My latest blood test results and current symptoms. I’m on 50 mg levo at the moment. Is that about right for my TSH? My urate is slightly too high and my calcium is slightly too low – although I have a calcium rich diet. Do the urate and calcium results mean anything?
Test results:
Serum free T4 level 18.2 pmol/L (10 - 20)
Serum TSH level 5.5 mu/L (0.5 - 4.4)
Serum free T3 level 4.3 pmol/L (3.5 - 6.5)
Serum folate 5.9 ug/L (3 - 17)
Serum vitamin B12 312 ng/L (190 – 800)
Vitamin D 53 nmol/L (24 - 167)
Serum urate level 421 umol/L (200 – 420)
Rheumatoid factor 6 ku/L (0 – 12)
Calcium adjusted level 2.16 mmol/L (2.20 - 2.60)
Symptoms:
Muscle and joint pain. Especially in toes/feet, fingers/hands, arms and elbows. Leg cramps. Back ache.
Itching, tingling or burning sensations in hands, wrists and feet.
Stomach ache. Constipation. IBS like symptoms.
Dry uncomfortable eyes. Sometimes painful.
Tiredness.
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You results show you need dose increase. See GP and request 25mcg dose increase in Levothyroxine
You are very under medicated. The aim of Levothyroxine is to increase dose in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range
Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine
(Many of us need TSH nearer 0.2 than 2.0 to feel well)
50mcg is only a starter dose. Bloods should be retested 6-8 weeks after starting and dose increased slowly over many months. Retesting 6-8 weeks after each dose increase. Most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine
NHS guidelines saying standard starter dose is 50mcgs
Your vitamins are low because you are under medicated
Vitamin D needs improving certainly to over 75-80. Many on Levothyroxine find it better around 100nmol
Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you supplement 1000iu-2000iu for 2-3 months and retest. It's trial and error what dose each person needs.
Once you Improve level, very likely you will need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk
Calcium will naturally rise as vitamin D improves
Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D
Magnesium supplements are very good for constipation too.
Burning and tingling is likely due to low B12 and folate
Known as peripheral neuropathy, it's common when under medicated or when B vitamins are low
Supplementing a good quality daily vitamin B complex, one with folate in not folic acid, can be very beneficial
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
If do you know if you have had TPO and TG thyroid antibodies tested? If not ask GP to test
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
IBS type symptoms are common with Hashimoto's and are often symptoms of gluten intolerance
All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
Thank you very much for your reply and advice. I’m going to see my GP when I can get an appointment. I’ve been able to see my blood test results on ‘Patient Access.’
I know that I have Hashimotos because my TPO and TG antibodies were tested when I was first diagnosed nearly a year ago.
My Vitamin D would probably have been lower if I had not been taking Vitamin D supplements for the last six months. I suppose Calcium would have been worse too without the Vitamin D supplements.
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct 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, help gut heal and slowly lower TPO antibodies
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