Hypo and thin?: Hi newbie can you be hypo and... - Thyroid UK

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Hypo and thin?

Liza2 profile image
18 Replies

Hi newbie can you be hypo and thin? Been taking thyroid hormone for 5 years, current dose 125 mcg of levothyroxine and always been thin since I was 16 now 32 didn't have symptoms of fatigue and cold hands and dizziness on T3 thanks

TSH 5.26 (0.27 - 4.20)

Free T4 13.1 (12 - 22)

Free T3 3.8 (3.1 - 6.8)

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Liza2
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SlowDragon profile image
SlowDragonAdministrator

Yes, not typical but not rare.

Do you feel OK or have you got symptoms, if so what

Do you have high thyroid antibodies? Do you know if antibodies ever been tested. If ever been high this Hashimoto's or autoimmune thyroid disease

Have you had vitamin D, folate, ferritin and B12 tested recently. Post actual results and ranges if you have.

If not ask GP to test and you might consider asking for coeliac blood test. Extremely unreliable test, but it might prompt them to take you seriously

Liza2 profile image
Liza2 in reply toSlowDragon

I have the symptoms of fatigue and cold hands and dizziness other results are

Thyroid peroxidase antibodies 485 (<34)

Thyroglobulin antibodies >2000 (<115)

SlowDragon profile image
SlowDragonAdministrator in reply toLiza2

So your antibodies are very high this is Hashimoto's, (also known as autoimmune thyroid disease). About 90% of hypothyroidism in UK is due to Hashimoto's.

Hashimoto's very often affects the gut, leading to low stomach acid, low vitamin levels and leaky gut.

Low vitamins that affect thyroid are vitamin D, folate, ferritin and B12.

Extremely important to test these. If they are too low they stop Thyroid hormones working.

Have these been tested, if not ask that they are. Always get actual results and ranges.

As you have Hashimoto's then hidden food intolerances may be causing issues, most common by far is gluten. Changing to a strictly gluten free diet may help reduce symptoms and eventually start to lower antibodies. Very, very many of us here find it really helps and can slowly lower antibodies, improving symptoms

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

chriskresser.com/the-gluten...

Low stomach acid can also be an issue

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

thyroidpharmacist.com/artic...

Another thing to help heal gut lining is Bone broth

thyroidpharmacist.com/artic...

Liza2 profile image
Liza2 in reply toSlowDragon

Yes vitamin and mineral levels are

Ferritin 12 (15 - 150)

Folate 2.3 (2.5 - 19.5)

Vitamin B12 147 (180 - 900)

Vitamin D 22.8 (<25 severe vitamin D deficiency)

No treatment for these yet

SlowDragon profile image
SlowDragonAdministrator in reply toLiza2

So when did GP get these? What have they advised

These levels are dire. Your thyroid hormones will struggle to work until really improved.

Are you being fully tested for coeliac.? endoscopy is only reliable test, requires 6 week high level gluten diet, called gluten challenge.

But over 80% with Hashimoto's find it best to be strictly gluten free. So it's probably not worth doing

I will include SeasideSusie on this.

She is the vitamins guru and will give you detailed guideline for necessary supplements

Liza2 profile image
Liza2 in reply toSlowDragon

GP got these a month ago and hasn't advised anything, GP said she would test me for coeliac but there was no request for the blood test on the screen

SlowDragon profile image
SlowDragonAdministrator in reply toLiza2

Is there another GP you can see?

This one is not helping you.

Blood test for coeliac is only correct 50% of time

SeasideSusie profile image
SeasideSusieRemembering in reply toLiza2

Liza2 No treatment for these yet - GP got these a month ago and hasn't advised anything

You need to make an urgent appointment to follow these up, it is negligent of your GP to have had these results for a month and done nothing about them. You should ask why they have been ignored.

