Hi, I've been a long time lurker here can honestly say I'd have no idea about thyroid disease if it wasn't for the info and advice posted, so thank you all x.
I'm still suffering with hypo symptoms with no improvement after years of being on 200mgs levo.
Thought I may have Hashimotos, as along with other things these symptoms began after the birth of my youngest 9 years ago, so when I received my last blood results in July, questioned the doc about it and he said "oh, yes it's on your notes from the endo you seen in 2014 you have hashi's" !.
Anyway, I have begged to see an endo again as I feel (like many of you) I just can't continue feeling this ill and being told I'm on the correct dose of levo so it must be my depression and to exercise more.
Could anyone please give me advice before my appt please?.
Recent results - free t4 was 16
Tsh seems to be decreasing each year was 1.6 in 2014, 0.39 in 2015 and 0.13 last month.
I asked for everything to be tested but these were all I got back.
Also on my result print out it states I am Hyperthyroid !
Absolutely any advice given will be appreciated xxx.
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crystalwings
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The reason it says you are hypERthyroid is because your TSH is under range. However, your FT4 at 16 is within range therefore you are not hyperthyroid. I don't understand why doctors don't get this. Mine is the same. My TSH is suppressed (undetectable) but my FT4 is near the top of range and FT3 around half way through range, but she's she's still prattling on about over medicated, osteoporosis, atrial fibrillation, etc, ad nauseum, despite the fact that I have no symptoms of being over medicated or hyper.
Do you have the ranges for your tests, and any older tests for comparison? Do you have any FT3 results. You are on quite a high dose of Levo and I'm just wondering how well you're converting T4 to T3.
Also, regarding the Hashimoto's, have you gone completely gluten free to try and reduce the antibody attacks. A low TSH also helps reduce them (which you have and it's a pity your doctor does know about this), also supplementing with selenium helps helps reduce them.
Are you taking any other medication? An antidepressant?
Also, for thyroid hormone to work properly we need optimal levels of vitamins and minerals (not just in range). Ask your GP for Vit D, B12, ferritin and folate to be tested. If your GP won't do them you can get a private at home fingerprick test through Blue Horizon, their Thyroid Plus Eleven covers everything you need to give a full picture.
Thank you both for replying. The test ranges for TSH (0.2-4.5) I am 0.13 and for Free T4 ( 9-21) I am 16.
I haven't been tested for FT3 yet but is that how I'll find out if I'm converting T4 to T3?.
I will ask endo for both FT3 and antibodies tests.
I was tested 2015 for B12 (180-2000) I was 679
Ferratin (15-200) I was 31
Folate (2.8-20) I was 5.6
Wouldn't test for vit D, stated that probably everyone in Scotland is deficient, just sit in the sun a bit more.
Which brings me to a major annoyance I've had for a few years now, my head and face sweats are terrible, it actually runs down my face which make it not only uncomfortable but really embarrassing. Could this be linked to vit D deficiency as I can't tolerate the sun at all, I'm always so hot, even in winter (thought hypothyroidism made you cold).
I do take 375mgs daily of venlafaxine which is an antidepressant.
I have been reading up on the benefits of supplementing with selenium etc and taking vitamins, also being gluten free. I was never sure whether to do it or if any of the info I was reading applied to me but am going to do it now asap as I'll do anything to feel even a bit better.
Thank you both again SO much, I actually feel like crying now that I can go to docs/endo and have an idea what I'm taking about xxx.
Yes, you need FT4 and FT3 done at the same time to see how you are converting. Your FT4 isn't optimal, it should be in the top third of it's range so 17+.
For a treated hypo patient the aim is for TSH to be 1 or below or wherever it is needed for FT4 to be in the top third of it's range and FT3 to be in the top quarter of it's range.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, wrote this in a Pulse Online magazine article:
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
If you email louise.warvill@thyroiduk.org.uk she will let you have a copy of the article which you can print out and show your GP/Endo.
