Thyroid UK
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I'm new here- have Hashimoto's & am subclinical hypo- should I start Levothyroxine?

I'm completely new to all this having had my thyroid and then antibodies tested only a couple of weeks ago for the first time (TSH 9, T4 11, antibodies over 1000.)

I have had what I now realise were thyroid symptoms for around 5 years and have self treated with supplements such as iron for hair loss, B vitamins for fatigue, fish oils for brain fog etc etc. I cut out gluten 9 months ago and try to avoid it as much as posssible but not 100% of the time. I recently started vitamin D and folate. My health food shop sold me Thyroid Support which I took for a week but, having read half of The Root Cause yesterday, I have stopped the Thyroid Support as it contains 200mcg of iodine and I'm worried about taking this with Hashimotos.

My question is this- should I ask for levothyroxine straight away (the doctor is happy to prescribe) or spend 3 months following Hashimoto's Protocol and trying to reduce my antibodies? Or do both? The thing that worries me most about Hashimoto's is that I have read that, once the thyroid has been destroyed, the antibodies can start destroying other parts of the body resulting in things like MS, diabetes etc. I haven't seen a GP face to face since Monday night when they phoned with the test results. I have an appointment for the end of April and don't know whether to ask to see an endocrinologist. Are there any good/ sympathetic ones around Oxford that anyone knows of?

Sorry for the long post. Thank you in advance if anyone has any advice to offer.

5 Replies

Yes, get some meds in you and see how you feel. If you would also like to take action to reduce your ABs that's fine, being optimally medicated is meant to help. It is likely to be unmonitored by your gp (ABs are usually diagnostic only) but you can buy a private fingerstick test if you want to monitor it yourself.

I understand some recommend a multifocal approach to Hashi's (reduce ABs, change diet, address adrenals, address a stressful lifestyle etc) but the way this works out in real life is to confuse people (who are often very unwell) about what to address first. I've read on this forum that some people end up ill and confused after attempting to address their Hashi's without meds and you can end up down a rabbit warren. I did it myself and if I could go back I'd just get on the levo as well as trying whatever else I felt might help, not instead of.

I know the ranges are not included but this looks like outright Hashi's to me, not subclinical. If your t4 is not below range it must just have squeaked in at the bottom.


No, it's not true that Hashi's antibodies attack other parts of the body once the thyroid is killed off. When there's no more thyroid activity, the antibodies just go away. Which is why you want your TSH suppressed - no matter what your doctor may say. A TSH of 9 is not sub-clinical! Sub-clinical means over-range TSH with no symptoms. You have symptoms, and your TSH is overtly hypo. So, you, start the levo now! :)



Accept the Levothyroxine prescription. Your thyroid is failing and you need replacement hormone. You can take Levothyroxine and adopt the Hashimoto protocol. Hypothyroidism is usually managed in primary care unless the patient fails to respond to Levothyroxine therapy. If you want to see an endocrinologist privately email for a list of member recommended doctors.

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 Email if you would like a copy of the Pulse article to show your GP.

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, magnesium 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. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

There is no cure for Hashimoto's which causes 90% of hypothyroidism. 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. Occasionally eating gluten won't allow the gut villii to repair. It should be said that g-f doesn't help everybody and won't undo any thyroid damage already caused. Hashimoto's usually burns out when it has destroyed the thyroid gland. It is Graves antibodies which can go on to attack other organs.

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Hi - hypothyroid is usually handled (or not!) by your GP, endocrinologists normally only come into it with hyper, pituitary problems or if treatment is not helping. As you will read in many posts an endo doesn't necessarily know any more about thyroid anyway. But yes take the treatment now as you can slow down the destruction of your thyroid with treatment.

Good luck,

Gillian xx


I'm overwhelmed by your swift, supportive replies. Thank you everyone. I will accept the levo and follow the excellent advice about how to take it. Thank you to all of you.

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