I’ve just had my bloods done due to suffering with severe chapped lips for no reason. I’ve got a doctors appt tomorrow morning so need to arm myself with as much information as possible as I always have to fight to not reduce my dose. I currently take 150 levothyroxine. Any help is greatly appreciated .
serum tsh 0.08 (0.35-5.5)
t4 19.5 (10.5-22.7)
serum ferritin 115.8 (10-291)
B12 396 (211-911)
Vit D 78.9
Have you ever done a private test to see if you convert enough and what your fT3 levels were compared to fT4 level?
You would certainly benefit from boosting your B12 to top of range and also your Vit D to 100-150 nmol/L grassrootshealth.net/projec...
You are within your rights to refuse a dose change
Thank you for your reply. I think it may be time to do a private test re T3. I’m hoping the doctor will listen to my request to focus on getting the vits levels up before going down the road of reducing thyroxine but I always feel it’s a battle
Free T4 (fT4) 19.5 pmol/L (10.5 - 22.7) 73.8% You are not over-replaced!
Keep it simple and just say NO... thank you to any reduction🙂and you can baffle them by saying you will be getting a private Full Thyroid Panel done to properly assess your condition!
I find the less word you use the better and just be firm 🤗
You won't get any help with your low B12 and Vit D as they are within 'normal' range but optimizing is the key
no folate result ?
B12 very low but not low enough for GP to acknowledge or treat
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
How much vitamin D are you currently taking
Look to improve to around 100nmol
Do you always get same brand levothyroxine at each prescription
Was test early morning and last dose levothyroxine 24 hours before test
Refuse to reduce dose levothyroxine and get TSH, Ft4 and Ft3 tested 6 weeks after working on improving low vitamin levels
If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "
Vitamin D I take the spray better you with vit k
I always get my blood test first thing in the morning (tip seen on here ) and wait on taking levothyroxine until afterwards
I always get the same brand as well Accord (tip seen on here )
No folate result
The only other result I have that looks low is
lymphocyte count 1 58 (1.1-4.5
Thanks for all advice
Vitamin D I take the spray better you with vit k
How many sprays per day?
3 sprays but every other day as didn’t think my levels were too low so maintaining after vit D crash a few years ago.
Suggest you increase to 3 sprays every day
Retest in 2-3 months
Yes I will do. Thanks for all your advice.
Given both your ferritin and b12 are low. I would look at the recent NICE Guidelines on b12. Yes your b12 is in range but if you have symptoms it still could be due to b12 deficiency. Look up b12d.org and do their assessment profile. The very chapped lips could be related to b12 deficiency. There is talk about the b12 test not being accurate since they bought in new testing equipment in the nhs labs. The b12 active test is also not as great as they thought it would be. The range isn't great and in the guidelines it does acknowledge that if you have symptoms and your b12 is on the low side your GP should be suspicious. Your GP need to test for homeosteine and MMA.
Hi. I've boost put your budgets into my blood test calculator to see the percentages.
TSH .08 (.35 - 5.5) -5.2%
Free T4 (fT4) 19.5 (10.5 - 22.7) 73.8%
Vitamin B12 396 (211 - 911) 26.4%
Vitamin D 78.9
Ferritin 115.8 (10 - 291) 37.7%
thyroid.chingkerrs.online/?...
Thank you this. I had my appt this morning. As expected they said all bits were fine but they did agree to leave thyroxine alone for the time being so a small win. I am going to have to get my vitamin levels up by myself so that is my priority.
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