Hi I have hypothyroidism diagnosed 2012 and I take 100mcg levo, symptoms are sweats, tiredness, irritability, depression, memory loss, dizziness, recurring bladder infections, muscle cramps, sores around mouth, heavy periods and body aches. Are these under medication symptoms? Thankyou
TSH 6.1 (0.2 - 4.2)
FREE T4 13.2 (12 - 22)
FREE T3 3.5 (3.1 - 6.8)
TPO ANTIBODY 375 (<34)
TG ANTIBODY 268.3 (<115)
Jentina Well, you're certainly undermedicated but they could also be symptoms of low nutrient levels, and the fact that you have autoimmune thyroid disease aka Hashimoto's (as confirmed by your high antibodies) could very well be a cause of low nutrients.
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You need an immediate increase in your Levo. 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.
If you've had vitamins and minerals tested, please post the results with their reference ranges and say if you are supplementing and what dose:
Vit D
B12
Folate
Ferritin
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As for Hashi's, this is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.
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.
Most doctors know little, if anything, about Hashi's and tend to dismiss antibodies as being of no importance. Read and learn so you can help yourself where Hashi's is concerned.
Gluten/thyroid connection: chriskresser.com/the-gluten...
stopthethyroidmadness.com/h...
stopthethyroidmadness.com/h...
hypothyroidmom.com/hashimot...
thyroiduk.org.uk/tuk/about_...
Thankyou I was hoping my meds would have been increased but they haven't been. I supplement but feel no better so I will post these
Jentina - who wont increase your thyroid meds and why? 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.
Make an appointment with your doctor and take the following information in support of your request for an immediate increase of 25mcg, and ensure that you have follow tests/increases of 25mcg every 6-8 weeks until you feel well.
From ThyroidUK, which you can say is NHS Choices recommended source of information for thyroid disorders:
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.
The GP hasn't gotten back to me about the thyroid results. They were done a week ago
Then ring the surgery and make an urgent appointment to discuss them. Sometimes we have to take things into our own hands to help ourselves. And considering it appears that your GP has ignored your dreadful nutrient levels, it might be a good idea to see a different GP.
TOTAL 25 OH VITAMIN D 40.3 (25 - 50 VITAMIN D DEFICIENCY. SUPPLEMENTATION IS INDICATED) taking 800iu D3 since 2014
FOLATE 2.0 (2.5 - 19.5)
VITAMIN B12 207 (180 - 900)
FERRITIN 17 (15 -150)
Jentina - presumably apart from the paltry amount of D3 you are taking, I assume you're taking nothing for the other dire levels?
FERRITIN 17 (15 -150)
For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range.
You need an iron supplement and as your level is so low you should ask for an iron infusion which will raise your level within 24-48 hours, tablets will take many months.
You can also 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 also need to know if you have anaemia due to the very low ferritin level, ask for an iron panel and full blood count.
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FOLATE 2.0 (2.5 - 19.5)
VITAMIN B12 207 (180 - 900)
These work together. You are folate deficien with a very low B12. Check for signs of B12 deficiency here b12deficiency.info/signs-an... then you need to post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc You may need to be tested for Pernicious Anaemia and you may need B12 injections. You will need a folic acid supplement but don't start taking that until other investigations have been carried out.
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."
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TOTAL 25 OH VITAMIN D 40.3 (25 - 50 VITAMIN D DEFICIENCY. SUPPLEMENTATION IS INDICATED) taking 800iu D3 since 2014
3 years of supplementing with 800iu daily and you are still Vit D deficient. That is because you are on the wrong dose. If your original dose was below 30 then you should have been given loading doses, but as your level is now 40.3 your GP can't prescribe more than 800iu. You should buy your own supplements and help yourself here.
As you are Hashi's you very likely have absorption problems, Hashi's and gut/absorption problems go hand in hand. Rather than using D3 tablets or softgels, you will get better absorption from an oral spray such as Better You. You can get 1000iu and 3000iu sprays and with your D3 level I would start with the 3000iu spray and take 6000iu daily for 3 months then retest. When you've reached the level recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose which may be 2000iu daily, 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
vitamindcouncil.org/about-v...
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 helps D3 to work and 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
naturalnews.com/046401_magn...
Check out the other cofactors too.
Better You actually do a D3/K2-MK7 combined spray which may be better for you.
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I shall link in SlowDragon who has lots of links and information about Hashi's and absorption problems.
Thankyou yes I only take 800iu
IRON 5.7 (6 - 26)
TRANSFERRIN 15 (12 - 45)
RBC 4.38 (3.8 - 5.8)
WBC 6.13 (4 - 11)
MCV 74.3 (80 - 100)
MCHC 377 (310 - 350)
MCH 28.1 (28 - 32)
HAEMOGLOBIN 115 (115 - 160)
PLATELETS 248 (140 - 400)
HAEMATOCRIT 0.40 (0.37 - 0.47)
IRON 5.7 (6 - 26)
MCV 74.3 (80 - 100)
MCHC 377 (310 - 350)
MCH 28.1 (28 - 32)
HAEMOGLOBIN 115 (115 - 160)
These results suggest iron deficiency anaemia so you need to point this out to your GP and ask for the appropriate treatment - NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines):
cks.nice.org.uk/anaemia-iro...
How should I treat iron deficiency anaemia?
•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.
Take each iron tablet 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.
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You mentioned the 800iu D3 in your previous post and I have suggested what you should do about raising the dose.
Following x
Your antibodies are high this is Hashimoto's, (also known by UK medics more usually as autoimmune thyroid disease).
About 90% of hypothyroidism in UK is due to Hashimoto's.
Hashimoto's affects the gut, leading to low stomach acid, malabsorption causing low vitamin levels and leaky gut.
Low vitamins that affect thyroid are vitamin D, folate, ferritin and B12. When they are too low they stop Thyroid hormones working.
Obviously your levels are dire, in part because you are under medicated
But also food intolerances are often not helping, usually gluten
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood
Changing to a strictly gluten free diet may help reduce symptoms, slowly lower antibodies and help heal gut
thyroidpharmacist.com/artic...
thyroidpharmacist.com/artic...
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
scdlifestyle.com/2014/08/th...
drknews.com/changing-your-d...
Low stomach acid can be an issue
Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL
thyroidpharmacist.com/artic...
drmyhill.co.uk/wiki/hypochl...
Other things to help heal gut lining
Bone broth
thyroidpharmacist.com/artic...
Probiotics
carolinasthyroidinstitute.c...
Hashimoto's can be triggered by infections
hypothyroidmom.com/hashimot...
Great film definitely shows why just testing TSH is inadequate and how complex it is
drbradshook.com/understandi...
If you own GP remains unhelpful then suggest you see another ASAP
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