Thyroid

[Summer89]

Hi

I am newly diagnosed hypothyroid taking 25mcg levothyroxine feedback welcome on results thank you

TSH 38.9 (0.2 - 4.2)

Free T4 10.1 (12 - 22)

[SeasideSusie Remembering]

Summer89 Are these results what got you diagnosed, and therefore you were then prescribed 25mcg Levo?

[Summer89 in reply to SeasideSusie]

Yes those results were when diagnosed and then given TG 25mcg levothyroxine

[SeasideSusie Remembering in reply to Summer89]

Well, unless you are a child, elderly or have a heart condition, your GP could have started you on 50mcg Levo.

There's nothing to say about your results other than you have primary hypothyroidism and you need Levo. The ultimate aim for a treated hypo patient 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.

You will need repeat testing/increases of 25mcg Levo every 6 weeks until your symptoms abate and you feel well.

When having thyroid tests, always book the first appointment of the morning, fast overnight (water allowed) and leave off Levo for 24 hours (take after blood draw). This gives the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction. TSH is highest early morning and lowers during the day, it also lowers after eating. This is a patient to patient tip and your GP or phlebotomist will say you don't have to fast, you can take your Levo, you can eat, etc. Best to follow the advice of experienced patients!!

Always take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc. If you take any other medication or supplements, leave at least two hours between Levo and taking them, four hours for iron, calcium and magnesium.

[Summer89 in reply to SeasideSusie]

Ok thanks I seem to have symptoms of sweating and tremor and they don't seem to be symptoms of hypothyroid

[Clutter in reply to Summer89]

Summer89,

There are around 300 symptoms of hypothyroidism and sweating and tremor are common symptoms. They should improve when you are optimally dosed but that will be several months away. Unless you are >50 years of age, have heart disease or are frail an appropriate starting dose would have been 50-100mcg with TSH 38.

cks.nice.org.uk/hypothyroid...

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

thyroiduk.org.uk/tuk/about_...

[SeasideSusie Remembering in reply to Summer89]

Have you had thyroid antibodies tested? If they are positive then you can swing from hypo to hyper, and sweating/tremor can be symptoms of hyperthyroid.

There are two types of antibodies. The NHS rarely does Thyroid Peroxidase (TPO) and almost never does Thyroglobulin (TG) unless an endo requests it. However, you can be negative for TPO but positive for TG.

If not tested, ask your GP to test antibodies.

Also, ask for vitamins and minerals to be tested -

Vit D

B12

Folate

Ferritin

Most of us Hypos seem to have low levels or deficiencies which need supplementing. They all have to be optimal for thyroid hormone to work.

[Summer89 in reply to SeasideSusie]

TPO antibodies 304.5 (<34)

TG antibodies 369.3 (<115)

[SeasideSusie Remembering in reply to Summer89]

There you are then, your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

This is most likely why you are experiencing sweating and tremor.

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.

Read and learn about Hashi's to help yourself, most doctors dismiss antibodies as not being important without realising or understanding what can happen. They often mistake hyper swings as you being overmedicated then reduce dose drastically or even stop Levo. This isn't the case, it's all part of Hashi's and the fluctuations. The hypo-hyper swings are temporary, dose adjustment can be made at these times, but readjustment made when things get back to normal.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Gut/absorption problems tend to go hand in hand with Hashi's and you could find you have low nutrient levels. If you haven't had them done already, ask for those vitamin and mineral tests.

[shaws Administrator]

Your dose should have been minimum of 50mcg not an incremental dose of 25mcg particularly with such a high TSH. It could have been slightly higher.