Results 🤔

[Steakxchips]

Hi again I now have results would appreciate help understanding these as doctor tells me all Normal but need to buy vitamin d 500 take twice a day..🤔

[SlowDragon Administrator]

so vitamin D, folate and B12 are too low and need improvement by self supplementing

This is common when on too low a dose of Levo

Are you still back on 75mcg levothyroxine

Or have you managed to get some 100mcg Teva now

Suggest once you get 100mcg you initially increase on alternate days …..

Take 75mcg one day and 100mcg the next day for 6-8 weeks then retest thyroid and vitamin levels

Increasing by 25mcg was perhaps too much to tolerate, especially while vitamin levels are low

To tolerate good dose Levo we need GOOD vitamin levels

It’s chicken and egg

Low thyroid levels results in low vitamin levels

Low vitamin levels make it difficult to tolerate increase in Levo

Your GP could should add note to all future prescriptions

Either “Teva Levo only”

Or

“Lactose free levothyroxine only”

That’s either Teva or Vencamil

[SlowDragon Administrator]

vitamin supplements

Only add one supplement at a time and wait 10-14 days to assess before adding another

Are you currently taking any vitamin D

If yes…..how much

U.K. government recommends EVERYONE supplement vitamin D at least Oct to April minimum

Many (most?) thyroid patients find they to supplement continuously all year

Your

Vitamin D result 35.9nmol

GP should prescribe 1600iu everyday for 6 months, however with thyroid disease you are likely to need higher dose

Suggest you start on 3000iu daily

Retest in 2-3 months

NHS Guidelines on dose vitamin D required

panmerseyapc.nhs.uk/media/2...

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

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

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]

B12 and folate are both within range …..but too low

GP only obligated to treat vitamin deficiencies

B12 361 (197-771)

Folate 4.5 (3.6- 26.8)

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...

In-depth article on different forms of B12

perniciousanemia.org/b12/fo...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

perniciousanemia.org/b12/le...

And why aiming to keep B12 over 500 recommended

perniciousanemia.org/b12/le...

Great reply by @humanbean on B12 here

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 and may need separate methyl folate couple times a week

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) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

[SlowDragon Administrator]

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

Do you normally take your Levo waking or bedtime?

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

markvanderpump.co.uk/blog/p...

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[SlowDragon Administrator]

High cretanine and low GFR

Indicators of kidney function

Kidney function often impaired when hypothyroid, this should improve as your dose Levo increases

pmc.ncbi.nlm.nih.gov/articl....

TSH had a significant positive correlation with serum creatinine and a significant negative correlation with eGFR in all patients with thyroid dysfunction. Serum creatinine increases while eGFR decreases in hypothyroidism whereas serum creatinine decreases and eGFR increases in hyperthyroidism. These results are in accordance with previous research [2,7,8]. An increase in serum creatinine was linked with an increase in TSH levels.

The GFR is reversibly decreased (by roughly 40%) in more than 55% of hypothyroid people. There are several mechanisms for the GFR decline seen in hypothyroid people. Reduced cardiac output, increased peripheral vascular resistance, intrarenal vasoconstriction, decreased renal response to vasodilators, and decreased expression of renal vasodilators like vascular endothelial growth factor insulin-like growth factor-1, all contribute to the reduction of renal blood flow in hypothyroidism.

[Steakxchips in reply to SlowDragon]

SlowDragon I cannot THANK YOU enough for all your time ,help you have given me..and all others on this forum you truly are such a kind dedicated person help each and everyone here needing the best help and advice Thank you so so much...I am learning so much from this forum I never realised just how much our thyroid controls are body's..doctors told me absolutely nothing..just take this tablet,because I was recovering from head,neck cancer I just done as I was told.yes I told my doctor that you Slow dragon advised that my dose was to low so no questions he upped it I have now been taking 100mg Teva for 2 weeks I'm bit dizzy, in mornings until I take levo wait hour then after breakfast I feel ok.Kidneys still reading high bit of stomache every day back pain as well but a whole lot better then few weeks ago! Thank you S/D

[Tina_Maria in reply to Steakxchips]

Just wanted to say low Vitamin D levels can have a surprising influence on your overall wellbeing - and as Slowdragon has pointed out, upping your level can assist in improving how your thyroid hormones are working.

Although the daily recommended allowance for Vit D3 is 600IU in the UK, this is far too low to build up a sufficient level, if your levels are low like yours, especially in winter and when you have absorption issues. There are excellent supplements that provide 3000IU Vit D3 + Vit K2 in one supplement. As Vit D3 and Vit K2 are fat soluble, they should be taken with a fatty meal. Add Magnesium in as well, as it is a co-factor for Vit D and will help with bioavailability.

It takes a while to build up your levels, especially when they are low, but you will soon see improvements once you are on a daily regimen.

[Steakxchips in reply to Tina_Maria]

Thank you so much for your advice can I ask where you could suggest is best place to shop for all vitamins needed..thank you Tina Maria..

[SlowDragon Administrator in reply to Steakxchips]

Google who’s cheapest & has brands you are looking for

Amazon or iherb have extensive ranges

Vitamin D - Better You vitamin D mouth spray with K2

Widely available including high st.

Vitamin B complex, B12, magnesium all probably only available and/or cheaper online

[Lulu2607 in reply to Steakxchips]

Hi Steakxchips . For vit D get the Better You Vit D, + K2 spray 3000IU. Readily available in eg Boots. It is better than tablets as it doesn't enter the digestive system. Spray inside mouth (cheek) as directed. Your vit D is very low and the spray will bring it up. The impact of low vit D is profound, more so in hypothyroid patients. It can make a big difference to your feelings of wellbeing.

[Steakxchips in reply to Lulu2607]

Thank you so much Lulu2707 I took your advice, just great to know you can relie on such help from this forum

[Tina_Maria in reply to Steakxchips]

No worries

Amazon have a good range of Vit D3 supplements with K2, try to source one that has no nasty fillers or other additives.

I have good experience with this one, but there are others out there as well.

amazon.co.uk/gp/product/B07...

Basic Thorne and Igennus B-complex can also be obtained on Amazon, as can magnesium.

Try to test your Vit D level again after around 6 months, after you had daily supplementation. This way you can see where your levels are and if you need to adjust your dose. Good luck!

[ Link edited to remove excess information which might link back to poster. ]

[Steakxchips in reply to SlowDragon]

SlowDragon you suggest I take 100mg levo alternat days would I be ok doing that tho I've taken 100mg for past 2weeks? Thank you.

[SlowDragon Administrator in reply to Steakxchips]

If you’re fine on 100mcg every day…..stick on that

Retest after 8-10 weeks

Your previous post …you said had gone back down to 75mcg ….good you are now tolerating 100mcg

doctors told me absolutely nothing..just take this tablet,because I was recovering from head,neck cancer

Presumably you had radio therapy..

ahns.info/survivorship_intr....

Many patients who have radiation therapy for head and neck cancer receive radiation to the area of the thyroid gland, an important organ located in the midline lower neck. Damage to the thyroid gland from radiation therapy can result in hypothyroidism.

How common is it among head and neck cancer patients?

Up to 50% of patients treated for head and neck cancer with radiation therapy develop hypothyroidism. This can occur years after completion of therapy.

[Steakxchips in reply to SlowDragon]

Yes S/D 33 doses of radiotherapy thank you for this info.