Ferritin 12 (15 - 150)

For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. You need an iron supplement. Ideally you need an iron infusion so ask for one, but you may only be prescribed tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours. 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 can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

If not already done, you need an iron panel and full blood count to see if you have iron deficiency anaemia and if this is diagnosed the treatment is 1 x ferrous fumarate 2 or 3 times daily.

**

Folate 2.3 (2.5 - 19.5) Vitamin B12 147 (180 - 900)

To ignore these is extremely negligent. Folate deficiency and B12 deficiency. Check for signs of B12 deficiency here b12deficiency.info/signs-an... and I would be very surprised if you don't have any.

You need testing for Pernicious Anaemia and very likely you will need B12 injections.

You could post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc

Do not take any supplements for either of these until further investigations have been carried out.

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."

You may wish to watch the first film on this page so that you can see the seriousness of your GP ignoring your B12 deficiency to back up your request for further investigation b12deficiency.info/films/

**

Vitamin D 22.8 (<25 severe vitamin D deficiency)

As you can see, you are severely Vit D Deficient. See NICE treatment summary for Vit D deficiency:

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)."

Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and demand that he treats you according to the guidelines and prescribes the loading doses. Do not accept 800iu, that is barely a maintenance dose for someone with a decent level, it will not raise your level. Once the loading doses have been completed you will need a reduced amount to bring your level up to what's recommended by the Vit D Council and then you'll need a maintenance dose (not 800iu) 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.

Tiredmum75 profile image
Tiredmum75

Hi yep l have lost 20 kilos and counting been swinging from Hashimotos to graves which is probably why I feel like a pendulum sometimes

silverfox7 profile image
silverfox7

You are so low in everything and your thyroid resultsshould more medication needed as well. Addressing other results will help but is there another doctor at the surgery you can see as you are not getting any help or support from this one.

norwood1 profile image
norwood1

Hi, I was diagnosed in 2007 and I am just under 8 stone now, so yes you can be slim in my opinion. I was always around 9 9.5 stone so have lost weight in the last year. I am on 100mcg of levothyroxine daily and have been for the last few years. You should go back to your Doctor as your vitamin levels are way too low. You need to supplement or have injections. I have B12 injections 3 monthly. Best wishes and I wish you well.

SilverAvocado profile image
SilverAvocado

These thyroid results show you are very undermedicated for thyroid, too - these all cycle into each other, as being hypo makes your stomach acid poor quality, so the vitamins from your food are not absorbed.

For the thyroid tests you want your freeT3 to be in the top third of the range, this is the most important one. The TSH will be close to 1 or below, this is probably the number your GP will care about.

But all these vitamins also need addressing, you are deficient in many things, and this will be making you ill.

Puska profile image
Puska

I’m thin and have had hashimotos for years. I asked to be tested years before GP finally did the test - she kept saying I was too thin to have a thyroid problem. I’m still thin. And currently hypo as treatment isn’t doing its thing.

LMor profile image
LMor

Hi. I'm a size six-eight and was told by my doctor that I can't possible have an under active thyroid because I'm too thin. Even though my Tsh was 9.81 (range 0.27-4.2) Free Thyroxine 11.7 (range 12-22) My thyrogloblin Antibody is 633.000 (range 0.00-115.00) and my thyroid Peroxidase is 108. (Range 0.00-34.00) They've given me 25mcg of levothyroxine which I'm grateful for, but it's so wrong that just because it's not textbook GP's think you can't have it.

klr31 profile image
klr31

It looks like you are under-medicated. Do you take your thyroxine away from any other food and only with water? Have you gone gluten-free? Ask for an increase and see how you go on.

Karen

Liza2 profile image
Liza2 in reply toklr31

Yes I take meds away from food and only with water and not gluten free because GP thinks I am coeliac thanks

SlowDragon profile image
SlowDragonAdministrator in reply toLiza2

Even if endoscopy is negative for coeliac over 80% with Hashimoto's benefit & find it essential to be strictly gluten free

Have you got date for endoscopy?

Yes. I am - well, not thin but slim anyway. But I have secondary hypo and low cortisol tends to make you thinner, I think.

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