hello!
I’m just after some info about thyroid levels.
I don’t know much about it and I’d like to know if it’s contributing to me feeling lousy. 36yo female, Australia
TSH 1.15 mIu/L (range 0.4-3.5)
Free T4 10.9 pmol/l (range 9.0-19.0)
I have B12 deficiency, Raynauds, and recent tests showed mild deficiency in Vit D (44nmol/l from a range of 50-140). I’ve heard the words mild deficiency before with the B12 though so I’m assuming it’s actually not great.
thank you!
Ft4 is very low in range
TSH is not responding to that
Improving low vitamin levels is first step
Then retest thyroid including thyroid antibodies and Ft3
Also request ultrasound scan of thyroid
You need folate and ferritin levels tested too
Ideally full iron panel test as well
Are you vegetarian or vegan
Any autoimmune diseases in your family
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 when hypothyroid, especially with autoimmune thyroid disease
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
Often medics only test TG antibodies if TPO are high
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels
VERY important to test TSH, Ft4 and Ft3 together
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
thank you!
You need folate and ferritin levels tested too
- folate was 56 something (I take a small dose on injection days plus my diet has lots of folate rich foods)
- ferritin was 53 (sorry don’t have my tests with me right now)
Ideally full iron panel test as well - my levels were good last test, including the ferritin of 53. I think that’s the highest I’ve ever had in my life.
Are you vegetarian or vegan - no, very balanced diet
Any autoimmune diseases in your family - pernicious anaemia is under investigation. Mum has lupus and MGUS
For full Thyroid evaluation you need TSH, FT4 and FT3 tested - i think FT3 isn’t commonly tested or it’s a cascade test here in Australia, and since mine are in range, it hasn’t triggered the cascade? (Could be wrong)
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
- B12 injections frequently so testing is pointless
Your mum has autoimmune disease
Request that both TPO and TG thyroid antibodies are tested at next test
As you have B12 injections it’s recommended also to supplement a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.
This can help keep all B vitamins in balance and may help maintain B12 levels between injections
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
Vitamin D need improvement to at least around 80nmol
GP will often only prescribe to bring vitamin D levels to 50nmol.
Some 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
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
thyroid test results after a 25mg increase, could someone have a look for me ..
Levels update
Hypo
Follow up from GP call 
B12
