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Thyroid, vitamin D test results - advice?


Erica in OR
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I have read many of the threads on the boards related to thyroid tests, including many comments on doctors seeing a number that is in the "normal" range and not wanting to proceed with further testing, even though many people would feel better if they received treatment that put them into the "optimal" range.

 

I recently had testing done and am wondering what to do next.

 

Vitamin D 25 hydroxy was 29.26 ng/mL

TSH was 3.00 ulU/mL

 

Symptoms have been fatigue, brain fog, mood problems. I typically have seasonal affective disorder, but this year it just never went away. Dr sent a message this morning that the test results look ok and suggests starting a couple months of antidepressant.

 

I feel like the less than optimum levels of both of these could be enough to push me into the depression-type symptoms, and I'd rather try to address them first than automatically go antidepressant. I have been taking 2000 UI Vitamin D3 daily since last fall (gel capsule form, has soybean and corn oil).

 

I am wondering whether to ask for further thyroid testing? Try a different brand/type of vitamin d3? Something else?

 

Erica in OR

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You aren't taking enough d3 to correct that deficiency. At those levels I'd be doing 10k iu.

 

Your TSH is just out of range, and far from ideal ("normal" people have TSH around 1) but you really need to have Free T3 and Free T4 tested, I'd throw in anti-body panel for Hashimotos as well (as 90% of hypo is Hashi's), along w/ thyroid tests you need a full iron panel as the body needs iron to utilize the thyroid hormone.

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tsh = thyroid stimulating hormone.  it's made by the pituitary gland - not the thyroid.  optimal is <1.5  (mine is <0.6)

there are five thyroid hormones.

the bare bones minimum thyroid tests you need are

free t3 - this is the thyroid hormone your body actually uses . . .

free t4 - this is a storage hormone.  it must be converted to t3 in order for your body to use it.  a synthetic version is also the most commonly prescribed thyroid replacement hormone.

reverse t3 - what your body will start to make if there is too much t4 - but can't convert it into adequate quantities of t3.  you can have high rt3 (other numbers are ok - but rt3 is high) - or be pooling.  not getting to your cells

 

I take natural desiccated thyroid - because it contains all five hormones.  it was standard up until the 60s when the synthetic hit the market.

 

iron, and a bunch of other things can also affect your thyroid numbers.

 

as for d3:

the usrda is 400ius.   that was when they thought vitamin d was about strong bones and teeth.  (rickets can happen with a d3 level of 7) not that long ago - 30 was considered a basement minimum d3 level. that is now 50.  our NDs, prefer 70 - 80.

one oncologist said she never had a patient  with a d3 level >30.

 

this came up in one of dd's classes - d3 is being reclassified as a hormone. it is essential in many parts of the body.

 

the best absorbed are drops - with vitamin k.  next are geltabs.   olive oil and similar make the best suspension.

I take  NOW 5,000IUs daily. 

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as for d3:

the usrda is 400ius.   that was when they thought vitamin d was about strong bones and teeth.  (rickets can happen with a d3 level of 7) not that long ago - 30 was considered a basement minimum d3 level. that is now 50.  our NDs, prefer 70 - 80.

one oncologist said she never had a patient  with a d3 level >30.

 

Just to be clear, I think you are referring to Vitamin D level, 25(OH)D, not D3 ?

 

D3 is chemically closer to calcitriol 1,25(OH)2D, so close that they are often referred to as the exact same thing, though my rough understanding is that they are not quite.  Chemically, both are steps downstream from the Vitamin D level 25(OH)D.  So, my son's vitamin D level, 25(OH)D, was around 28 or 30, but his calcitriol 1,25(OH)2D was 90-something, which is too high (a typical symptom of inflammation) and so we don't want to add any more D3.

 

FWIW, there is some controversy over whether a low 25(OH)D measurement is merely a symptom rather than causative.  See e.g  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160567/ for some discussion and explanation. I don't know how correct this is; I just know that supplementing D3 is clearly bad for my kiddo (causes more autoimmune symptoms) (ETA, in his case, he has a homozygous VDR taq, though I can't remember whether it's an actual mutation or just a polymorphism)

Edited by wapiti
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Just to be clear, I think you are referring to Vitamin D level, 25(OH)D, not D3 ?

