Autoimmune Hypothyroidism Hashimoto's Started Medication

Looking for some reassurance please. I had my first Endo visit on the 14th of this month. On examination I've been told I have a goitre and am sub clinically 'euthryoid'. I have strong thyroid peroxidase antibodies titre >1,300 in keeping with Hashimoto's. I started leveothyroxine 50 mcg 10 days ago. Just wondering is it normal to feel slightly exhausted with difficulty concentrating? I didn't seem to have symptoms before medication although felt a bit tired. How do you all feel when you first started medication?

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  • Gill-56, you are subclinically hypothyroid if TSH is >5 and <10 with FT4 in normal range. Biochemically euthyroid (normal) is when TSH is between 1-2.

    It's not uncommon for symptoms to seem worse when starting Levothyroxine. Symptoms will accrue during the 7-10 days it takes to absorb the Levothyroxine before it starts working and it takes up to six weeks to feel the full impact of the dose. You should have thyroid levels checked 6-8 weeks after starting Levothyroxine because the starting dose is rarely sufficient and usually needs increasing. Arrange an early morning fasting (water only) blood draw as TSH is highest early and drops post-prandially. Take Levothyroxine after the blood draw. Get into the habit of asking for your results with the lab ref ranges (figures in brackets after results) and post them in a new question for interpretation and advice.

    For maximum absorption Levothyroxine should be taken with water on an empty stomach, 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from iron, calcium, vitamin D and oestrogen.

    Your hypothyroidism has been caused by autoimmune thyroid disease (Hashimoto's) which destroys thyroid cells when it infiltrates the the thyroid gland. 100% gluten-free diet can be helpful in reducing Hashi flare ups and antibodies.

    chriskresser.com/the-gluten...

    thyroiduk.org.uk/tuk/about_...

    Hashi/hypothyroid patients often have low/deficient ferritin, vitamin D, B12 and folate which can cause fatigue, musculoskeletal pain and low mood similar to hypothyroid symptoms. Ask your GP to test and post the results with the lab ranges in a new question for advice.

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    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thank you Clutter. The consultant doesn't want to see me until 12 weeks after first visit. He gave me a form for blood tests to do a week before. When I looked at the sheet later I saw that there was nothing for thyroid function which I felt was strange so I rang the receptionist who is going to send me an amended form. I think I'm going to ring back and ask why am I waiting that long since starting medication? Thanks for the info regarding gluten free which I am researching but not sure whether to go down that route before discussing with him at my next appointment.

  • Gill-56, You're having to wait so long because it's taking 3 months to get endo appointments. Not ideal, when patients are living with symptoms :(

    Very few endos seem aware of the gluten-thyroid connection and the potential benefits of dietary changes to improve symptoms. Discuss it with your endo but research it yourself and make your own mind up. Most doctors have the sketchiest knowledge of nutrition.

    _______________________________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thanks again Clutter. I'm researching lots as I really want to bring my antibodies down.

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