Your ferritin is very low at 31 (15-200). It should really be half way through range, and a minimum of 70 for thyroid meds to work properly. That could be one reason why you're on such a high dose and still symptomatic. You should supplement with iron. You could try ferrous fumarate or ferrous sulphate which is what is normally prescribed by GPs at one tablet twice daily. This gives around 130-140mg of elemental iron. Some people are fine with that, others find it harsh on their tummies and get constipated. If that happens you could try Iron Bisglycinate (Solgar Gentle Iron is one brand and contains 20-25mg elemental iron). Take each iron tablet with 1000mg Vit C to aid absorption and help prevent constipation. Take iron 4 hours away from thyroid meds and other supplements.
Folate is rather low at 5.6 (2.8-20). Again it should be at least half way through range so 11.5+. You can get a B Complex containing methylfolate. Thorne Basic B or Jarrows B Right both contain 400mcg methylfolate. Avoid a B Complex containing folic acid, this is synthetic and needs to be converted by your body into folate and we're not all good at that. The methylfolate is already converted and readily bioavailable. This is another decent one bodykind.com/product/5178-B... and contains 1000mcg methylcobalamin (B12) which is a good amount to maintain your B12 level. The Pernicious Anaemia Society recommends 1000 and the amount of B12 in the Bodykind supplement should give your level a bit of a boost. If your B12 had been much lower I would probably have suggested a B12 supplement 1000mcg. If you do want to supplement B12 separately then Solgar or Jarrows sublingual methylcobalamin 1000mcg dissolved under the tongue for direct absorption into the bloodstream are the ones usually recommended.
The endo's remark about Vit D is ridiculous and just shows how they are now saving money. Yes, most of us are deficient in Vit D and sitting in the sun helps in the summer. However, you have less of it in Scotland and your winters are probably a lot worse than ours in the rest of the UK. Personally I would do a private Vit D test with City Assays vitamindtest.org.uk - an easy at home fingerprick test which costs £28 and you get the results in less than a week. Come back with your result if you do it and members can help with dosage if you are deficient.
Selenium helps us thyroidies anyway, it aids conversion of T4 to T3, and also helps reduce antibody attacks for Hashi's patients. 200mcg is the normal recommended amount.
I am not good with antidepressants but it's frequently mentioned on here that they don't do us much good. Depression can be a symptom of hypothyroidism, you are symptomatic of hypo and this depresssion could be one of the symptoms. If you are optimally treated thyroid-wise you may find the depression disappears. I know they can be difficult to come off, and I have no real advice to give about that, maybe someone else will.
Not sure of your age, but sex hormones play a part as well. Could your sweating be connected? I had some sweats during peri-menopause and menopause, nothing major, just enough to be up and down opening the lounge door for some air to cool me down. Also adrenals play a part. Dr Peatfield (legendary thyroid expert frequently mentioned on here as Dr P) always looks to addressing any adrenal problem prior to starting thyroid treatment. And the Levo patient information leaflet says (amongst other things):
Do not take this medicine if you:
• have any condition that affects your adrenal glands (your doctor will be able to advise you if you are not sure)
I think I'm right in saying that no GP ever does this before prescribing Levo.
Have I missed anything? Just ask if I have.
One other thing, please avoid cheap supplements, H & B own brand, supermarket ones, they are cheap for a reason, they contain cheap ingredients which are usually the wrong form anyway so wont work. If you want recommendations just ask.
Hi, and am sorry you aren't feeling so good. Many women do become temporary hyper sometimes after childbirth, or become hypothyroid.
When you post your results, its very helpful if you give the ranges as well as the results (labs differ throughout the country) and it makes it easier to comment when the ranges are stated.
To confirm whether or not you have Hashimotos (the commonest form of hypothyroidism) is to have an antibodies blood test and if you do have antibodies that's the confirmation. Hashimoto's causes the antibodies to be too many at times thus causing the sensation of hyperthyroidism, and then too low till gradually the thyroid gland is destroyed and you are hypothyroid.
I don't have TUK's most recent quarterly Harmony (members get this quarterly) with me and there had been a review of a new book on hashi's which the reader said that it provides excellent helpful info.
Ask the surgery for a print-out of your latest results and I'm sure the ranges will be stated. You also need B12, Vit D, iron, ferritin and folate to be tested as well as antibodies.
I shall give you a link re pregnancy which you might find helpful (after the first two questions).
Hi, Both yourself and Seaside Susie replied to me and I couldn't figure out how to paste both your names into the reply, so have just written the one to you both. I really appreciate all your advice too, thank you. I look forward to the links. xx
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