Hi I am a 26 year old female and a newly registered member. I was diagnosed last week with underactive thyroid. I am taking 25mcg levothyroxine and my symptoms are constipation, upset stomach, eczema, goitre, tiredness, muscle cramps, pins and needles, hair loss and puffy eyes and feet, when will I notice a difference in symptoms or are these not of low thyroid?
TSH 38 (0.2 - 4.2)
Free T4 10.6 (12 - 22)
Free T3 2.7 (3.1 - 6.8)
Thyroid peroxidase antibody 745.3 (<34)
Thyroglobulin antibody 277.5 (<115)
Thank you
Written by
Tashab
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Tashab It takes about 6 weeks for Levo to be fully effective. You should, at that time, have a new thyroid test, a dose increase of 25mcg, another retest 6 weeks later, another dose increase, and so on unil your symptoms abate and you feel well.
When having thyroid tests, always book the first appointment of the morning, fast overnight (water allowed) and leave off Levo for 24 hours (take after blood draw). This gives the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction.
Always take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only. Keep Levo away from other medication and supplements by 2 hours, some need four hours.
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Thyroid peroxidase antibody 745.3 (<34)
Thyroglobulin antibody 277.5 (<115)
These high antibody results confirm autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks can cause fluctuations in symptoms and test results.
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.
Some of your symptoms are indicative of low nutrient levels. Have you had the following tested, if so please post the results, if not ask for them to be done
Vit D
B12
Folate
Ferritin
All of these need to be optimal for thyroid hormone to work.
Ferritin and folate are also out of range, B12 is low. Have you asked your doctor why taking vitamin D supplements is not raising your level into the acceptable range?
Your doctor should be doing something about all of these not just vitamin D and he's not treating you correctly for vitamin D either.
Read SeasideSusie posts to other people to find out the correct treatment for your deficiencies. Then visit the doctor and tell him/her you want to be treated appropriately.
Thanks I have just been told that the vitamin D supplement I take should bring my level up but it hasn't so I will go back and ask him. It isn't the first time I have had below range folate or ferritin, I will go back about these levels and demand the right treatment if I have to. I clearly have a problem maintaining nutrient levels for some reason.
•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).
•Treat with oral ferrous sulphate 200 mg tablets two or three times a day. ◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.
◦Do not wait for investigations to be carried out before prescribing iron supplements.
•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.
• Monitor the person to ensure that there is an adequate response to iron treatment.
Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.
You are folate deficient and your B12 is low. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... If so post these results on the Pernicous Anaemia Society forum here on Health Unlocked for further advice, mention your ferritin/iron results and any signs of B12 deficiency.
If no signs of B12 deficiency then your GP should prescribe folic acid for the folate deficiency and you will need to raise your B12 level by supplementation.
I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:
"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."
And an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
That's good enough for me and I keep mine around 1000. Sublingual methylcobalamin lozenges are what's needed to supplement B12 yourself (5000mcg daily to start and when the bottle is finished change to 1000mcg daily as a maintenance dose) along with a good B Complex to balance all the B vitamins.
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Vitamin D 42.6 (25 - 50 vitamin D deficiency. 800iu vitamin D
800iu D3 is going to take forever to raise your level. It is hardly a maintenance dose for someone with a reasonable level. I suggest you buy your own D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 3 months then retest. When you've reached the recommended level, which the Vit D Council say is 100-150nmol/L, then you'll need a sensible maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/index.html
There are important cofactors needed when taking D3
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
When you start levothyroxine you should get another blood test 6 weeks after you started and then increase the dose until you feel well or reach a TSH near to 1.0. It will take a while to feel well. Your symptoms could be attributed to under active thyroid and you could also get your vitamin levels tested as you may be deficient.
Your going to need to read up and learn all about Hashimoto's. Your GP will only treat the low thyroid hormones and not look for the cause.
Hashimoto's often affects the gut causing LOW stomach acid. Symptoms are almost identical to high stomach acid, but the treatments are very different
As you can see from your own vitamin results Hashimoto's also affects these. Your going to need to supplement as SeasideSusie has explained in excellent detail.
But you also need to look for the root cause, usually gluten intolerance, but it may be dairy (instead or as well)
Don't be surprised if GP completely unaware that a thyroid disease is connected to the gut and gluten
Masses of info about Hashimoto's at The Thyroid Pharmacist website
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