New member taking 50mcg levo for hypothyroid diagnosed 5 years ago GP says I am depressed do below results suggest this thank you
TSH 6.10 (0.2 - 4.2)
Free T4 10.3 (12 - 22)
Free T3 3.1 (3.1 - 6.8)
Thyroid peroxidase antibody 485 (<34)
Thyroglobulin antibody 298.3 (<115)
Vitamin D total 18.3 (<25 severe vitamin D deficiency. Patient may need pharmacological preparations)
Ferritin 14 (30 - 400)
Folate 3.2 (4.6 - 18.7)
B12 177 (180 - 190)
Hi and Welcome 
No you do NOT have depression - but you do have a VERY poorly treated thyroid and are deficient in so many vital nutrients. Of course there is no blood test for depression so patients can easily be fobbed off. Your Doc needs educating and fast ....
Your dose of T4 should have been increased as you are still on a starter dose - testing every six weeks with dose increases until you are without symptoms.
Your TSH should be 1 or under when on treatment. Your TSH is above the range and the FT4 below and the FT3 just there. Of course you will depressed with levels like those. Am assuming you had these tests done privately.
You also have high anti-bodies indicating Hashimotos. I despair at your results and I would like you to click onto SeasideSusie - then click onto her REPLIES and read her wonderful information to others with results like yours. It is so much to type out - so better you read as suggested
What did your GP say about these appalling results .... ??
Hi GP has not said anything about results but endo has and she has said that after examining me thinks I have adrenal insufficiency so I am not sure if my dose should be raised yet
Endo must have seen your results but made no comment about how dire they are? It is astonishing. I think they know more about diabetes than hypothyroidism.
Adrenals can suffer if we're not on an optimum of thyroid hormones. I was told by a doctor who knew how to diagnose by clinical symptoms that the adrenals can sort themselves out once on an optimum of thyroid hormones. I am astonished she hasn't increased your dose of levo.
You are bound to have adrenal insufficiency as you have iron deficiency - folate deficiency - B12 deficiency - VitD deficiency - thyroid deficiency. Has the Endo suggested treatment to correct all these very obviously below range issues ? It really is a scandal ....
Did you click onto SeasideSusie to read how to treat your deficiencies ?
You will be depressed with levels like that! Vit D deficiency alone can cause depression never mind that you are clearly undermedicated and deficient in ferritin, b12 and folate!! I would be thinking about a change of gp! Get on the thyroid UK website and read through the info there, perhaps print some off to take with you to the doctor's x
There's so much that can be improved with your results! I got my TSH down from 3.8 to 1 and was shocked by my lack of depression symptoms I'd been suffering with for years x
You have an inefficient doctor who is another who knows nothing about treating a hypothyroid patient. The aim is not a TSH somewhere in the range but 1 or below.
Once we are diagnosed the aim is a TSH of 1 or lower and some need it suppressed.
The Endocrinologist is not very knowledgeable either.
Your FT4 is below range and FT3 low in range when both should be in the upper part of the range.
Your GP MUST check you for Pernicious Anaemia due to your very low B12. I will add SeasideSusie into this as she will advise on your other results. In fact I think both Endo and Doctor should be dismissed as both are inefficient.
They seem to be completely unaware that if we are not prescribed with sufficient hormones, everything in our body suffers, brain and heart especially need optimum hormones to function efficiently.
It is a learning curve and we have to do it ourselves. I am giving you a link of clinical symptoms - tick off the ones you have and tell your doctor you are now a member of Healthunocked Thyroiduk.org.uk - recommended by the NHS for information and advice and say you need an increase now. Depression can be caused by low FT3 so anti-d's aren't the answer but more thyroid hormones and you definitely need an increase in dose. 50mcg is a starting dose and you should have had increments of 25mcg till your TSH was 1 or lower
The disgrace is that you have been diagnosed for five years. Awful.
One doctor said we are now given too low doses as we used to get between 200 and 400mcg. Nowadays doctors are putting our whole lives in danger because they know nothing about what the function of the thyroid gland with result that patient can develop other more serious illnesses.
Aeveen1988 It really is shocking the amount of times we hear about this claptrap doctors are spouting, they really know nothing about treating hypothyroidism and so many patients are being kept extremely unwell due to their ignorance.
You haven't said whether you have had your dose of Levo changed at any time since diagnosis, nor have you said if you have been prescribed anything for your low vitamins and minersls, so I will just reply based on your current dose of 50mcg and assume your dire nutrient levels have been ignored.
TSH 6.10 (0.2 - 4.2)
Free T4 10.3 (12 - 22)
Free T3 3.1 (3.1 - 6.8)
I am tempted to say that you should ask your doctor how he would like to struggle through each day with an over range TSH and under range FT4 and FT3 barely scraping in at the bottom of the range.
You are grossly undermedicated. 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 when on Levo. Ask your doctor for an increase in dose and use the following information to support your request:
According to the BMA's booklet, "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.
Booklet written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist. It is published by the British Medical Association for patients. Available from pharmacies and Amazon for about £4.95. It might be worth buying, highlighting the relevant section to show your GP and Endo in support of an increase in Levo.
