New results

[Judyrabbit]

I saw the endo last week. Told her all my symptoms but she didn’t seem interested just that my TSH and ft3&ft4 were in limits. She said a lot of my symptoms could be from something else or age related. I said about vitamins and she said she would do them so that I could take some to see if that helped. She said about a good B complex but something about if magnesium was in had to be careful as I might take too much but I don’t know what my vitamins are. She took my bloods at 1.30 after I had had my tablet in the morning!!! She advised dr to put my tablets up from 100 daily to 125/100 mcg alternate days. How do I know which vitamins and how much I should be taking. These are my results

[SlowDragon Administrator]

which brand Levothyroxine is your 100mcg

Ideally get same brand for 25mcg

Do you should get test results for vitamin D, folate, ferritin and B12

What vitamin supplements you currently taking

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common on Levothyroxine

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[SlowDragon Administrator]

vitamin D needs improving to at least 80nmol and around 100nmol maybe better

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But 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 and thyroid disease

grassrootshealth.net/blog/t...

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...

Recipe ideas

bbc.co.uk/food/articles/mag...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[SlowDragon Administrator]

if endocrinologist didn’t test B12, folate and ferritin get these tested via GP or via private testing

Medichecks or Monitor My Health or BH

Do NOT start B vitamins until tested

Ferritin test - early morning and only water to drink between waking and test

Come back with new post once you get results

[Judyrabbit in reply to SlowDragon]

these are m results from March

W

[SlowDragon Administrator in reply to Judyrabbit]

Ferritin is low

Want to aim to maintain at least over 70

Around 100 may be better

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

Look at increasing iron rich foods in diet

Retest in another 3-4 months

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

If taking iron supplements Stop 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

If you need supplements

Posts discussing Three Arrows as very effective supplement

Great replies from @FallingInReverse

re ferritin and Three arrows

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great reply by @fallinginreverse

healthunlocked.com/thyroidu...

Iron patches

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron

healthline.com/nutrition/he...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

healthunlocked.com/thyroidu...

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:

Females 18 ≤ age < 40. 30 to 180

Females 40 ≤ age < 50. 30 to 207

Females 50 ≤ age < 60. 30 to 264l

Females Age ≥ 60. 30 to 332

Males 18 ≤ age < 40 30 to 442

Males Age ≥ 40 30 to 518

The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.

[greygoose]

She said a lot of my symptoms could be from something else or age related.

They rarely are interested in symptoms because - as she said - they are non-specific: i.e. they could all be due to 'something else'.

However, aske her which scenario is the more likely: a) you have 36 diseases with one symptom each or b) you have one disease with 36 symptoms?

As for age related, getting old is not a disease and should not cause a bunch of symptoms.

She said about a good B complex but something about if magnesium was in had to be careful as I might take too much

Hardly likely. Magnesium is water soluble, so any excess is excreted. Besides, most of the population is magnesium deficient because soils are depleted and they're not getting it in their food any more. Being hypo will make that worse. And, if you are going to take vit D, you must take magnesium because the two work together.

The nutrients you have to be careful not to over-dose on are: vit D, vit A, vit E and iron. Because they are fat soluble so build up in fatty tissues and excess is not excreted.

But, as a general rule, never take nutritional advice from a doctor because they just know nothing about it. They don't 'do' it in med school.

[Judyrabbit in reply to greygoose]

So should I take a vitamin B complex tablet and if so could you advise a good one

[greygoose in reply to Judyrabbit]

With your level of B12 it's usually suggested that you start by taking a sublingual methylcobalamin (B12) tablet of 1000 mcg for a week or so, and then add in a B complex. Take the two together until the sublingual B12 is all gone, and then continue with the B complex as a maintenance dose.

A good B complex contains methylcobalamin and methylfolate, rather than cyanocobalamin and folic acid. Two I can recommend from personal experience are Thorne Basic B, and Igennus B complex. There are others but I don't know them.

Oh, and that comment about magnesium in a B complex... I've never seen a B complex with magnesium, so I think your doctor was getting confused with multi-vits and B complexes. Multi-vits are definitely not recommended - not because of the magnesium but for a whole host of other short-comings.

[FoxyTed in reply to greygoose]

Good reply re in answer to GP!! One could not make this stuff up! God help us😫

[SlowDragon Administrator in reply to Judyrabbit]

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.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

Low folate

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...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements

thyroidpharmacist.com/artic...

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

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 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

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

[FallingInReverse]

greygoose

However, aske her which scenario is the more likely: a) you have 36 diseases with one symptom each or b) you have one disease with 36 symptoms?

As for age related, getting old is not a disease and should not cause a bunch of symptoms.

here here!!!!

😭😭😭😭😭😭😭

[rosael56]

Annoys me so much when doctors say it could be "something else" but don't actually know what that something else could be

Or just blame it on age

Or the ever dreaded "depression" label......

I had all this before going private. I genuinely thought I had a serious mental illness but it was just hypo!!