Newbie to site and to Hypothyroidism - need advice

[Peggy-Priceright]

After some years of feeling unwell - exhaustion, gut issues (IBS, Acid Reflux, Diverticulitis), huge increase in weight, followed by menopause (more weight!), I have in November 2016 been diagnosed Hypo. Just trying to figure out how to unscramble the vast array of symptoms and get to the root cause to help myself regain health! In the meantime, my GP has prescribed Levothyroxine which he has recently increased to 50mcg. I initially saw a big change in my test results

TSH 31.84 which is now 11.79 (0.20 - 4.60)

free T4 5.8 which is now 10 (7.0 - 17.0)

and a slight reduction in the awful symptoms, although I am still not well as you can imagine from my results.

I am seeing my GP on Friday and will ask him to increase my Levo. I also want him to test for free T3 to see how much T4 I am converting and Thyroid Peroxidase antibodies, and Thyrogbulin antibodies to see if I have the autoimmune disease Hashimoto's. However, I would like some advice on what else I should be seeking from him? I've seen discussions on this site about the benefits of NDT and combinations of T4/T3. Also about mineral deficiencies and their impact on the thyroid so would like to know what I should be tested for in this respect.

Ideally, I would like to attend my next GP appointment with enough understanding and knowledge about this subject that I can fully participate in my treatment plan. Any help with the start of my journey with Hypothyroidism would be gratefully received.

[Clutter]

Welcome to the forum, Peggy-Priceright.

TSH 11.6 shows you are under medicated and need a dose increase. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article.

FT3 is rarely tested in primary care unless TSH is <0.03 because NHS is looking for evidence of hyperthyroidism not low FT3 in hypothyroid patients. Your FT3 is probably low because it is low FT3 and FT4 which causes TSH to rise.

Your GP can order thyroid peroxidase antibodies (TPOab) but probably won't be able to order thyroglobulin antibodies (TgAb). If TPOab are positive it confirms autoimmune thyroid disease (Hashimoto's). If they are negative you may want to order a private thyroid test to check because some patients are TPOab negative and TgAb positive.

There is no cure for Hashimoto's which causes 90% of hypothyroidism and treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

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

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

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine and after any dose adjustment. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

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

Hypothyroid patients are often low or deficient in ferritin, vitamin D, B12 and folate and we recommend you ask your GP to order tests because deficiencies can cause musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms.

[Peggy-Priceright in reply to Clutter]

Thank you so much Clutter for your speedy and really informative reply! I so appreciate it.