Firstly I would like to say hello to everyone as this is my first post.I really need help to put things right with these results but just don't know where to start. It's all a bit overwhelming.
I have hypothyroidism.
I am on 100mg of levothyroxine (accord). Been on that dose for around 10 years.
Tests were done 24 hrs after last dose at 8.50am . Only water from wakening.
My weight is 74kg.
I am not on any other medication or supplements. Levo is the only thing I take. Don't drink for at least an hour before or after taking and no food for 3 to 4 hours before or after.
Very tired all the time, no energy and the brain fog is terrible and memory getting bad amongst all the other symptoms of this.
The test results from medichecks are as follows.
Crp hs (0-3) 2.13
Ferritin (30-264) 145
Folate serum (7-35) 11.8
Vit b12 active (37.5-187.5) 82.1
Vit d (50-200) 77
Tsh (0.27-4.2) 0.904
Free t3 (3.1-6.8) 4.3
T4 (12-22) 21.7
Tgab (0-115) 24
Tpa (0-34) 21.8
I would be so grateful for help here, to know where to start. Thank you in advance.
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It’s trial and error what dose we need, with thyroid issues
Perhaps try 1 or 2 sprays per day initially
Retest in 2-3 months
Couple weeks later add a magnesium supplement in afternoon or evening (at least 4 hours away from Levo). This can help with poor sleep
B) folate on low side.
Look at adding a daily vitamin B complex
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
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)
Retest thyroid and vitamin levels 6-8 weeks after adding last vitamin supplement
Thank you so much for your speedy reply slowdragon (wow). I am scratching my head now wondering why I have not done this before now. This forum is amazing. I will start on the vit d ASAP. Will follow the advice as I go along.
A trial of strictly gluten free diet is always worth trying
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, especially brain fog
While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
First off - just sending a big hug as so many of us have been made to feel stupid by doctors :
Quite why, ages ago, you were not allowed to take T4 - Levothyroxine and an iron supplement is beyond me -
many of us find that once hypothyroid and with a slowed metabolism we have trouble extracting key nutrients just from food -
and need to supplement to maintain optimal levels of ferritin, folate, B12 and vitamin D which are the co-factors to being able to convert the T4 into T3.
T4 - Levothyroxine is a pro-hormone and needs to be converted in the gut into T3 which is the active hormone that runs all your bodily functions - from your physicality and stamina through to your mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.
We generally feel best when the T4 is up in the top quadrant of its range at around 80% with the T3 tracking just behind at around 70% through its range and at around a 1/4 ratio T3/T4.
So currently your T4 is at 97% with a T3 at 32% showing your body struggling to convert the T4 into T3 - and with poor conversion -
Put another way once the T4 is up in the top quadrant of its range - we generally feel best when we come in this little conversion ratio at 1 / 3.50 - 4.50 - T3/T4 - at 4 or under -
so if I divide your T3 result of 4.30 - into your T4 result of 21.70 I'm getting your conversion coming in at 5.04 - so wide of the accepted conversion ratio of 4 or under and simply confirms your struggling to convert T4 into T3.
Optimal vitamins and minerals for optimal conversion of thyroid hormone replacement means, for me , my ferritin maintained at around 100 - folate at around 20 - active B12 125 ( serum B12 500++) and vitamin D up at around 125.
You may well find once you build your B12 and vitamin D your level of T4- on the same dose of T4 - goes down with your T3 going up - because of a better foundation core strength vitamin and minerals.
Your conversion of T4 into T3 can also be down regulated by inflammation, antibodies, and long term chronic health issue, any physiological stress ( emotional or physical ) depression, dieting and ageing - so yes, there is a lot to understand and goal post can move as one ages.
You inflammation a little high - this can also cause a raised ferritin level - ?? - so seeing as you were needing to supplement iron years ago - I trust your ferritin level a true picture since low ferritin seems to be common for many of us.
Do you remember why you were diagnosed with hypothyroidism - was it due to high antibodies and Hashimoto's ?
