Advice on results following increase in levo

[UFU011878]

Hi all, I've just had a Blue Horizon Thyroid profile done as my TSH had doubled in 3 months and T4 had started to drop. I have a dramatic drop in TSH and would appreciate some advice. Thanks in advance 🙂

TSH (.27 - 4.2)

20/12 3.55

10/3 .17

FT4 (12 - 22)

20/12 16.4

10/3 21.3

FT3 (3.1 - 6.8)

20/12 3.6

10/3 4.7

Active B12 138 (37.5 - 150)

Folate 16.2 (8.83 - 60.8)

Ferritin 49 (13 - 150)

D(25-OH) 23 (50 - 200)

Magnesium 0.9 (.7 - 1)

CRP <0.6 (<5)

Anti Thyroglobulin Abs 25 (<115)

Anti Thyroidperoxidase Abs <9 (<34)

Cortisol (8am fasting) 375 (166 - 507)

[SlowDragon Administrator]

so looking at previous posts

Now on 100mcg Levo ?

Which brand is it

Presumably you tested as recommended early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

How are you feeling

Free T4 (fT4) 21.3 pmol/L (12 - 22) 93.0%

Free T3 (fT3) 4.7 pmol/L (3.1 - 6.8) 43.2%

Shows slightly high Ft4 and poor conversion

Improving low vitamin levels should help improve conversion rate

Exactly what vitamin supplements are you currently taking

D(25-OH) 23 (50 - 200)

Vitamin D is deficient

Folate 16.2 (8.83 - 60.8)

on low side. Are you taking vitamin B complex?

Ferritin 49 (13 - 150)

Look at increasing iron rich foods in your diet

[UFU011878 in reply to SlowDragon]

Should have said🤦 the blood was taken fasting at 8am, 24hrs after last levo. My dose was increased to 100 on 8th January and I'm taking Accord. I was feeling ok until the last couple of weeks, when there's been a slow build up of anxiety for no apparent reason. My weight has stabilised and hair loss has stopped My folate hasn't been great so I've been taking Thorne basic b complex, though I stopped it approx 1 week before testing because of the biotin. My iron has been low - 8 (10 - 30) so I've been taking iron and it and Ferritin have been coming up slowly.

It's the first time my vit D has been checked, so I'm not supplementing it yet. Have you any recommendations for it?

Should I take a separate Folate supplement?

[SlowDragon Administrator in reply to UFU011878]

I've been taking Thorne basic b complex, though I stopped it approx 1 week before testing because of the biotin.

folate drops rapidly when you stop B complex

In days before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

vitamin d

Suggest you start on 2000iu or 3000iu daily and increase to 5000iu daily…..retest in 8 weeks

You need total of 300,000iu over 6-8 weeks

NHS Guidelines on dose vitamin D required

panmerseyapc.nhs.uk/media/2...

improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[UFU011878 in reply to SlowDragon]

This is great info. Thanks so much!

[UFU011878 in reply to SlowDragon]

Can I just ask - would you be concerned about how low my TSH is? Should I consider lowering my levo?

[SlowDragon Administrator in reply to UFU011878]

I was feeling ok until the last couple of weeks, when there's been a slow build up of anxiety for no apparent reason.

If you feel over medicated ….You might consider reducing dose to 75mcg one day per week

Retest in 8 weeks

But you should see Ft3 increase and Ft4 reduce a bit by improving low vitamin D