Help with blood tests - T4/T3 folate and cholesterol

[Pinkcosmo]

Hello everyone.

I haven't posted in a while although I keep reading and trying to learn.

After a lot of pressure from family about the 'risks of buying meds online' I stopped taking the Thyroid -S last summer and I've just been going through the motions, taking the prescribed 125mcg of Levothyroxine and feeling miserable. In fairness, summer is better than winter, when I honestly feel like I might die from the cold and just want to hibernate.

A few weeks ago I had my meds review blood test and my TSH has come into range - 0.84 mu/L (range 0.30- 5.50) after being low for many years, so they didn't test my T4.

Unfortunately, my cholesterol has increased even more:

Serum cholesterol 6.7 mmol/L (range 0 - 5)

Serum triglycerides 0.91 mmol/L (range 0.80 - 1.80)

Serum HDL cholesterol 1.88 mmol/L (range: non-known)

Serum non-HDL cholesterol 4.8 (range 0 - 2.5)

Serum LDL 4.40 mmol/L (range: non known)

Serum cholesterol/HDL ratio 3.6 1/1 (range: non-known)

I received a text asking me to make an appointment with the nurse to discuss these results (everything apart from Cholesterol was 'normal) so I did a full test with Monitor My Health - attached images as they don't list ranges for vitamins - (Blood test taken 8.30 am - 24 hrs after the last dose of Levothyroxine, fasted since the previous evening. I always get the same brand of Levothyroxine and normally take D3 and B12 supplements but hadn't for about a month before this test.)

I've read as much as I can about cholesterol and am still confused!

I'm quite well-read on a healthy diet and I think I'm doing all I can in that respect to control cholesterol so I'm unsure if an appointment with the practice nurse will be helpful, and since my lovely, sympathetic GP is no longer available, a five-minute appointment with the new practice GP also feels overwhelming.

I can see that I need an increase in Levo but folate also looks low?

Any advice is very gratefully received.

[SlowDragon Administrator]

Which brand of levothyroxine do you get?

Aiming for Ft4 and Ft3 at least 60% through range

Request “trial” dose increase in Levo to 137.5mcg daily

Either 125mcg and 150mcg on alternate days or cut a 25mcg in half to make 137.5mcg daily

what vitamin supplements have you been taking

Folate is far too low

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...

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 if last test result serum B12 was below 500 or active B12 (private test) under 70

[Pinkcosmo in reply to SlowDragon]

Thank you for the speedy reply! I always have the same Levo brands - 100 mcg Almus, 25 mcg Mercury. I take D3 + K2 and recently changed to Nutrition Geeks B12 Dual Power because I was find the other brands too expensive.

[SlowDragon Administrator]

cholesterol will reduce once Ft3 improves

Currently Ft3 is BELOW RANGE

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

[Mandyj2]

Hi Pinkcosmo, please go back and read your posts from a year ago: you were cleaning out attic space and sounded full of energy. You’d found your sweet spot

Maybe your family would understand now as they can see you’re not well without the self prescribing? The meds will sort out your cholesterol too.

I hear you about the dreaded cold.

Good luck.x

[Pinkcosmo in reply to Mandyj2]

Thank you! I've just read that post and it sounds like a different person. It takes all the energy I have to even make it upstairs atm! I also understand how alarming it sounds when you say you are buying medications from Thailand. Perhaps I'll print out that post and show hubby.

[Mandyj2 in reply to Pinkcosmo]

That’s a good idea. I’m having a similar conversation with my other half tonight, am dreading it! I keep reminding myself that if I could get medicated correctly from my GP I would!

Good luck ☀️

[Pinkcosmo in reply to Mandyj2]

Good luck! I try to imagine what I'd be saying to him if it were the other way around and I'm sure I wouldn't understand. It's so complicated to explain and he can't understand why the NHS wouldn't treat me if I need more meds.

[Tina_Maria]

I think it was very wrong for your family to pressure you stopping a medication you so clearly need. I have been reading previous posts and especially your T3 was in a much better place then, as was your cholesterol!

T3 is the driver of your metabolism, which means that if your T3 is low (or in your case under-range even!), your metabolism is severely compromised. That means, apart from feeling tired and not having enough energy, your metabolism cannot deal with lipids such as cholesterol, hence the levels will rise, as your liver cannot effectively clear them from your circulation. This is not a dietary problem, but a problem of your metabolism. High cholesterol is a recognised sign of hypothyroidism (even the NHS states that on their website), hence you should be given an increase in your medication.

TSH is not a good guide for treatment, as the normal TSH feedback is not working in the same way as it does in a person without thyroid disease, therefore the free T4 and T3 should guide your treatment.

You definitely need an increase in thyroxine with both your T3 and T4 so low, but if the T3 will not come up to a decent level even when your T4 is much higher, I would think again about T3 medication. At the end of the day, it is your health that is at stake, no one else's! And you need to decide what is acceptable for you and what is not. And being ill and not feeling well should not really be acceptable for you or your family.

[Pinkcosmo in reply to Tina_Maria]

Thank you for your comments. I think my family were just worried about me. You read stories all the time about people becoming seriously ill after buying fake drugs online and it's hard for them to understand why the NHS don't seem to offer the treatment that would make me well. I'm going to ask for more Levo and if it doesn't help I will have to try the Thyroid-S route again I guess. I can't carry on like this any longer for sure.