Also,
Dr Toft states in Pulse Magazine (the doctors' 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)."
Email louise.roberts@thyroiduk.org for a copy, print it and highlight question 6 to show your GP and endo.
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Thyroid peroxidase antibody 485 (<34) Thyroglobulin antibody 298.3 (<115)
Have any of your doctors bothered to tell you that you have autoimmune thyroid disease aka Hashimoto's as confirmed by your high antibodies? This is where antibodies attack the thyroid and gradually destroy it.The antibody attacks cause fluctuations in symptoms and test results. If you have had dose changes in the past, these fluctuations could be the reason.
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.
Gluten/thyroid connection: chriskresser.com/the-gluten...
stopthethyroidmadness.com/h...
stopthethyroidmadness.com/h...
hypothyroidmom.com/hashimot...
thyroiduk.org.uk/tuk/about_...
We frequently find that low levels of nutrients go hand in hand with Hashi's due to gut/absorption problems. If SlowDragon is around she will give more information and links about that.
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Vitamin D total 18.3 (<25 severe vitamin D deficiency. Patient may need pharmacological preparations)
As you are severely deficient, the following applies:
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. Once these have been completed you will need a reduced amount (not the 800iu that you will be prescribed) 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 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.
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Ferritin 14 (30 - 400)
Have you had an iron panel and full blood count carried out to see if you have iron deficiency anaemia? If not ask for them to be done. If you are diagnosed with iron deficiency anaemia then the treatment is ferrous fumarate 3 times daily.
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...
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Folate 3.2 (4.6 - 18.7)
B12 177 (180 - 190)
Folate and B12 deficient. Do you have any signs of B12 deficiency b12deficiency.info/signs-an...
You need to post these results on the Pernicious Anaemia Society forum for further advice, include also your ferritin result (and iron deficiency diagnosis if you have one) plus any signs of B12 deficiency. You will probably need testing for Pernicious Anaemia and may need B12 injections healthunlocked.com/pasoc
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."
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If all these nutrient levels have been ignored then I would make an appointment with another GP and insist on the appropriate treatment. When this has been sorted, I would give serious consideration to making a formal complaint against this GP and maybe even the endo who has ignored all these results.
Wow - time to write that GP Manual Susie. 😊😊 " How to Understand Test Results " .....
What a scandal it all is. No wonder the country is so sick .
It's scary stuff Marz. I imagine we get just a very small percentage of hypo patients who come to the forum, but so many of them have these dire results. How many more are there who don't know about TUK or don't have internet access? And the fact that most doctors seem to know nothing about nutrients and how important good levels are is really frightening.
Hi endo knows I am on a low dose and I have been kept on 50mcg for all this time. Complete blood count and iron panel showed iron deficiency anaemia thanks
Aeveen1988 Iron deficiency anaemia diagnosed, plus ferritin level of 14 - your doctors are an absolute disgrace and shouldn't be practising. They would be better off in another job that doesn't involve anything to do with people's health.
NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines)
cks.nice.org.uk/anaemia-iro...
Have a read through but this is the treatment:
How should I treat iron deficiency anaemia?
•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.
And your endo knows absolutely zero about treating hypothyroidism.
Seriously, throw the effing book at these idiots. They are not only keeping you extremely unwell, they will probably end up killing someone.
You have all the information you need to ask for appropriate treatment. See another GP and if necessary ask for a referral to a new endo, one that knows about thyroid. They're almost all diabetes specialist so email louise.roberts@thyroiduk.org for the list of thyroid friendly endos.
Take someone with you to your appointment if necessary, and ask for the following:
1) An immediate increase in your levo to achieve the levels recommended by Dr Toft and to allieviate your symptoms.
2) Treatment for your dire ferritin level and your iron deficiency anaemia. Remember that thyroid hormone can't work unless ferritin is 70+
3) Loading doses for your severe Vit D deficiency.
4) Further investigations into your folate and B12 deficiencies. Testing for Pernicious Anaemia and likely B12 injections (hopefully you've posted on the PA forum and have had further advice about this)
As well as getting your Levo dose higher and improving vitamins (with SeasideSusie's excellent advice), you also need to consider the high antibodies. This is Hashimoto's or autoimmune thyroid disease and it almost always affects the gut, leading to low stomach acid, low vitamin levels and leaky gut.
With Hashimoto's, leaky gut and 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. Very, very many of us here find it really helps and can slowly lower antibodies.
thyroidpharmacist.com/artic...
thyroidpharmacist.com/artic...
amymyersmd.com/2017/02/3-im...
chriskresser.com/why-changi...
scdlifestyle.com/2014/08/th...
Many GP's are unaware of the gluten issue. You are going to have to read and learn as much as possible and manage all your vitamin supplements and keep good records on all your blood tests over time. Always get actual results and ranges for every test
Your current GP has been negligent keeping you on far to low a dose of Levo and also not treating your clearly and obviously low vitamin
If you can find an alternative GP then suggest you do so ASAP
Updated Test Results
