She has been told normal no action. Due to symptoms of high pulse and sweating she has been asked to reduce and has been told it will do no real damage. She finds it hard to talk to people, she is anxious, depressed, has lost her appetite, forgets things, has debilitating headaches, loses things, has trouble concentrating amongst physical symptoms of constipation, heavy periods, feeling cold, tiredness. She has gotten on better than she did 6 years ago and has managed to hold down a job for 2 months so I am worried about the dose reduction because when she has been on lower doses she has felt absolutely terrible and unable to work. She is taking antidepressants and is being referred to Positive Steps for her mental health problems, just wondering if this is the right plan of action for her and if the doctor is right in saying she has fibro or mental health issues?
Thanks in advance.
Thyroid peroxidase antibodies 274 (<34)
Thyroglobulin antibodies 228.3 (<115)
Ferritin 16 (15 - 150)
Folate 2.3 (2.5 - 19.5)
Vitamin B12 197 (180 - 900)
Total 25 OH vitamin D 35.5 (>75 adequate vitamin D)
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Juliec1966
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These high antibodies mean that she is positive for autoimmune thyroid disease aka Hashimoto's, where antibodies attack the thyroid and gradually destroy it. There is no treatment for Hashi's, it's the resulting Hypothyroidism that is treated.
She can help reduce the antibodies by adopting a strict gluten free diet which has helped many members enormously. Gluten contains gliadin which is a protein thought to trigger antibody attacks. Read about the gluten/thyroid connection here
Ferritin must be at least 70 for thyroid hormone to work properly, half way through range is recommended and for females I've seen it said that 100-130 is best.
Has she had an iron panel done, a full blood count and haemoglobin test to see if she has iron deficiency anaemia? If not she should ask for these to be carried out.
If she is prescribed iron tablets then each tablet should be taken with 1000mg Vit C to aid absorption and help prevent constipation. Iron should be taken four hours away from thyroid meds and two hours away from any other medication and supplements as it affects their absorption.
Eating liver once a week and other iron rich foods will help raise ferritin. See list of iron rich foods here
If so take all this information and post on the Pernicious Anaemia Society forum here on Health Unlocked for further advice then she needs to speak to her GP.
Total 25 OH vitamin D 35.5 (>75 adequate vitamin D)
Recommended level for Vit D is 100-150nmol/L. It's unlikely her GP will prescribe anything with her current levels on she could buy her own D3 softgels like these
and take 10,000iu daily for 6 weeks then reduce to 5000iu daily. Retest after 3 months. When the recommended level is reached reduce to 5000iu alternate days, maybe less in summer. When supplementing with D3 it is advised to retest once or twice a year to keep within the recommended range.
When taking D3 there are important cofactors needed which you can read about here
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium comes in different forms, check here to see which is most suitable and as it's calming it's best taken in the evening
She has had an iron panel and complete blood count done, no idea what the results mean. Her periods are extremely heavy and she bruises and bleeds from her gums easily so I am guessing her chances of losing iron these ways is not helping.
Juliec1966 Low MCV, high MCHC and low haemoglobin point to iron deficiency anaemia. This needs to be discussed with her GP.
With her ferritin also just scraping in at the bottom of the range, ask for an iron infusion. If given iron tablets I believe the correct treatment is 2 or 3 x Ferrous Fumerate daily.
Here is the NICE Clinical Knowledge Summary of treatment for iron deficiency anaemia
All these vitamin levels are dire. Suggest at the very least you go back to GP with your daughter and ask for iron supplements to improve low ferritin
Also Testing for pernicious anemia and intrinsic factor for low B12 & folate
Testing for coeliac too as all her vitamin levels are so low - but coeliac test is unreliable and most with Hashimotos are not coeliac but are gluten intolerant
Vitamin D - GP will say is on range - but when on Levo we seem to need level around 100.
You can supplement vitamin D soft gels or mouth spray by Better You is good. Usual recommendation is to take 5000iu for 3 months then retest (private finger prick test £28 via vitamindtest.org.uk )
She has Hashimotos which can really affect the way our digestive system works, leading to leaky gut. Going strictly gluten free for at least 3-6 months to see if this helps (it does for about 80-90% with Hashimotos)
I see SeasideSusie has already given her excellent reply
Yes, definitely get a new GP asap - clearly has no idea what they're doing!!!
I wouldn't even begin to consider mental issues or fibro until the rest sorted. I saw your other post and I would normally increase my thyroid meds with those results - not decrease. She is deficient in everything and almost certainly iron deficient. My GP and endo always treat me for aneamia at those levels and always treat me for vit D deficiency if drop under 50. Folate is clearly under range. B12 well they've still got a bit to learn about that one so they haven't taken my levels seriously yet lol.
My heart rate was 120 resting most my life even when extremely hypo and was actually only recently resolved after being treated for Vit D deficiency. Whenever my Vit D goes under 40, my heart rate goes up so may have nothing to do with thyroid at all.
I used to be pretty much in exactly the same position as your daughter with everything you mention even including the bleeding gums so I would also absolutely recommend looking seriously into coeliac/gluten intolerance as this would cause the majority of her issues so definitely worth ruling out properly. Coeliacs should be tested for but the blood test is unreliable and can only truly be determined via endoscopy. However, I tested negative for coeliacs but was diagnosed with non-coeliac gluten sensitivity because of the improvement of apparently non-reversible life long disorders, lower antibodies and disappearance of historic high inflammation levels and deficiencies etc etc. Going gluten free for at least three months making sure it's 100% gluten free is definitely worth a try even if just to rule out as not much to lose by trying to be honest.
Fixing iron, B12 , folate and vit D will make a huge difference in her wellbeing! Of course she is feeling very poorly as just down to that bad iron there is less oxygen carried through red cells.
Keeping her at that stage is almost abuse from doctors!!!
Mental health issues are one symptom of all these deficiencies! So just a symptom , not a cause.
I have not heard from antidepressants that would fix nutritional deficiencies!
Going gluten free can be life changing. Your daughter should ask GP to test then go GF anyway, immediately after testing. Better to cut down gradually over a week or two to give the body time to adjust and make sure she gets plenty of vegetable fibre and probiotics to keep things moving.
Avoiding stress is also very important so try to encourage her to take time out for relaxation such as walking in nature, yoga, lavender baths etc.
Excellent advice from others above, I hope she feels better soon.
Having deficiences can cause problems but if your daughter's doctor suggested fibro/mental health issues this could be caused due too low T3.
Doctor should test her Free T3 although it might be a bit skewed if she's already taking some but it may not be sufficient to relieve your daughter's symptoms.
I shall give you a couple of links which were by a doctor who ran the Fibromyalgia Research Foundatio before his early death. If your daughter has low Free T3, it could be the cause of mental problems as the brain contains the most T3 receptor cells and is the only thyroid hormone which is Active.
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