Feedback please

[Ems5]

Been started on 50mcg levothyroxine, also prescribed ferrous fumarate to take 3 times a day, loading doses of B12 and vit D, prescribed folic acid and being tested for intrinsic factor antibodies and coeliac disease, also addisons.

TGAB >2000 (<115)

TPOAB 89.5 (<34)

TSH 48.7 (0.2 - 4.2)

FREE T4 11.3 (12 - 22)

FREE T3 4.2 (3.1 - 6.8)

FERRITIN 11 (15 - 150)

FOLATE 1.7 (4.6 - 18.7)

VITAMIN B12 144 (190 - 900)

VITAMIN D 23.1 (<25 SEVERE VITAMIN D DEFICIENCY. PATIENT MAY REQUIRE PHARMACOLOGICAL PREPARATIONS)

List of symptoms

Dry skin

Panda eyes

Tiredness

Stomach pains

Trapped wind

Hair loss

Muscle cramps

Spasms

Constipation

Heavy periods

Weight loss

Insomnia

[greygoose]

Yes, I'm not surprised you feel awful with those results. You must be pretty ill.

So, what can I tell you...

1) always take your levo on an empty stomach - early morning is probably best at the moment - with a large glass of water to make sure it goes right down to the stomach, and wait an hour before eating or drinking anything other than water.

2) I warn you, you are going to have trouble fitting everything in, and need to keep to a tight schedule. It would be a good idea to draw up a timetable. Certain things need to be taken away from other things :

a) iron usually needs to be taken two hours away from everything else, but check the label, you might have one that needs to be taken with food. It absolutely needs to be taken 4 hours away from levo, or you won't absorb the levo. It might be a good idea to take some vit C with your iron, to help absorption, and avoid constipation.

b) vit D also needs to be taken 4 hours away from levo, but two hours away from iron, and needs to be taken with a fatty meal, because vit D is dissolved in fat.

c) folic acid needs to be taken with food, two hours away from levo - so perhaps with lunch?

d) I imagine your B12 is sublingual methylcobalamin? If so, you can take it any time you like, because it goes directly into the blood and doesn't come into contact with anything in the stomach.

3) Do not start taking all these things on the same day! Because if one of them disagrees with you - always a possibility - you won't know which one it is. Leave about two weeks between starting each one.

4) You are very hypo, with that high TSH, so be kind to yourself! Get as much rest as you can, and avoid driving if you possibly can until your TSH gets below 20. Your concentration will be impaired.

5) Your FT4 is below range, but as your levo dose increases, it will rise.

6) Considering your TSH, your FT3 isn't that bad, but that will be because of the TSH driving conversion. It could go down. Keep a close eye on it, if you can.

7) You have very high antibodies, which means you have Hashimoto's Thyroiditis - doctors call it Autoimmune Thyroiditis - I don't know if you know you have it? It might be a good idea to try a 100% gluten-free diet to lower them. In the future, you could also try taking selenium, but I wouldn't bother with that at the moment, you have enough to contend with!

8) Imperative you get retested six weeks after starting the levo, because you are going to need an increase of 25 mcg. When you go for your next test, make the appointment for very early in the morning, and fast over-night. Leave 24 hours between your last dose of levo and the blood draw. And continue going for a test six weeks after every subsequent increase - always 25 mcg - until your TSH has come down to under one, and your FT4/FT3 are high enough in range to make you well.

9) Learn about your disease, because doctors know little about it. If you know what should be done, then it is harder for them to fob you off.

10) Always ask questions on here. We know what we're talking about!

[greygoose in reply to greygoose]

Forgot to add : always, always get a print-out for any blood test you have, and keep your own records. On the back you can note how much of everything your taking, and what your symptoms are. You won't believe how helpful this can be in the future, when you have forgotten everything!

[eeng]

Finally! A doctor who knows what he/she is doing!! We have seen so many posts on this forum recently by people who have results like yours and are prescribed nothing except a very low dose of Levothyroxine if they are lucky. Best of luck and I hope you start to feel well soon.