I decided to have my thyroid fully tested after reading lots & lots of posts on this forum. I too have been to the doctors and battled to have my thyroid tested as was feeling 'not right'. Weight gain that no mater how hard I try can not shift, extreme tiredness, lethargic, hair loss & cold all the time (mostly in my hands). The doctor agreed to test as my Dad has Graves disease.
I only went onto levothyroxine in May this year - 50mcg daily.
Results from Doctors NHS tests in May 2017:
TSH 4.9 (0.27 - 4.20)
T4 11.4 (12-22)
TPOab 63.0 (0-34)
I was then re-tested 6 weeks later, only TSH tested:
TSH 2.1 (0.27 - 4.20)
I discussed this result with the doctor who said to stay on 50mcg as my TSH was middle of range, no other tests done which I now understand is quite often the case. I explained that I wasn't feeling any better, no symptoms had eased and the weight was still creeping up! The male Doctor suggested I start more cardio exercise to shift the weight as my thyroid is now functioning normally and the weight and sluggish feeling was purely down to 'lack of exercise' to which I did explain I talk 5+ miles a day and have three daughters - I wish!
So after feeling like I'd been fobbed off by the Doctors I went ahead and booked Medichecks Thyroid test. I could really do with some guidance as what to do as am very keen to start feeling well again. All help is greatly appreciated.
Thanks in advance x
Written by
doran01
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Tell your GP because you have been feeling unwell with many symptoms that you've taken the advice of the NHS Choices for information/advice Thyroiduk.org.uk and had your own private test from a recommended lab.
The aim of levothyroxine is to lower your TSH to 1 or below and some need it suppressed. Your TSH has risen due to your low 50mcg the aim of levo is to reduce TSH and relief of all clinical symptoms. Not an increase in symptoms.
Your Free T4 and Free T3 are too low. Give him a copy of the following (tick off your symptoms).
Your B12 is far too low and to try to prevent dementia/alzeimers, we have to have it around 1,000 so supplement with methylcobalamin sublingual tablets. Amazon have a selection and I'll give you a link to Amazon Affiliate and TUK get a little commission which helps defray their office expenses.
Your ferritin and folate are low and I will link in SeasideSusie for comments. Also get GP to test Vit D if he hasn't done so as both B12 and Vit D are prohormones with essential work in our body.
Thank you so much for your feedback - I'm writing this with a lump in my throat and watery eyes. Weird, I've been following this site for a while but It's all become real now it's me. I can't thank you enough x
doran01 Monday morning and after reading a couple of posts, I see that there is still as much ignorance in the medical profession about treating hypothyroidism as ever!
I was then re-tested 6 weeks later, only TSH tested:
TSH 2.1 (0.27 - 4.20)
I discussed this result with the doctor who said to stay on 50mcg as my TSH was middle of range
As Shaws says, the aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo, and of course the relief of symptoms. You need an increase of 25mcg Levo now, retesting in 6-8 weeks and maybe even another increase. To support your request for an increase, see thyroiduk.org.uk/tuk/about_... > Treatment Options:
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.
The booklet is written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist. It's published by the British Medical Association for patients. Avalable on Amazon and from pharmacies for £4.95 and might be worth buying to highlight the appropriate part and show your doctor.
Also -
Dr Toft states in Pulse 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)."
You can obtain a copy of the article by emailing louise.roberts@thyroiduk.org print it and highlight question 6 to show your doctor.
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Also, your high TPO 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. You may find that as the antibodies fluctuate, they can cause hypo to hyper swings, and back again.
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.
Hashi's can cause gut/absorption problems which can lead to low nutrient levels which are very obvious from your results.
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Ferritin: 22.9 (13-150)
For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. However, as it is so low, you might want to ask your GP to do an iron panel and full blood count to see if you have iron deficiency anaemia.
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...
You could take an iron supplement although iron tablets are difficult to fit around thyroid meds because they must be kept 4 hours away. They also need to be at least 2 hours away from any other medication and supplements. Absorption is affected if iron is taken anywhere near any other meds and supplements.
You could discuss your GP giving you iron supplements (after seeing if you have iron deficiency anaemia for which the treatment is ferrous fumarate 2 or 3 times a day). Whether your GP gives you them, or whether you decide to buy your own (you can buy ferrous fumarate and ferrous sulphate from ebay and Amazon) then you must keep an eye on your level, retest 3 months after starting then monitor. Too much iron is as bad as too little.
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B12: 212 (140-724)
Folate: 4.31 (2.91-50)
First of all, check if you have signs of B12 deficiency here b12deficiency.info/signs-an... If so you need to post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc If not then you must improve your level.
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."
Sublingual methylcobalamin lozenges are what's needed if you wish to self supplement, and I would start with 5000mcg daily then when the bottle is finished change to 1000mcg dose as maintenance.
When supplementing with B12 we also need a good quality B Complex to balance all the B vitamins.
Look at Thorne Basic B which contains 400mcg methylfolate which will help raise your low folate level, that needs to be at least half way through it's range.
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As Shaws says, you need your Vit D testing as it's very likely that will be deficient too. You can do that with a blood spot fingerprick test with City Assays vitamindtest.org.uk/
costs £28. When you have your result, post and a suggestion can be made for a good supplement and dose.
Thank you SeasideSusie your knowledge is amazing. I've written all your advise down and am booking another appointment with the GP today, so fingers crossed.
I was keen to get the TPO antibodies test back and will be moving onto Gluten Free straight away, funny as I've had issues with gluten for some time (gut pain),
I also checked the link to Pernicious Anaemia and I seem to have quite alot of the signs of B12 deficiency
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