Hi - I am new to this forum and have gained a greater insight into my condition and I would be grateful if anyone can advise next steps that I could take.
I was diagnosed as Hypothyroid in 2008 with a TSH of 6.0 after being kept on a borderline watch for some time. I was started on 25ucg of Levo titrated to 100umcg and I now take 75ucg / 100 ucg alternate days. I have TSH, free T4 checked checked yearly by my GP and always have the same info from the medical secretary (OK - no action needed). I have had chronic joint pain for years diagnosed as Osteoarthritis, my feet are the worse, I can hardly walk on getting out of bed. I recently asked my Dr if I could have RA and she did some inflammatory screening tests which were normal. This forum have maybe me think that maybe this could be related to my hypothyroidism. Over the last 6 months I am having difficulty sleeping, the minute I go to bed I am really restless, thrashing around. I wear a Fitbit and my average sleep is 3hrs/night. I don't suffer from fatigue the next day so wondered if I was maybe overmedicated on Levo so back to GP who repeated TSH/T4 and said as usual all normal. Following threads on this forum I decided to have a Thyroid check with Medichecks. Below are the results, lappear to be positive for the antibodies,my Vit D looks low although in range and my Ferritin is really High?
TSH - 1.32 (0.27-4.20)
Free Thyroxine 18.9 (12.0- 22)
Total T4 96 (59 - 154)
Free T3 3.35 (3.10 - 6.8)
Reverse T3 32 (10-24)
Reverse T3 Ratio 6.82 (15-75)
Thyroglobulin Antibody 429 (0-115)
Thyroid Perioxidase Antibody 185.8 (0-34)
Vitamin B12 291.2 (140-724)
Folate 6.4 (2.91 - 50 )
25 OH Vitamin D 52.5 (50-200)
Ferritin 248 (13-150)
CRP 2.8 (0-5)
I am 62, on no other medication besides Levo, my grandmother and both her sisters all had goitres diagnosed and treated with surgery in the 1920's.
Any help in understanding whats going on would be greatly received because even with these media check results my GP will look t the TSH and thyroxine and say all normal no action. Thanks in advance.
Written by
ryanj
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You are going to have to treat yourself as doctors aren't taught nutrition.
Are you aware you have Hashimotos - autoimmune thyroid disease? The treatment for this is the same as for hypothyroidism so your GP won't do anything. You can if you wish share your medichecks results with your doctor but they will likely just be filed away. The advantage of this is if you have any other problems you can point out you have autoimmune thyroid disease and want to be checked for other autoimmune diseases. However be aware many GPs don't understand any sort of autoimmune or immune diseases.
You need to go gluten free as that helps stop the body, immune system, attacking the thyroid gland. By gluten free this means eating proper food and not consuming lots of stuff from the gluten free ranges in supermarkets as the fillers in them are junk.
(if you look over to the right hand side there is a topic called "Gluten Free chats" which will be worth having a look at)
You also need to supplement vitamin B12, folate and vitamin D plus selenium.
For vitamin B12 buy methycobalamin lozenges of Amazon - Jarrows or Solgar are good brands. You want your vitamin B12 level to be over 500. There is no point retesting vitamin B12 as once you are supplementing this all a test confirms is that you are supplementing.
For folate get a good vitamin B complex as it well help ensure all the B vitamins are balanced. You are aiming for you folate level to be half way in the range. If you are due a blood test you should stop taking this supplement around 5 days before hand as the biotin in it can give false readings.
For vitamin D buy 5,000IU of vitamin D3 daily for 6-8 weeks then take one every other day as you need to get your vitamin D level to around 100nmol/L. You will need to test your vitamin D level in 3 months and once you get it to around 100nmol/L you will just need to test it every year in late September/early October.
You should also take a selenium supplement.
However none of this supplementation will work properly if you don't go properly gluten free.
