Help with results please I'm new .

[Jes1]

I had an autonomously functioning nodule in 2004 and large goitre. I then had a thyroid storm and was treated with carbimizole for three months before radioactive iodine.

My Goitre disappeared and I became hypothyroid and was started on 50 mcgs of thyroxine. I've never felt well on this but test results always came back in normal range so I plodded on. Since then I have been diagnosed with sjogrens and pmr for which I'm taking hydroxychloroquine and prednisilone.

I still feel really exhausted and have palpitations My recent bts showed that I had low ferritin although my haemaglobin is fine .I am now taking ferrous fumerate 200mg b.d.

Every time my GP increases my levothyroxine I have terrible hyperthyroid symptoms so have to remain on 50 mcgs of levothyroxine

Tsh 2.4 (range 0.27-4.20)

Free t4 (12.19 range 12-22)

FreeT3. 3.95 ( range 3.2-6.8)

T4 total 99.6. (range 64.5-142)

CRP 9.9 range < 3

Ferritin 12.8 ( range 20 - 150)

Transferrin saturation 14.55% ( range 20-50%)

Haemaglobin 13.4 ( range 11.7 -13.8)

I would be very grateful for any thoughts or suggestions

[Jazzw]

The reason you're struggling to raise levo is probably that low ferritin. Your body needs ferritin to utilise the levothyroxine - it can't convert T4 (levo) to T3 (the active form of thyroid hormone - the stuff your cells need) without it. The palpitations are also probably to do with the low ferritin.

Do you know why it's so low? Are you a fussy eater? Do you have stomach/bowel issues? Other thing to think about is whether you're also low in B12. It's often the case that if the gut is struggling to absorb nutrients, you'll be low in B12 and ferritin. You'll probably have low Vit D as well. Being low in any or all of those will make you feel terrible, but sadly it seems to go alongside hypothyroidism.

[Jes1 in reply to Jazzw]

Jazz and SlowDragon

Thank you for your reply.

I've know idea why my ferritin is low , I do get nosebleeds from time to time with the sjogrens, but they are not heavy.

I have had my vit d tested and you are right , it was low <10 range 25-50 ng/ml

I was prescribed 8000 iu daily until it got up to 60 ng/ml.

I'm now on 1000 iu daily but need testing again.

My b12 410 - told it was high

Serum folate 14.3 (range 10.4-42.4)

I've had both sorts of thyroid antibodies checked and they were normal.

I didn't know that you had to take Levi on an empty stomach so will take it at night.

I'm thinking I might give gluten free diet a go to see if that helps.

Thank you both so much for your replies.

[SlowDragon Administrator]

ask GP to also check levels of vitamin d, b12, folate. These all p, as well as ferritin, need to at good (not just average) levels for thyroid hormones (our own or replacement ones) to work in our cells.

Also have you had thyroid antibodies checked? There are two sorts TPO Ab and TG Ab. (Thyroid peroxidase and thyroglobulin) Both need checking, if either, or both are high this means autoimmune thyroid - called Hashimoto's, the most common cause of being hypo. NHS rarely checks TPO and almost never checks TG.

If you can not get GP to do these tests, then like many of us, you can get them done privately

thyroiduk.org.uk/tuk/testin...

Blue Horizon - Thyroid plus eleven tests all these.

If you have Hashimoto's then you may find adopting 100% gluten free diet can help reduce symptoms, and lower antibodies too.

Assume you know that Levo generally should be taken on empty stomach and no food or drink for at least hour after. Many take on waking, some prefer bedtime, either as more convenient or perhaps more effective. No other medications at same time, especially iron or magnesium, these must be at least 4 hours away

Best advice is to read as much as you can. Vitamin and minerals levels are very important, but standard NHS thinking, doesn't at the moment seem to recognise this. You will see, time and time again on here lots of information and advice about importance of good levels of B12, folate, ferritin and vitamin D and gluten connection too.