Newbie, ?Hashimotos, what should I ask GP for?

[startagaingirl]

Hi everyone, I am new to this and have learnt a lot from reading posts but need some specific help please. I am 48 yo, female and post surgical menopause for endometrial cancer last year (also chemo & radiotherapy). No HRT allowed. Began getting fatigue in Mar, hot flushes increased again, previous slow and hard earned weight loss ground to a total halt in April so went to GP start of June. Battery of tests showed what he called borderline hypo and I asked to be treated. (don't have nos not on print-out - NOS) He put me on 25 of levo. 5 wks later re-test showed TSH 7 (0.27-4.2), FT4 16.3 (12-22). But action was "taken at 5 weeks, please continue and rpt in 6 wks". Well fatigue is getting worse, energy very low, no buzz after gym and generally feeling flat. So after reading I did BH private test. Results shown.

After ferritin at docs of 46 (30-400) I have put myself back on iron, also now on B12 lozenges, B Right complex and have ordered selenium (have been eating brazils meantime). Have been dosing D3 3000 spray since Nov for muscle & joint aches so prob ok. I believe I need real dose increase levo (why 25 start - surely too low and against NICE guidelines), and am unwilling to wait. I have been reading about gluten free and will now start that. Anything else I should be doing? How should I approach this with GP who is very helpful but obviously cautious?

BTW my younger brother has similar and gluten free seems to help him reduce anti-bodies.

TSH 5.59 (0.27-4.2) Total T4 83.4 (64.5-142) FT4 15.21 (12-22) FT3 4.49 (3.1-6.8)

Anti TPO abs - 231.1 <34, Anti TGO abs 560.3 <115

Ferritin 58.3 (20-150), B12 278, Folate 31.9 (10.4-42.4), CRP 0.3 (<5)

Thank you.

[Clutter]

Welcome to the forum, Startagaingirl.

You are undermedicated. Most people on Levothyroxine need TSH 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 Pulse article to show your GP when you requesta dose increase.

Ferritin is optimal halfway through range. Taking iron with 1,000mg vitamin C aids absorption and minimises constipation.

B12 is very low, 1,000 is optimal. Supplement 5,000mcg methylcobalamin for a couple of months and then reduce to 1,000mcg. Take a B Complex vitamin too.

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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.

[startagaingirl in reply to Clutter]

Thank you, I may well request a copy of the article and hold it in reserve in case required.

[greygoose]

You are under-medicated BUT you cannot go any faster than increasing levo by 25 mcg every six weeks. That is a hard and fast rule. He did start you on too low a dose, but now you are, I presume, on 50 mcg, and must follow the protocol, or stress your body. There are reasons why we go so slowly. You are, at least, converting well, so that's one blessing!

How much B12 are you taking? With a low result like that, you should be taking 5000 mcg methylcobalamin.

If I were you, I would give up the gym for the time being. Your T3 is low, which means that each time you go to the gym, you use it all up and leave yourself zero for everything else. Which is why you are tired. You cannot easily replace it because you don't have enough to convert, yet, and your thyroid isn't able to make enough. So, just gentle walking/swimming/yoga until T3 is optimal.

[startagaingirl in reply to greygoose]

Thank you for the advice. Unfortunately I am not yet on 50mcg, still on 25 - that is why I am keen to have a dose increase approved. I understand the need to titrate up gradually but 12 weeks on what is a baby dose seems a bit much to me.

I have just received (through TUK Amazon link!) Solgar 5000 mcg B12 lozenges and B-Right complex so will take 1 of each per day.

Yes it does appear the gym is a double edged sword. 4-5 months ago it gave me energy now it just drains me. As it happens I haven't been this week and yes I am less tired. Drat and I worked hard for that fitness!

[greygoose in reply to startagaingirl]

Oh, I'm sorry, I thought you said he'd increased it. No, 12 weeks is much too long to stay on a starter dose. Go back after six weeks and say you still feel bad, and you think your levels should be tested now. There's absolutely no reason to wait 12 weeks. So, if he argues, ask him to justify his reasoning. Bet he can't! lol

[LindaC in reply to startagaingirl]

Yes, I used to get amazing energy from PT sessions and my studio gym - but it can strain the adrenals enormously, which impacts the thryoid too. Doing only resistance, Pilates and HIIT can help with the fatigue and still have fitness levels that are good for overall health.