Hi pennyannie and thank you for replying. What you and slowdragon are saying has started to make a lot of sense to me though I have just skimmed it and will need time to really digest it all. When the dr took me off the ferrous phosphate she said it was because it would cancel the levothyroxine out, but I know now that would only be if I was taking it close to the levothyroxine. I don't remember if it was high antibodies and hashimotos.
Ok then - there is a lot to get your head round and yes -
Levothyroxine - T4 - is a fussy hormone and needs to be taken well away from any other medication - and on an empty stomach - and taken with water with the need to then wait another good hour before you eat or drink anything other than water -
and why I take my thyroid hormone replacement in the middle of the night at a toilet break - as I doubt I'd wait long enough in the morning before downing a cup of tea or coffee.
Any iron supplement needs to be taken well away from any other supplement - and it does become a question of which supplement and when - and we can advise on that if you wish.
Yes I have started taking it in the wee small hours too as I like my coffee on wakening also it just makes the eating and drinking so much easier to navigate. I will start on the vit d then will get advice on how to introduce the magnesium. Thank you.
I take - an Ingennus magnesium complex- which is a mix of citrate, taurate and bisglycinate and taken in the evening it helps with bowel motility the following day and gives a deeper nights sleep
Thanks pennyannie. There's so so much out there, so it's half the battle to know what I should be looking for. That's the kind of thing I was finding so overwhelming so I am grateful for all the advice. I don't feel so alone in all this now. I have actually felt my shoulders dropping today. I know I have a long way to go but I'm so glad I have finally took the bull by the horns.😊
Well it's because of people like you we have this forum. I too have not had the confidence until now. I have been watching and reading posts for the past few years and have became 100% trusting in the advice given.
If you get lost reading around on the forum - just press your Profile Icon - sitting alongside the My Hub - Chat - Post - Alert and Menu functions on the task bar - top right on this page if on a laptop.
All forum members have Profile pages - where you can read their thyroid journey and all they have ever written on the forum - just press their Profile Icon which sits alongside their name in any post.
You might like to dip into the Thyroid Uk website which is the charity who supports this patient to patient open forum - and where you will find all things thyroid and supporting charities, businesses and associations. thyroiduk.org
A doctor took you off levothyroxine because she said it would cancel out the ferrous phosphate ... OMG, I truly despair when I hear things like that. 🤦♀️ Makes you wonder how on earth she managed to get a medical licence - and come to think of it, I think she should actually hand it back!
At least you know that the advice you get on here makes a lot more sense, and once you start to improve your nutrients, you will see improvements. It can take some time, so try to be patient with yourself, but in time you will notice a difference! Sending you a hug 🤗.
Thank you Tina Maria. At least I feel hopeful now. I didn't think it was right at the time but stupidly trusted what I was told. There is a lot to be said for going with your gut instinct.
Oh Tina Maria I was put on levothyroxine by my own doctor then another doctor told me it was iron I needed and took me off the levothyroxine. Then my own doctor told me I had to go back on the levothyroxine and I should not have been taken off it and took me back off the ferrous phosphate.
We can all read everything that is written - when you reply to a forum member just ensure you use the Reply icon within their post as then as you start writing their user name pops up which means they get an email notification to return to your post.
We generally try and answer all new posts as thoroughly as possible within around a 24 hour window from first posting and move on due to volume of new posts stacking -
and any new information deserves a new post/question - so all forum members have an opportunity to reply and support -
rather than tacking anything onto the bottom of what is considered an old and answered question.
Your Alert icon might be a bit dodgy - mine is - it doesn't light up when forum members ping me - and when lit and ' on ' stays on even though I have opened and accessed its function - and can only clear it by closing down the forum and starting again - hope that makes some sense!!
Yes that makes sense pennyannie. I do everything on my phone. I will start a new post next time I post. Yesterday when I tried to post my first reply I pressed the reply button but didn't realise I had to press it again after I had written, to send as well, I was looking for a send button. I'm not very techy but I will get there. Thank you very much.
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