Advice on medication

[Missykat41]

Hi I am looking for some advice / help - my daughter was diagnosed 5 years ago (at the age of 18) with Graves Disease - she had a total thyroidectomy on 3rd July - since having this done her health hasn't been the best and she has been going back & forth to the hospital to get her bloods taken and appointments with the endocrinologist to try get the correct level of medication. She was put on 100mg of levothyroxin after the TT which was upped to 150mg 4 weeks ago but after her results this week has been upped again to 200mg. Her TSH seems to be rising !! I asked for her B12 to be checked and the results came back 497 which the endocrinologist said was in range. I have posted her blood results below to see if you guys can advise what to do next - I feel the endocrinologist isn't listening to my daughter and I hate watching her suffer .

[Nanaedake]

Without seeing laboratory ranges for your daughters blood test results its difficult to comment. Have you got them and could you add them? Labs vary so it's important to include them.

However, even without the lab ranges I would guess that a TSH of 40.1 as shown on the document means she is very hypothyroid and will be feeling very unwell. I can't tell without the lab range but FT3 looks low.

She may benefit from taking 200mcg of selenium daily. Conversion from T4 to the active hormone T3 is selenium dependent. Although she has had a thyroidectomy she will still have thyroid antibodies and selenium may help to prevent their activity.

ncbi.nlm.nih.gov/pmc/articl...

Very important to get vitamin levels tested because all can be deficient in people who have thyroid conditions. Folate, ferritin and vitamin D should be tested. I note you've already tested B12. B12 is best at top of lab range so find out what the top of the range is. The Pernicious Anaemia society suggest that anything lower than 500 is not optimal.

[Missykat41 in reply to Nanaedake]

I asked the endocrinologist for all her results to be emailed to me - I got a strange look and no email ! He handed me a post it note with the results I have posted. Sorry for sounding silly but what is selenium and can doctors prescribe this in the UK ? They took bloods yesterday to do a cealiac screening but not to go back for another month - another month of my daughter feeling dreadful .... the endocrinologist just isn't interested - she has seen 4 different ones since her op 11 weeks ago

[Nanaedake in reply to Missykat41]

According to the website below, selenium is a mineral found in soil. Most people get enough from their diet but some people can be deficient. 400mcg is the upper limit for an adult so it seems that 200mcg should be a safe amount even if you get some from your diet. Brazil nuts can contain a lot of selenium but it depends whether they were grown in selenium rich soil.

webmd.com/a-to-z-guides/sup...

You are unlikely to get it on presription. You can buy selenium tablets from a good healthfood store or from Amazon.

[Missykat41 in reply to Nanaedake]

Thanks - I will have a look for it online x

[Nanaedake in reply to Missykat41]

Your daughter can register to get her GP blood tests through an online portal. She needs to get a password from her GP reception and may need to sign a document and provide ID. Make sure to ask for enhanced access to get blood test results, not just access for making appointments. Then you register online using the password supplied. You will not be able to view hospital blood tests at the moment.

[Nanaedake in reply to Missykat41]

Cealiac blood tests are notoriously unreliable but hopefully if your daughter does have cealiac disease the test will pick it up. Many people with thyroid conditions function poorly with gluten in their diet even if they have not got cealiac disease. You will read a lot about it on this forum.

Do you know what brand of levothyroxine your daughter is taking? It could be the levothyroxine that is causing a problem. Has it recently been swapped for a different formulation?

[Missykat41 in reply to Nanaedake]

I'm not sure what brand she is on I will ask her tomorrow x

[Nanaedake in reply to Missykat41]

Let us know, if she has been swapped onto TEVA it could be causing the problem.