Hi I am new here, I was diagnosed with Hashimotos in 2014 and since leaving my last job a year ago I have had my former employer (she is self employed) sending me P60s since I did not give her my P45 and has been calling my phone and leaving messages every day. We did not leave on good terms and I don't know what more I can do about it. She said she didn't believe I was ill and threatened to sack me if I did not improve.
My current dose is 100mcg levothyroxine. Thanks for any advice given, I am not feeling good at all right now and this whole thing is making me very stressed and unhappy
TSH 6.3 (0.2 - 4.2)
FREE T4 13.6 (12 - 22)
FREE T3 3.8 (3.1 - 6.8)
TPO ANTIBODY 376 (<34)
TG ANTIBODY 467.3 (<115)
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Teemo
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Teemo I'm not surprised you're not feeling well with those levels. 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 only. You need an immediate increase in your dose so go and see your GP and ask for one. You need 25mcg immediately, retesting and another increase of 25mcg in 6-8 weeks time, then contininue retesting/increasing every 6-8 weeks until you feel well.
However, your Hashi's isn't making things easy. Have you had dose changes in the past? If so were they based on test results?
Has anyone explained what Hashi's is and what it does? I doubt it because doctors know very little, if anything, about Hashi's and attach no importance to antibodies. However, they can make life very difficult for you. Hashi's is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results and if doctors don't know about this they see a low TSH or high FT4, panic then reduce meds.
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 and gut/absorption problems tend to go hand in hand and very often result in low nutrient levels. We need optimal levels of vitamins and minerals for thyroid hormone to work. Have you had the following tested, if so please post the results, with reference ranges, and say if you are supplementing, with what and the dose:
Jeez, you've got a donkey for a GP!!! Not only are you undermedicated he has neglected some serious deficiencies here!
You need to make an urgent appointment to discuss these, and I suggest you see a different GP - one who cares about his patients and knows what he's doing.
Point out your thyroid results and the fact that you need an immediate increase in your Levo and the fact that all these deficiencies have geen ignored.
FERRITIN 21 (30 - 400)
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...
MCV 75.3 (80 - 98)
MCHC 365 (310 - 350)
HAEMOGLOBIN 113 (115 - 150)
IRON 5.3 (6 - 26)
All this suggests iron deficiency anaemia. Point this out to the GP and ask for the appropriate treatment - 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.
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.
Folate deficiency with extremely low in range B12. You need to go straight over to the Pernicious Anaemia Society for further advice healthunlocked.com/pasoc
You probably need testing for Pernicious Anaemia and may need B12 injections. You will need folic acid prescribed but you mustn't take this until other tests have been carried out.
Post your folate, B12, ferritin/full blood count.iron panel results, and mention any signs of B12 deficiency you may be experiencing which you can check here b12deficiency.info/signs-an...
Don't underestimate the problems this level of B12 can cause, this needs sorting.
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VITAMIN D 21.6 (<25 SEVERE)
As you can see, you are severely Vit D deficient and need loading doses prescribed, do not accept 800iu, it must be the loading doses - see NICE treatment summary for Vit D deficiency:
"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 maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU 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 regims 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 (more than 800iu so post your new result as the time for members to suggest a dose) 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, 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 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
When you have seen a different GP and sorted treatment, give serious consideration to making a formal complaint for negligence against this GP. He's not only neglecting you, there will be other patients too.
Hi, I’m on my husbands iPad and saw this, I lived for 6 months with a T-SHIRT at 5.9, it was what I called thyroid hell! I couldn’t do anything, I couldn’t sleep, work, think...I was like a zombie, tho I ate and gained 15 lbs. I hope youv3 se3n a Doc by now, but your doseage needs to be higher.
I will disclose, I was post thyroidectomy. Nonetheless it’s too high.
I had hashi’s too. But I had several nodules. That led to an array of medical drama that led to the thyroidectomy with a cancer dx. I’d get yourself to an EMT that’s experienced well in thyroid.
I’m fine now, took a bit to tweak meds but it gets better.
Your employer is supposed to give you a P60 at the end of each tax year to say how much tax you have paid and a P45 when you leave employment. Is there no way for you to block her on your phone? If not, tell her to stop contacting and harassing you or you will make a complaint to the police.
You are undermedicated to have TSH 6.3 on 100mcg Levothyroxine. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.roberts@thyroiduk.org if you would like a copy of the Pulse article to show your GP.
Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.
Your employer has to give you a P60 at the end of each tax year, which to me says you are still on the payroll, yet you say you left last year, but then you say you think she wants to sack you. If you are still employed and sending her medical notes to confirm this she cannot sack you when you are off sick. She can request you have another independant medical confirmation but that would be at her own cost and would probably cost her £200-£300 minimum. Depending on the sick pay scheme at work, if you are just receiving statutory sick pay you would have been transferred to the DWP and they would be paying your sick pay not her.
If you are no longer on the payroll you are no longer an employee of hers ! Start logging dates, times and the number whenever she rings - don't speak to her - then contact the Police - this is harrassment. She has no reason to contact you ! Plus you don't need the stress.
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