual as it's easy to adjust dose and absorbs well, something like.... amazon.co.uk/Anumegeo-Vitam...

[Blodders2 in reply to TiggerMe]

Thank you so much for info. Take care

[SlowDragon Administrator in reply to Blodders2]

So you need to work on improving low vitamin D and low folate

vitamin D

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 with Hashimoto’s, 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

vitamindtest.org.uk

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

Suggest you try 2 sprays per day - 2000iu

Retest in 3 months

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 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

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[SlowDragon Administrator in reply to Blodders2]

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 5-7 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)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

[humanbean]

PMR - What is this?

[Blodders2 in reply to humanbean]

Polymyalgia Rheumatica Arteritis.

[Sleepman]

I am trying to understand this for my Mum. She took same steroid and it stopped hip pain. Her CRP and inflamation markers were low so likely not PMR.Have you had cortisol levels checked ? Could it be adrenal related.

You seem like you have TSH too high and T4 too low. How long had you been on 125 before the increase to 150 ... just been nosey

Have you ever tested your T3 thyroid levels? Mums are very low.

[Blodders2 in reply to Sleepman]

Hi Sleepman. My inflammation markers weren't too high CRP 19 ESR 3, I have not had my cortisol checked yet, I did send for a private medical test for Thyroid which included cortisol but before use I read instructions which said not to use if on steroids i.e. Prednisolone so returned test. I was on 125 mcg of thyroxine for a few months, I am having blood tests TSH, FT4, FT3 (hopefully), Thyroid Antibodies, CRP, ESR, HBA1. tomorrow morning 29.08.24. at my doctors surgery, I will ring today to see if they will also do cortisol.