In my first post a week ago I asked about my thyroid results so far and vitamins: healthunlocked.com/thyroidu.... I had lots of useful advice on the interpretation of my thyroid results and a recommendation to do some bloods to look at vit D, B12, ferritin and folate.
I am vegan and 47. I am on HRT. I'm not taking any supplements - I wanted a baseline before starting.
So I did the Monitor My Health Full Health test on Monday and these were my results:
Thyroid:
TSH: 7.29 (0.27-4.2) This is 178.6%, up from 4.8 or 115% 9 days ago, but test was done at 07:20 compared to 09:30.
FT3: 4.7 (3.1-6.8) This is 43.2%, from what I've read >75% is ideal.
FT4: 15.7 (12-22) This is 37% from what I've read ~50% is ideal.
I know I fall in the subclinical hypo category at the minute and I tested positive for TPOAb, Hashis, earlier in the month. I'm not on levothyroxine. I've developed rosacea at the same time and been given metrosa gel to try. I plan to start an elimination diet from 10th Feb.
Vitamin D:
Vit D: 28nmol/L - very low/deficient. Wasn't surprised, I did think it would be. I think I should be aiming for >75nmol/L (optimal), is that right?
Anaemia:
They have said the results below are all 'normal', however I'm aware there is a difference between normal and optimal. They also said they don't have reference ranges for the tests below, just cut off points which I've added below:
Haemoglobin: 124g/L (<120 suggests anaemia) I may have 'passed' but it is at the low end, is there an optimum?
Ferritin: 89ug/L (<15 suggests iron deficiency) I found a website which suggested low is 15-29 ug/L, indeterminate is 30-99 ug/L, normal is 100-310 ug/L and high is >310 ug/L. So is this a bit low?
Transferrin saturation (TSAT): 37% (<16% suggests iron deficiency)
Folate: 5.4 ug/L (<3 suggests folate deficiency) I found a website which suggested indeterminate zone is 3-4.5 ug/L. I can't find an optimal. So is this OK?
Active B12: 58pmol/L (<38 suggests deficiency). I'm vegan, so I thought it would be low. Is optimal >70? I found a website which suggested average female levels are 114pmol/L?
So I'm going to supplement vitamin D (with K2-MK7) and B12, but I'm not sure about iron. If you could confirm that I've understood this properly I'd appreciate it! Any suggestions of good quality supplements or other next steps would be welcomed too.
I'm hoping that when my GP appointment comes through I'll be better informed and able to advocate for myself. It's been suggested I find out my iodine levels, which I'll ask for. Are there any others important ones I should request (selenium, magnesium, potassium, zinc) or interactions?
Many thanks
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What vitamin supplements have you been taking up until this test
Yes B12 and folate are too low
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.
As vegan likely to need ongoing separate B12 at least a few times a week
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) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70
Thank you so much for all this information @SlowDragon - I've been digesting it over the weekend and have ordered vitamin D (with cofactors) and B12 based on your recommendations. I'll space them apart and delay the elimination diet till I've started all the vitamins. I've still got a bit of reading to do on the B-complex info you shared before ordering that.
I've been vegan for 7 years (and I was vegetarian for about 30 before that). I've not been a regular supplement taker. Occasionally I've take magnesium (if struggling to sleep) or some vitamins if I'm feeling run down, but nothing on a regular basis. I will be more diligent now.
I really appreciate the wealth of info you've shared - it will save me wasting any more money and hopefully make a big difference ☺️
Push to be starting on Levo or if GP won’t agree see thyroid specialist endocrinologist privately
standard STARTER Dose is 50mcg and 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
Thank you for this also @SlowDragon! I will definitely push for treatment or a referral and failing getting either see what I can do to see someone privately. The info you have provided will be really helpful in making a case 🙏
I had a look through my records and I had a blood test when my thyroid was working normally 9 years ago - at that time my TSH was 1.77, so I have some info on what normal was/should be for me, which is fortunate.
By the way, Rosacea was one of my first symptoms years before diagnosis. It resolved once I got on thyroid hormone replacement. And it will only flare up when there’s something going on with my hormones overall. Right now it’s my perimenopause causing issues : )
Metrogel didn’t work for me. Not sure if there’s an equivalent to Soolantra available where you are. It’s an ivermectin cream that works for me and a couple other people I know where metrogel didn’t work.
Separately - your iron status is good right now. It needs to be monitored over time when you’re hypo, but you can drop it to the bottom of your priority list until you take care of your other more pressing needs!
That's really interesting FallingInReverse - I'm glad the thyroid hormone replacement has helped to sort your rosacea out. The metrosa gel isn't really doing much (I've just had a big flare up). It just seems to generally be spreading and getting worse over time. I plan to talk about the link with my GP at my next appointment and see if there is an alternative, especially if I'm not offered any thyroid hormone replacement. I'm perimenopausal too (on HRT) and it's hard working out which symptom matches which issue when all the hormones are retreating! I'm hoping my residual issues will clear if I'm offered thyroid hormone replacement.
I haven’t read any of your background or other posts if you have any.
But from my experience - part of rosacea is genetic predisposition, then if that is there, there are two distinct triggers - vascular when it comes to flushing, and inflammation when it comes to the little pimple like dots.
Being hypo exacerbates both of those triggers. Hypo can also include gut issues or histimine reactions that also cause inflammation triggered rosacea flare ups.
Hormone changes throughout our monthly cycle can also trigger blood vessel dilation issues and inflammation.
On top of it, there’s a mite/bacteria issue, a certain type is at play with rosacea.
So I learned that metrogel inhibits and reduces the bacteria and mites, and therefore reduces the inflammation because there are less of them. But it also doesn’t target any hormonal or histimine causes of the redness.
But soolantra kills the mites entirely, AND it also targets inflammation pathways directly .
Even as prescribed, metrogel says 4-8 weeks of use and soolantra says 2-4 weeks to work.
Personally the metrogel never worked and the soolantra noticeably works overnight esp when I catch a pimple early.
That being said - soolantra isn’t even covered by my awesome current private insurance here in the US so I am milking the tube I have from a couple years ago to make it last. The good news is thyroid treatment has reduced my flare ups to one time a month if at all, and the flare ups are really small surface area now.
Lastly… there’s also a brand called Mirvaso. That too I have a small bottle from a long time ago… it is a pure vaso -constrictor.
That too isn’t covered by my insurance and I can’t imagine any public insurance would cover it but who knows!
It’s a clear gel that with the tiniest amount smoothed over your skin in about 10-15 minutes all your blood vessels close up and all the red in your skin disappears like magic. So effective I have to be really careful putting it on or you get white halos around the dot I’m erasing. It is like erasing the red, and your skin turns a normal skin color like photoshop! It only lasts a few hours but for events or parties it’s great to not worry about powder touch ups all night.
That being said - metrogel seems to be the inky thing we can get easily huh.
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