Jax2345 You are undermedicated, your TSH is over range. Why hasn't your GP increased your Levo? The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges if that is where you feel well.
"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)."
Dr Toft is past president of the British Thyroid Association and leading endocrinologist. You can obtain a copy of the article by emailing louise.roberts@thyroiduk.org print it and highlight question 6 to show your GP in support of your request for an increase.
Increases should be in 25mcg increments with a retest after 6 weeks, another increase followed by another retest 6 weeks later, and so on until you feel well and symptoms abate.
It's more than likely that undermedication is causing any depression you may have (if indeed you agree with your GP), depression is a symptom of Hypothyroidism.
Perhaps you should find another GP. You have the information you need to argue your case in the article by Dr Toft.
Now you have added your list of symptoms, some of them are indicative of low nutrient levels. Have you had the following tested, if so please post the results with reference ranges, of it ask for them to be done
Ferritin 55 (30 - 400) - 210mg ferrous fumarate once a day
Twice a day would be better.
Ferritin should be half way through it's range.
Eating liver regularly, maximum 200g per week due to it's high Vit A content, will help, as will including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
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Folate 1.7 (2.5 - 19.5)
Vitamin B12 206 (190 - 900)
5mg folic acid once a day B12 injections once every 3 months
That's pretty standard treatment. But some people find a B12 injection every 3 months is not enough and either provide their own or supplement with sublingual methylcobalamin. You could ask the Pernicious Anaemia Society for further advice healthunlocked.com/pasoc
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Vitamin D 56.3 (50 - 75 suboptimal) 800iu vitamin D once a day
800iu D3 isn't going to raise your level. It is hardly a maintenance dose for someone with a reasonable level. You need far more.
The recommended level is 100-160nmol/L according to the Vit D Council.
You could take some D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 6 weeks then retest. Once you've reached the recommended level 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
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
Haematologist has said he does not want my ferritin below 50 and has said because my stomach has been upset on more than 1 ferrous fumarate tablet he has said once a day is enough
I had iron infusion done last year which brought up my ferritin to 187 and I don't want it dropping any more
I had iron infusion done last year which brought up my ferritin to 187 and I don't want it dropping any more
So is your ferritin 55 or 187? If it's 187 then 1 x FF is fine, but you posted your ferritin result as 55.
Are you taking your iron tablets with 1000mg Vit C to aid absorption and help prevent constipation? Do you take it with food to help prevent digestive discomfort?
Jax, I think you need to find another doctor and see that you get your levo increased. No wonder you have so many symptoms you are under medicated and need an increase of 25mcg and then a retest of bloods after 6 weeks and then another increase if your TSH is still over one. Suggest you get antibodies, Vit B12, iron, ferritin, folate and Vit D tested also. GP probably won't agree so if you can get a finger prick test from Medichecks (thyroid Thursday they do offers) or Blue horizon. Anyone would be depressed with results like yours. Antidepressants are just such a cop out by the GP don't take them!
Persackly! How is greater than 1500 not positive for TPO antibodies when the top of the range is 34? Some GPs like to call it autoimmune thyroiditis, but it is the same thing.
Who says not hashimotos, that useless GP. You do have Hashis with sky high antibodies so you will have problems getting enough Vitamins into your system. I have Hashis and reduced Ab's by going gluten free. I permanently have to supplement B12 methylcobalamin and Vit D with vit K.
Sorry to say but your doctor is an idiot even compared to conventional doctors that go strictly by the book. Find a new doctor quick! Even though my GP has his weaknesses, ever since starting me on Synthroid he has been fine to move me from the top part of range to bottom part of range. And not is your TSH above range but your antibodies are sky high, evidence for Hashimotos.
So he is a useless endo if he has never heard of Hashi's. No doubt a diabetes specialist! Your Bloods results are pretty dire and GP has given you useless levels of supplements, they will never improve your levels. Seaside Susie is ace with how much you need to supplement etc.
That is ridiculous did the endo say it was autoimmune hypothyroidism? Pernicious anaemia, inability to absorb vit b 12 is also an autoimmune illness. You would also benefit for investigations into gluten intolerance, coeliac cdisease. Even if that is negative going gluten free can help reduce antibodies. You need new doctors.
Hi I'm unsure but dont think leakyngut and stomach acids been mentioned,
It's vital to heal your gut to be able to absorb properly ( a few products around I use Sustain fromNutri in a shake ). This surely has to be the first port of call, please tell me if wrong, I too have awful depression, I think the levo does this, it kind of pulls you together do you find but also,depressed, good luck I'm like you with similar readings x
I asked endo if I had Hashimotos and he said no he has never heard of it
That's because in doctor speak it's "autoimmune thyroiditis".
You definitely have Hashi's and it will eventually destroy your thyroid. The antibody attacks 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.
Well, there are no proper tests for depression - no bloods, no ultrasound - nothing except the subjective opinion of your GP (and her incentive of more funding points for prescribing anti-depressants). But there are objective signs of undermedication for hypo in your results - your TSH should be under 1 and free T4 in the top quarter of its range (as well as all your symptoms). If the GP wants to give you one of those anxiery and depression questionnaires look it up online first and make sure you don't answer any of the questions positively - you can get away with a score of 3 on 2 things but that still gives you "mild depression" - in fact everyone who isn't 100% bubbly, and jumping up and down has mild depression. You are undermedicated.
I asked endo if I had Hashimotos and he said no he has never heard of it
In the UK doctors don't use the name Hashimoto's Thyroiditis, that tends to be an American term.
Instead, in the UK, they use the following terms :
autoimmune hypothyroidism
autoimmune thyroiditis
Be aware though that in the UK doctors usually don't mention antibodies at all, and don't mention the word "autoimmune". They don't understand what relevance antibodies have. They don't have a pill to treat them. Many of them think that "everyone has antibodies, they mean nothing". Some of them say that all women have antibodies, and they are of no importance. They might say that if you have antibodies it means you are at greater risk of developing hypothyroidism (if you don't already have it).
They say an awful lot of things, many of them rubbish, but what they won't tell you is the real significance of the results and what to do about them.
You could do a search for Izabella Wentz. She is a Hashi's sufferer herself and has written a lot on the subject - she has a website, a facebook page, has written a couple of books, and appears in several Youtube videos.
You have interesting comments concerning your thyroid but as the endocrine system is linked to
the gynaecological hormones. You have not just thyroid symptoms but possibly menopausal symptoms. Your oestrogen and progesterone hormones need testing as may be you
have fibroids in the womb. Even endometriosis may be possible. This would mean that your hormone imbalance is giving you a hormone related depression.
Some GPs recommend drugs for the menopause, but sometimes you might get side effects which
are unpleasant. Many people might improve with the right treatment.
Lifestyle factors might influence your heavy periods. These are alcohol, which exacerbate menstrual flow. I found tannins in tea and coffee red wine and beer were affecting me
and now drink Ribena weakly diluted and have a weak cup of coffee as a treat.
Reducing salt might help. If you get pre menstrual bloating, and fluid retention this
can make you put on weight just before a period. If you get headaches or migraines
or low back ache, this might be a sign of gynaecological troubles. Vitamin C is useful to take if you are on iron supplements as it helps absorption. Good luck with a GP - ask for a lady doctor she might be more sympathetic and give you a holistic health picture.
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