results

[Thelostboys]

Hello everyone my blood test records came today i don’t understand what everything means but i’m sure you will let me know if anything is wrong. I am on 50mg of Levothyroxine plus iron and folic acid prescribed by my doctor as i was low in iron. My T24 was normal TSH normal my vitamin D and B12 were normal as well i don’t know whether to take B6 as the tablets i am on are making me anxious and grumpy ⭐️

[helvella Administrator]

You have posted five new posts today.

results

healthunlocked.com/thyroidu...

results

healthunlocked.com/thyroidu...

vitamins

healthunlocked.com/thyroidu...

results

healthunlocked.com/thyroidu...

results

healthunlocked.com/thyroidu...

This makes it next to impossible for us follow.

One does have some results in the post but they are too small to be able to read properly.

You need to go to a one of your posts - maybe this one - and use the Reply button. Replies stick with the post they are with.

And it might be better just to type out your results in a reply.

I'll close any remaining posts so that we do not get replies spread across them all!

[Thelostboys in reply to helvella]

Thank you very much i was having trouble putting the picture on that’s why there are so many. Shall i try tomorrow and put the post above on .I am so sorry ⭐️

[Jazzw in reply to Thelostboys]

Well, here’s the only picture I can see. Are there any more?

Your TSH is still quite high—I’d say it indicates that you might benefit from a raise in levothyroxine, perhaps to 75mcg per day

Blood test results

[Thelostboys in reply to Jazzw]

Thank you it is very small writing i am so sorry. Couldn’t put the other picture up but it was my vitamin D and B12 and they came back normal.

[Jazzw in reply to Thelostboys]

It’s fine—we can see enough.

What were your B12 results, do you know?

[Thelostboys in reply to Jazzw]

Yes my B12 was normal so we’re all my others but i don’t know if i should take extra vitamin B do you have any suggestions.Thank You.

[Jazzw in reply to Thelostboys]

You really need to know what the result is. “Normal” is often more of an opinion than a fact, especially with results like B12. In some countries, normal is having a serum B12 result of more than 500. But in the UK, many of the lab ranges start at 180 or so, which is too low and is likely to be causing symptoms.

[Thelostboys in reply to Jazzw]

Hi Jazzw it says serum level 211 for my B12. But it says normal next to it.

[SlowDragon Administrator in reply to Thelostboys]

You Serum B12 looks EXTREMELY low

Please add ranges

Please add folate result too

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...

[Thelostboys in reply to SlowDragon]

Thank you very much i am going back to the doctor in two weeks i will mention all that you have said.

[SlowDragon Administrator in reply to Thelostboys]

When you see GP

Have a clear list of hypo symptoms

GP won’t prescribe vitamins you will need to self supplement

Start B12 supplement NOW

and add Vitamin B complex a week later

[SlowDragon Administrator]

50mcg is only standard STARTER dose

As I added in previous post earlier today ….you need dose increase in Levo now

healthunlocked.com/thyroidu...

TSH 2.26

This is rather high for someone on Levothyroxine

FT4: 12.7 pmol/l (Range 7.8 - 18)

Ft4 only 48.04% through range

Request 25mcg dose increase in Levothyroxine

If GP is reluctant ask as a “trial “

Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)

cks.nice.org.uk/topics/hypo...

bnf.nice.org.uk/drugs/levot...

nhs.uk/medicines/levothyrox...

Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.

Some people need a bit less than guidelines, some a bit more

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

onlinelibrary.wiley.com/doi...

If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).

sciencedirect.com/science/a...

The optimal daily dose in overt hypothyroidism is 1·5–1·8 μg per kg of bodyweight, rounded to the nearest 25 μg.

[Thelostboys in reply to SlowDragon]

Thank you very much i will mention this to the doctor ⭐️

[SlowDragon Administrator in reply to Thelostboys]

Print out clear guidelines in links I gave you

Be ready to show these ONLY IF GP reluctant to increase dose

They may be happy to increase dose…..don’t antagonise

[Thelostboys in reply to SlowDragon]

Is it alright if my husband prints them off and then i can take them with me. I don’t understand it all.And to tell you the truth i don’t think my doctor has ⭐️

I won’t antagonise i will be as sweet as i can be 🤣

[SlowDragon Administrator in reply to Thelostboys]

The basic point (often not understood by GP) is that once we start on Levo (usually at 50mcg daily) in almost all cases dose levothyroxine needs to be slowly increased upwards over next 6-12 months until on approximately full replacement dose (approximately 1.6mcg per kilo of your weight per day)

Levo doesn’t “top up” your own thyroid hormone levels, it replaces it . This is because once we start on levothyroxine the pituitary “senses/sees” the Levo dose and reduces TSH

TSH is the message from pituitary asking thyroid to make thyroid hormones

Lower TSH means thyroid isn’t making as much thyroid hormones……so you need next dose increase

Improving low vitamin levels will help reduce symptoms and improve how you use levothyroxine. It makes it easier to tolerate dose increases

Retest bloods 6-8 weeks after each increase in dose

Once you work out which brand Levo suits you best…..ideally always get that brand

[Thelostboys in reply to SlowDragon]

Thank you i didn’t know THS did that in fact i don’t understand quite a lot of things.I suppose i will learn quite a lot from this group.

[SlowDragon Administrator]

low B12 and folate

GP will only prescribe supplements when results are below range

But the range is too wide

Down to you to self supplement to maintain OPTIMAL levels

It’s chicken and egg when hypothyroid

Low thyroid levels results in low stomach acid, this results in poor nutrient absorption and low vitamin levels

Low vitamin levels affect how well we convert Levo (Ft4) into active hormone (Ft3)

[Thelostboys in reply to SlowDragon]

Hi i’m confused what do you suggest i take.Thank You.

[SlowDragon Administrator in reply to Thelostboys]

I gave you details above regarding starting with a separate B12 supplement

A week later add a separate vitamin B complex

Here it is again…..

With serum B12 result below 500, recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

(Or private test - active B12 below 70)

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 until over 500

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

[Thelostboys in reply to SlowDragon]

So sorry i forgot i have read the article by human bean she/ he really knows what’s going on ⭐️