Hi just joined, I have coeliac disease and I have got so many other problems at the moment - hair growing on face/body, hard stool, tiredness, dizziness, ears ringing, hair loss, weight gain around hips, pins and needles, anxiety, dark rings under eyes, decreased thirst, loss of appetite, heavy periods. Anything stand out below? Taking 100mcg levothyroxine, felt better on 200mcg levothyroxine and 20mcg T3, diagnosed hypothyroid 2013. Iron deficiency corrected in 2016 with an iron infusion, taking 5mg folic acid and 800iu vitamin D as well. Below results done in July 2017. Thankyou
TESTOSTERONE 2.2 (0.2 - 1.7)
TSH 4.01 (0.2 - 4.2)
FREE T4 15.1 (12 - 22)
FREE T3 3.4 (3.1 - 6.8)
THYROID PEROXIDASE ANTIBODY 98.5 (<34)
THYROGLOLBULIN ANTIBODY 255.3 (<115)
FOLATE 2.3 (2.5 - 19.5)
VITAMIN B12 169 (180 - 900)
VITAMIN D TOTAL 25.5
RED BLOOD COUNT 4.47 (3.80 - 5.80)
WHITE CELL COUNT 6.13 (4.0 - 11.0)
MEAN CORPUSCULAR VOLUME 76.2 (80 - 98)
MEAN CORPUSCULAR HAEMOGLOBIN CONC. 377 (310 - 350)
MEAN CORPSCULAR HAEMOGLOBIN 28.1 (28 - 32)
HAEMOGLOBIN ESTIMATION 120 (115 - 150)
HAEMATOCRIT 0.400 (0.370 - 0.470)
PLATELET COUNT 255 (150 - 400)
IRON 12 (6 - 26)
TRANSFERRIN SATURATION 15 (10 - 40)
Written by
Jennat90
To view profiles and participate in discussions please or .
You have vitamin B12, folate, vitamin D and iron deficiencies. Your TSH is too high which means you need to increase your thyroid meds. Most people don't feel well until their TSH is near to 1.0 or a little lower. Why were your meds reduced?
As you have coeliac disease, has your doctor tested for pernicious anaemia? Post your B12 and folate results on the Healthunlocked Pernicious Anaemia forum for their advice.
You have elevated thyroid antibodies which means you have an autoimmune thyroid condition otherwise known as Hashimotos. Has your doctor told you that? You can read more about it on Thyroid UK's website. You need to learn all you can about it as doctors know very little.
Meds were reduced because of low TSH of 0.02 (0.2 - 4.2) free T4 20.8 (12 - 22) and free T3 5.6 (3.1 - 6.8) Haven't been tested for pernicious anaemia so will look into this now.
Your TSH is far too high, you need immediate dose increase of 25mcgs and retesting in 6-8 weeks. Highly likely more increases needed and T3 adding back in once vitamin levels are improved
You now have very significant vitamin deficiencies, due in large part to dose reduction, I will add SeasideSusie here as she gives excellent detailed advice on how to improve
Your high testosterone suggests perhaps PCOS - have you been tested. But it could also be side effect of having dose reduced massively and/or low T3
Obviously being coeliac you are already gluten free but Hashimoto's has other effects on gut to
Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime
Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.
MEAN CORPUSCULAR VOLUME 76.2 (80 - 98) MEAN CORPUSCULAR HAEMOGLOBIN CONC. 377 (310 - 350)
These suggest you still have iron deficiency anaemia.Your iron infusion may have corrected it back in 2016 but it's obviously a problem again. You obviously have not been monitored - see
NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines)
•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.
You need to ask your GP to treat you appropriately now, and ensure that your levels are maintained, either by a maintenance dose or other means. If you are prescribed iron tablets then take each one 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.
**
FOLATE 2.3 (2.5 - 19.5)
VITAMIN B12 169 (180 - 900) taking 5mg folic acid
So your GP has taken notice of your folate deficiency, but ignored your B12 deficiency? < SIGH >
Check for signs of B12 deficiency here b12deficiency.info/signs-an... Then pop along to the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc Quote your Folate, B12, iron/blood count results, Ferritin level if you have it, and any signs of B12 deficiency you may be experiencing. Bear in mind that taking folic acid can mask signs of B12 deficiency so think back to before you started taking it.
You may need testing for Pernicious Anaemia and you may need B12 injections. Your GP should not have started you on folic acid until further investigations into your below range B12 had been carried out.
Whatever the PA forum advises, discuss with your GP and ask why he has ignored your B12 result.
**
VITAMIN D TOTAL 25.5 800iu vitamin D
You are 0.5 away from severe Vit D deficiency and 800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level.
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 ask 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 a paltry 800iu) 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 which may be 2000iu daily (not 800iu), 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
and supplementing with selenium l-selenomethionine 200mcg daily can help reduce the antibodies, as can keeping TSH suppressed.
**
Meds were reduced because of low TSH of 0.02 (0.2 - 4.2) free T4 20.8 (12 - 22) and free T3 5.6 (3.1 - 6.8)
Another doctor who knows diddly squat about treating hypothyroidism. Your FT4 and FT3 are well within range and that's what counts, they are the thyroid hormones. TSH is a pituitary hormone, the pituitary looks for thyroid hormone, if there isn't enough it sends out a signal TSH (Thyroid Stimulating Hormone) to the thyroid to produce some, in this case TSH would be high. When taking synthetic replacement thyroid hormone, the pituitary detects that there is enough hormone there, doesn't need to send the signal so TSH will be low. Pretty basic stuff if only they knew about it!
T3 stopped by NHS endo because he said it was an unsafe medication to take, this was decided 3 months ago.
I assume this was a new endo and the original one, who prescribed T3 in the first place, was happy enough for you to take it so didn't consider it to be unsafe. I think it's so wrong for a different doctor to overrule what another doctor has put in place.
*
It's very obvious from your results on the lower dose of Levo and with no T3 that your TSH has risen to the top of the range, FT4 has lowered right down and your FT3 is now barely scraping in at the bottom. FT4 and FT3 results show very clearly that your conversion is poor and that you need T3 reinstated.
For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. So you need an iron supplement. See what your doctor is going to do about the iron deficiency. If you get another iron infusion, you need to follow this up with further testing and make sure that your ferritin is kept at least 70, 100-130 is better for females. This can be by iron tablets but a good way of maintaining ferritin level is 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...
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Medicheck results - Vitamin issues
New to Hyperactive Thyroid Issues
Results are back although has flagged up Liver issues
Vitamins and minerals
Dipping my toe into the possibility of thyroid issues
