Newly diagnosed with hashimotos

[Summer1986]

Hi I have hypothyroidism diagnosed in 2014 and I take 50mcg T4 but my GP has diagnosed me with hashimotos. My endo removed my T3 in December last year.

My symptoms are difficult swallowing, weight gain, constipation, heavy periods, joint pain, dry skin, hair loss, puffy face, puffy eyes, feeling cold and puffy legs. Is there anything I need to do about my latest blood results? Endo has said there is no reason for me to feel so poorly with thyroid results like these.

Thank you

April 16

!Serum TSH level - 9.8 (0.2 - 4.2) Endo letter comments - you should be taking 50mcg levothyroxine. Please inform us if this is incorrect

Serum free T4 level - 12.7 (12 - 22) - As above

Serum free T3 level - 4.9 (3.1 - 6.8) - As above

!Thyroid peroxidase antibodies - 366 (<34) GP notes - fh autoimmune disease

!Thyroglobulin antibodies - 401 (<115) GP notes - fh autoimmune disease

!Serum ferritin - 14 (15 - 150) - GP notes - not clinically significant

Serum folate - 5.0 (4.6 - 18.7) GP notes - normal no action

!Serum vitamin B12 - 697 (191 - 663) GP notes - normal because patient is on B12 supplementation

Total OH vitamin D - 66.4 (50 - 75 suboptimal) GP notes - acceptable

[shaws Administrator]

You are very undermedicated with a dose of 50mcg of T4, that's why its highlighted as a question:

Endo letter comments - you should be taking 50mcg levothyroxine. Please inform us if this is incorrect

I think lab (Endo) is querying if you are taking the miserable, starting dose, of 50mcg of T4. You have such a high TSH, nearly 10, which is the cut-off of the BTA (another stupid guideline). He will try to say that you aren't following his directions.

You have to look after yourself neither Endo or GP know anything about thyroid hormones or the action required in your body by the hormones.

50mcg of T4 for nearly 2 years is awful. You should be on a dose which brings your TSH to around 1 or lower.

You have an Autoimmune Thyroid Disease called Hashimoto's, which means at times antibodies flood your system making you feel hyper and then the recede for a time.

I think both the following disgraceful:

!Serum ferritin - 14 (15 - 150) - GP notes - not clinically significant

Serum folate - 5.0 (4.6 - 18.7) GP notes - normal no action 

[Clutter]

Welcome to the forum, Summer1986.

Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism.  100% gluten-free diet may improve symptoms and reduce antibodies.

chriskresser.com/the-gluten...

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

You are undermedicated to have TSH 9.8 with FT4 12.7 and that's why you are symptomatic.  The goal of Levothyroxine is to restore the patient to euthyroid status which for most will be when TSH is 1.0 or lower, with FT4 in the upper range.  Read Treatment Options in thyroiduk.org.uk/tuk/about_...  Email [e-mail] if you would like a copy of the Pulse article to show your endo.

Ferritin is optimal 75-100, yours is below range.  I'm not sure why your GP thinks it clinically insignificant, low ferritin is an indicator of iron anaemia.  Supplement iron and retest in 6 months.    Take iron with vitamin C to aid absorption and minimise constipation.  Iron should be taken 4 hours away from Levothyroxine.

B12 is fine but folate is a little low in range.  You can supplement 400mcg folate for a few weeks or try a B Complex vitamin.

VitD 66.45 is acceptable if you are able to get sunshine on your face and arms several times a week.  If not, supplement D3 1,000iu and take it 4 hours away from Levothyroxine.

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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.