GP appointment today

Hi I spoke with a different GP to get my dose increased since the one I have been seeing and my endo don't seem to have a clue with dropping my dose so drastically from 150mcg levothyroxine and 10mcg T3 to just 50mcg levothyroxine. They did not pay attention to my symptoms but the GP I have seen today did. She has increased my levothyroxine to 75mcg levothyroxine with a retest in 6-8 weeks time.

Also have been given iron tablets to take once a day for iron deficiency. 800iu vitamin D3 for vitamin D deficiency and B12 loading injections. Also 5mg folic acid for folate anaemia. She has requested a coeliac screen because she said to have folate and iron anaemia deficiency together could indicate coeliac disease.

I also have postiive anti nuclear antibodies and positive anti smooth muscle antibodies.

Thanks for feedback/reading.

*THYROID PEROXIDASE ANTIBODIES 410.8 (<34)

*THYROGLOBULIN ANTIBODIES 258.3 (<115)

*TSH 5.20 (0.27 - 4.20)

FREE T4 12.7 (12 - 22)

*FREE T3 3.0 (3.1 - 6.8)

*FERRITIN 12 (15 - 400)

*FOLATE 2.2 (2.5 - 19.5)

VITAMIN B12 202 (190 - 900)

*TOTAL 25 OH VITAMIN D 25.2 (25 - 50 VITAMIN D DEFICIENCY. SUPPLEMENTATION IS INDICATED)

2 Replies
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Kyla90 I despair, I really do. At least something is being done, but not enough. Why don't these doctors know how to treat deficiencies when the information is easy enough for Jo Bloggs to find???

Also have been given iron tablets to take once a day for iron deficiency. 800iu vitamin D3 for vitamin D deficiency

If you have a diagnosis of Iron Deficiency then the treatment is as follows:

cks.nice.org.uk/anaemia-iro...

•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.

Your local area guidelines can be found by a search on Google and should be the same or very similar. You can see that you should have been prescribed iron tablets two or three times a day, one a day is generally for low ferritin. I suggest you ask for an increase in your prescription.

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.

As your ferritin level was under range at 12 (15-400) then an iron infusion would be far more helpful as that would bring your level up in 24-48 hours whereas iron tablets will take months. Ask if you can have one.

**

As you have been diagnosed with Vit D Deficiency, then 800iu daily is not the correct treatment, that is a maintenance dose for someone who has a decent level already, and you need loading doses for deficiency as your level was less than 30.

NICE treatment summary for Vit D deficiency: cks.nice.org.uk/vitamin-d-d... (Again, each Health Authority has their own guidelines which you can search for but they will be very similar.)

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)."

Once these have been completed you will need a reduced amount to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and 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/

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.

**

You have Hashimoto's, it affects the gut (GP's seem to have no idea)

Low vitamins are extremely common. Follow Seasidesusies excellent advice on these. It really helps

Testing for coeliac, the blood test is notoriously unreliable. Only endoscopy give real result. Is it worth the hassle (will they even agree to it) you have to eat high level gluten for 6 weeks before test

About 5% with Hashimoto's are coeliac, about 88% react to gluten to various degrees and feel better on strictly gluten free diet. Some are severely gluten intolerant, but not coeliac. There's no test for gluten intolerance, you just have to try it. It has to be 100% to be effective. Antibodies should slowly fall too

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

Other things to help gut heal are bone broth and daily probiotic

Read as much as possible about Hashimoto's- as you have already found out, medics have little idea

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