In regards to your high ferritin - high ferritin is linked to inflammation and chronic infection. In your case the fact you have hashimotos is the likely cause. If you go gluten free and supplement then your body should release the iron it's holding so your ferritin level goes down. (Ferritin is your body's iron stores and it will store this if you have inflammation or chronic disease to protect your organs.)
ryanj You're certainly not overmedicated, the aim of a treated hypo patient generally is for TSH to be 1 or below and FT4 and FT3 in the upper part of their respective reference ranges. Your TSH is in a reasonable place, your FT4 just about right (in the upper third of it's range) but your FT3 is way too low, it should be in the upper quarter of it's range but is right down at the very bottom. This indicates that you aren't converting T4 to T3 very well at all and need T3 added to your Levo.
What you are doing, though, instead of making FT3, you are in fact making reverse T3 - confirmed by your way over range rT3 result and the low ratio of 6.82 (over 20 is said to be where it should be).
Unfortunately, NHS doctors either don't know anything about this or refuse to recognise it.
How to lower rT3? Well, it's recommended to lower Levo and add T3, sometimes it's recommended to take T3 only for a few weeks to clear the rT3 then reintroduce Levo.
Here are some links I saved when I was looking into this which will help (not in any particular order, just plough through them):
What do you then do with that knowledge? That's a hard one. It's usually a case of go it alone because the NHS doesn't treat it because it doesn't accept it.
**
As for the rest of your results:
Thyroglobulin Antibody 429 (0-115)
Thyroid Peroxidase Antibody 185.8 (0-34)
Both types of antibodies are high confirming autoimmune thyroid disease aka Hashimoto's (autoimmune thyroiditis in doctor speak). You could point this out to your GP but they just say the treatment is no different. Actually it isn't. Hashi's is where antibodies attack the thyroid and gradually destroy it. It's the resulting Hypothyroidism that is treated.
What your GP probably won't know is that you can help reduce the antibodies by adopting a strict gluten free diet. Gluten contains gliadin which is a protein thought to trigger antibody attacks. Read about the gluten/thyroid connection here
Supplementing with selenium L-selenomethionine 200mcg daily and keeping TSH suppressed also help reduce the antibodies. Some people find they need to be dairy free too. But one step at a time!
B12 and folate work together. Folate should be at least half way through the range, so 27+ with that range.
B12 under 500 can cause neurological problems. Recommended level is very top of range, even 900-1000.
You can buy some sublingual methylcobalamin lozenges 5000mcg (such as Solgar or Jarrow's) and take one daily. Finish the bottle then buy the 1000mcg dose as maintenance.
When taking B12 we need a B Complex to balance all the B vitamins. If you buy one with 400mcg methylfolate that will help raise your folate level. Look at Thorne Basic B (one daily) or Metabolics B Complex (two daily), both are good, the Metabolics has no fillers or unnecessary ingredients.
B vits should be taken in the morning, no later than lunchtime as they can be stimulating and may affect sleep if taken later in the day.
**
25 OH Vitamin D 52.5 (50-200)
Recommended level for Vit D is 100-150nmol/L. You can buy some D3 softgels (such as Doctor's Best) and take 5000iu daily for 3 months then retest. When you've reached the recommended level reduce to a maintenance dose. That could be 2000iu, maybe less in summer, we have to find our own maintenance dose by retesting 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 would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
Gosh - thanks so much. I really need to do some reading and shopping for supplements. I feel really annoyed that I am just told annually 'all in range and no action needed' - they don't even see me. I didn't even know I had an auto immune disease just told a deficiency. Thanks for your help, amazing.
Dear Bluebug - wow, many thanks for this information. I wasn't aware that I had Hashimotos, just told TSH borderline therefore thyroid deficiency. I certainly have a lot of useful info here to look at. Do you think my joint pains, restlessness and insomnia are all related. The reason I started to read more was that I thought my symptoms of not sleeping and not being tired meant I was overmedicated. Thanks so much for your advice.
Magnesium and vitamin D may well help with the sleep issues.
Medics don't recognise Hashimoto's, don't treat it and have no idea about the importance of good vitamin levels or the underlying gluten intolerance and leaky gut
A good daily probiotic can also help with repairing gut and improving good gut bacteria
Hashimoto's is strongly linked to poor gut health
Great article about low vitamin D and low B5 - which will improve with supplementing good vitamin B complex
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