 

D3 is chemically closer to calcitriol 1,25(OH)2D, so close that they are often referred to as the exact same thing, though my rough understanding is that they are not quite.  Chemically, both are steps downstream from the Vitamin D level 25(OH)D.  So, my son's vitamin D level, 25(OH)D, was around 28 or 30, but his calcitriol 1,25(OH)2D was 90-something, which is too high (a typical symptom of inflammation) and so we don't want to add any more D3.

 

FWIW, there is some controversy over whether a low 25(OH)D measurement is merely a symptom rather than causative.  See e.g  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160567/ for some discussion and explanation. I don't know how correct this is; I just know that supplementing D3 is clearly bad for my kiddo (causes more autoimmune symptoms) (ETA, in his case, he has a homozygous VDR taq, though I can't remember whether it's an actual mutation or just a polymorphism)

 

they have only very recently started separating them out.  I've only even heard about that since april of this year.

so no, I'm referring to the standard D3 - which is what is most commonly run.  there are very few drs who separate them.

d2 does NOT raise levels  long term, and isn't worth using.

 

and the level should be >50.

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What I'm trying to say is that I believe 25(OH)D is what has been run for years and years and 25(OH)D is what is referred to as the vitamin D level, and that I believe 25(OH)D is NOT the same thing as the D3 level.

It is the D3 that is so close to calcitriol 1,25(OH)2D that they are sometimes used interchangeably (that is, some people will say D3 *is* calcitriol since they are that close, apparently).  That may be somewhat newer info, but my kiddo's level of calcitriol 1,25(OH)2D was measured in Oct 2014 by Labcorp.  I don't know how long Labcorp has offered it, but AFAIK it was not an unusual request.

 

ETA, I see D3 is often used interchangeably with the other one so maybe neverrmind lol... i gotta run

Edited by wapiti
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I had read about the different measurements of D and had all of them tested last year but then I had a horrid time sorting it all out as the info out there is sparse and confusing. Anyway, I ended up just going back to the reg. test I know I feel better supplementing it so I just decided to leave it at that. 

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I have not heard about the vitamin D testing issues? I am waiting on my results and there was some confusion at the blood draw- wonder if I got the right one?

I have always tried to get to a level of 50. I think the preferred levels are now 50-80. I agree you need to up it and I have also heard it needs to be taken with vitamin k. I just heard that and had my supply but I will change it up next order. I think Now and emerald labs brands on amazon are good products. As is Thorne.

Many people know more than me on the thyroid. I was 2.5 TSH last testing and my dr didn't recommend I treat it either. I asked her if my levels were 5 and she treated me, would we be satisfied when I got to 3 or 2.5? No. So why should we be satisfied to start there?

That said, I upped my vitamin D and B12 levels and feel pretty good. I have decided not to treat my thyroid at this time.

Good luck! I hope you feel better.

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I have read many of the threads on the boards related to thyroid tests, including many comments on doctors seeing a number that is in the "normal" range and not wanting to proceed with further testing, even though many people would feel better if they received treatment that put them into the "optimal" range.

 

I recently had testing done and am wondering what to do next.

 

Vitamin D 25 hydroxy was 29.26 ng/mL

TSH was 3.00 ulU/mL

 

Symptoms have been fatigue, brain fog, mood problems. I typically have seasonal affective disorder, but this year it just never went away. Dr sent a message this morning that the test results look ok and suggests starting a couple months of antidepressant.

 

I feel like the less than optimum levels of both of these could be enough to push me into the depression-type symptoms, and I'd rather try to address them first than automatically go antidepressant. I have been taking 2000 UI Vitamin D3 daily since last fall (gel capsule form, has soybean and corn oil).

 

I am wondering whether to ask for further thyroid testing? Try a different brand/type of vitamin d3? Something else?

 

Erica in OR

 

You needed a full thyroid panel; TSH alone is not enough. HOWEVER, your TSH is way too high, which means you are hypothyroid, and you should be treated. If your doctor will not order a complete thyroid panel (Free T3 and Free T4, at a minimum, but there are antibodies that should be tested, as well, to rule out--or confirm--Hashimoto's), then I would encourage you, with all the seriousness I can muster, to find a new doctor who will, ASAP.

 

Check out Stop the Thyroid Madness.

 

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