Thyroid UK
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Symptoms getting me down

Hi I am new

Could anyone please help, diagnosed hypothyroid in 2014, having symptoms like dizziness, ears ringing for hours on end, sleeping throughout the day, puffy eyes and feet, passing less stool but when it comes it is hard to pass, joint pain, periods being heavy, low appetite and concentration. Thank you

Taking 100mcg levo

TSH 3.70 (0.2 - 4.2)

Free T4 15.1 (12 - 22)

Free T3 4.0 (3.1 - 6.8)

Thyroid peroxidase antibodies 708 (<34)

Thyroglobulin antibodies 269.5 (<115)

5 Replies
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Change your doctor or tell him how treating a thyroid patient should be done.

First, once diagnosed the aim is to get the patient's TSH to 1 or lower - not somewhere in the range.

Should should have 25mcg increases each six weeks approx until your TSH is 1 or lower.

Both your FT4 and FT3 are too low - need to be towards the upper part of the ranges. Hopefully as your GP increases levo these will too.

Levothyroxine is T4. T4 is inactive and is supposed to convert to T3. T3 (liothyronine) is the only active hormone and it is required in the billions of receptor cells (brain and heart need the most) and the lack of it could be attributing to your continuing symptoms.

Also ask GP to test Vitamin B12, Vit D, iron, ferritin and folate as deficiencies can cause symptoms too.

Blood tests for thyroid hormones should always be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose and the test and take afterwards. This helps keep the TSH at its highest as that's all that doctors seem to take notice of.

You have an Autoimmune Thyroid Disease called hashimoto's and the antibodies attack your gland and wax and wane and going gluten-free can help reduce the antibodies. Treatment is the same as being hypothyroid.

Always get a print-out of your results with the ranges for your own records.

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Thanks I have other results

Ferritin 27 (30 - 400)

Folate 3.8 (4.6 - 18.7)

Vitamin B12 195 (180 - 900)

Vitamin D 31.6 (25 - 50 deficient)

Taking 800iu D3 only

Thanks again

Reply

They are all dire. I shall add SeasideSusie for her expertise.

1 like
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Ellie3303 As Shaws has mentioned most of us Hypos are better with a TSH of 1 or below and free Ts in the upper part of their reference ranges.

From thyroiduk.org.uk/tuk/about_... > Treatment Options

"Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

Dr Toft states in Pulse Magazine, "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)."

Lactose Free Levothyroxine: Some people are lactose intolerant or intolerant of some of the fillers and binders within the levothyroxine tablet. There are brands of tablets that are lactose free or that don't have certain ingredients in them. If you require information on these brands contact us.

Dr Toft is past president of the British Thyroid Association and leading endocrinologist. If you would like a copy of the article to show your GP, email louise.roberts@thyroiduk.org.uk then print, highlight quesion 6 which is the appropriate part.

**

Thyroid peroxidase antibodies 708 (<34)

Thyroglobulin antibodies 269.5 (<115)

As Shaws says, you have Hashimoto's.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

**

Ferritin 27 (30 - 400)

This is dire. Ferritin should be half way through it's range.

You need an iron infusion, that will bring your level up in 24-48 hours, whereas iron tablets will take months, so ask for one. Also ask for an iron panel, full blood count and haemoglobin test to see if you have iron deficiency anaemia. If you already have this diagnosis are you being treated for it? The treatment is Ferrous Fumarate two or three times daily. For low ferritin it's once or twice daily.

If prescribed iron tablets then take each tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds (which you will be prescribed) and two hours away from other medication and supplements as it will affect absorption.

Eating liver regularly, maximum 200g per week, and eating lots of iron rich foods will also help.

Folate 3.8 (4.6 - 18.7)

Vitamin B12 195 (180 - 900)

Do you have any signs of B12 deficiency b12deficiency.info/signs-an...

You are folate deficient with very low B12.

Please take these results over to the Pernicious Anaemia Society forum here on Health Unlocked for their expert advice. Also include your ferritin/iron results and any signs of B12 deficiency.

You may need testing for Pernicious Anaemia, you may need B12 injections, you certainly need something for your folate deficiency and your very low B12 should be treated. See what the PA forum says then discuss their advice with your GP.

healthunlocked.com/pasoc

For us Hypos the recommended levels are B12 at the very top of it's range and half way through range for folate.

Vitamin D 31.6 (25 - 50 deficient)

Well, 800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level.

You are barely above the level where the NICE Clinical Knowledge Summary advises treating with loading doses -

cks.nice.org.uk/vitamin-d-d...

Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

Local area guidelines should be similar so it might be worth asking your GP for loading doses, if he wont prescribe them come back and we can advise you what to buy and the dose to take.

The recommended level is 100-150nmol/L according to the Vit D Council.

There are important cofactors needed when taking D3 vitamindcouncil.org/about-v...

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 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 naturalnews.com/046401_magn...

Check out the other cofactors too.

Reply

I have a steam engine in my head that's been there for around 30 years!!!! That (tinnitus) arrived about the time I was first diagnosed. A few years it disappeared for a day! I really thought I had suddenly gone deaf S I was in the options waiting to pick up an new pair of glasses. It was bedlam! Loud jazz much and an unruly family shouting above it! Thankfully I was moved to the rest of the shop to wait to be seen and suddenly quiet I was genuinely frightened but wanted to hear a noise but the family had now left! I was sitting at a desk so banged my hand down on it and I heard it! Great! Why I did t just cough I don't know but fright pushes logic out of the door! Why it stopped I've no idea and in a way it felt reassuring that it was back the next day! Lots of reading and years later I started wondering if a thyroid problem. When I started again on NDT-my very early years I was treated with that-I've had odd days without and even 2 separate weeks do it's something I'm sure to what I'm taking. Now my meds are spot on but I do take loads of supplements so I must get myself organised and increase each one in turn to see if that helps. Lack of B12 is often mentioned and magnesium so going to start there and now I've publicly said this I really must get on with it!

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