Hi all - happy new year!I posted 7 months ago for the first time as I was so ill and am really grateful for the advice I got. I was taking 50 of Accord and 25 of Teva. It was suggested that the Teva might be causing me problems and that I should try splitting the Accord tablet.
I did this and, within 2 - 3 days, the horrendous anxiety I had endured for at least 12 months disappeared. Whilst my reflux symptoms have not gone, I have been able to reduce my Esomeprazole dose from 80 to 20mg.
I had my results checked after approx 6 - 8 weeks. Fasting, pre taking meds.
Because my cholesterol was high and I was borderline anaemic, I was told to have them repeated in 8 weeks. I was then given iron tablets and had bloods repeated just before Christmas. When I phoned for results, I was told that everything was normal, so I asked for them to be printed. I'm concerned that my thyroid tests are moving in the wrong direction. I've gained 7lbs in 8 weeks, and am lacking energy despite improving iron and ferritin levels. My GP noted that my T3 was not to be tested again unless specifically ordered by him.
B12 (>350) 9/9, 719 20/12, 694
Folate (3-26.8) 9/9, 11, 20/12, 6.6
Transferrin (2-3.6) 9/9, 2.91 20/12, 2.83
Iron (10-30) 9/9, 8 20/12, 11
TSH (.27-4.2) 9/9, 1.86 20/12, 3.55
FT4 (12-22) 9/9, 18.2 20/12, 16.4
FT3 (3.1-6.8), 2/7, 3.5 20/12, 3.6
HbA1C (20-41) 2/7, 41
Apologies for lengthy post, but I would be very grateful for any further advice.
My GP has never tested for antibodies or referred me to an endocrinologist.
I supplement with Thyroid complex from Hey Nutrition and Iron Bisglcinate by Vitabright
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Most people when adequately treated on Levo will have Ft4 (levothyroxine level) at least 60-70% through range and Ft3 not far behind
Contact GP for next dose increase in Levo to 100mcg
75mcg is low dose unless extremely petite
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)
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
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).
Iodine not recommended for anyone on levothyroxine
Suggest you stop it now
Definitely get BOTH TPO and TG antibodies tested at next test - test 2-3 months after increasing dose Levo to 100mcg daily
Get vitamin levels tested at next test privately if necessary too
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
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
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking any iron supplements stop 5-7 days before testing
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
I was prescribed iron tablets in September but have struggled to take them as they aggravate my reflux. I'm usually managing around 40mg per day. GP wanted me to take 200mg every other day and did not tell me to stop taking them before the tests were done. As far as he is concerned, 11 is in the normal range.
The comment about the ferritin affecting hair is really interesting. I complained all summer that I thought it was thinning and it has definitely been better over the last few weeks, mirroring when my ferritin has started to come up again!
I have found, in my GP practice that no-one cares about optimal results. If it doesn't breach the normal range it's fine.
I know that I'm gushing, but I'm so grateful for the help I get here. I have been so ill and the only improvements in my health have come from the advice that you've all given
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
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
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
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
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Do u all think i need t3? Will i be able to tolerate levo with a little t3?
6 weeks on T4/T3 - thyroid, advanced iron and vit d test results - advice please and mini update :) 
Baffling results on T4&T3!
Advice on results - Reduce T3 ? 
Blood results
