Hashimotos

[Ami8]

Hi new to forum do I have Hashimotos thanks

TSH 7.1 (0.2 - 4.2)

TPOAB 885 (<34)

TGAB 369.3 (<115)

FREE T4 11.8 (12 -22)

FREE T3 3.0 (3.1 - 6.8)

[Nanaedake]

Yes, you have Hashimotos, how much levothyroxine have you been prescribed?

[Ami8 in reply to Nanaedake]

Thanks for reply I was prescribed 25mcg levothyroxine and diagnosed 2012

[Nanaedake in reply to Ami8]

You are undermedicated. When you were diagnosed, you should have been started on 50mcg unless you are very young, very old or infirm. Then you should have had a blood test every 6 weeks and adjusted your medication until your TSH was around 1.0 or a little lower with FT4 and FT3 in range which is where most people feel well.

You need a 25mcg increase of levo and test in 6 weeks time and adjust dose again if needed.

Always take levo on an empty stomach with no food or drink for one hour afterwards (water is ok). Other medication and supplements should be taken at least 4 hours later.

[Ami8]

Yes been on 25mcg this whole time.

Ferritin 44 (30 - 400)

Folate 2.3 (4.6 - 18.7)

Vitamin B12 231 (190 - 900)

Vitamin D 40.6 (25 - 50 deficiency)

[SlowDragon Administrator in reply to Ami8]

Your GP either ignorant or negligent. Levothyroxine should be started at 50mcg (unless frail or elderly) and tested after 6-8 weeks, dose increased in 25mcg steps, retesting after 6-8 weeks each time

Aiming for TSH of around one and FT4 near top of range around 18-20

All your vitamin levels are far too low see SeasideSusie detailed vitamin supplements

healthunlocked.com/thyroidu...

[SeasideSusie Remembering in reply to Ami8]

Ami8 God save us from stupid endos, they'll end up killing someone soon! Sheer stupidity and total ignorance of how to treat hypothyroidism if keeping someone on a 25mcg starter dose for 5 years. Where will all this end???

I will respond to these levels as if you're not taking any supplements. I am assuming you're not as your thyroid has been mis-treated for years.

Ferritin 44 (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 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...

I don't like recommending iron tablets in case there is something else going on so you could ask your GP to do an iron panel and full blood test to see if there is any iron deficiency anaemia considering how low in a very wide range you are. If you do take iron tablets then take each one 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 2.3 (4.6 - 18.7) Vitamin B12 231 (190 - 900)

You are folate deficient with low B12. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... You should post these results on the Pernicious Anaemia Society forum for further advice, mentioning any signs of B12 deficiency you might have, your ferritin result (with range) and any results of iron panel and FBC if they've already been carried out. Your B12 is too low for me to feel comfortable to suggest self supplementing as further testing might be necessary.

**

Vitamin D 40.6 (25 - 50 deficiency)

The Vit D Council recommends a level of 100-150nmol/L. You need to supplement to reach this level and I suggest 5000iu daily for 3 months then retest. When you've reached the recommended level 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.

Normally I would suggest D3 softgels but as you have Hashi's an oral spray is always recommended by SlowDragon. BetterYou do one in 1000iu and 3000iu doses. I would get the 3000iu one and double up to 6000iu for 3 months then see where your level lies.

BetterYou does a D3/K2-MK7 combined spray which you may prefer rather than separate D3 and K2-MK7 supplements.

**

As for the Hashi's, most doctors know very little or nothing about how it affects the patient and they usually dismiss antibodies as of no importance, so you need to read and learn to help yourself.

Hashi's 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.

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

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

[Puska in reply to SeasideSusie]

Your comment about endos killing people is interesting. I know it’s a flip one but in reality they can get away with being incompetent because it isn’t like mis diagnosing cancer or a heart attack so they can get away with incompetence without much kick back. And maybe when the patient never really gets on top of things they put it down to ‘being female’ ‘old age’ ‘stress’ etc etc. Thank God for the internet and no wonder some in the medical profession hate it.

[SeasideSusie Remembering in reply to Puska]

It would take someone a long time to die from undertreatment of hypothyroidism, and it would be a pretty miserable time for them. But the situation has driven people to suicide unfortunately. There was a letter written by one hypo patient who committed suicide, unfortunately I don't have a link to where I saw it. It was truly heartbreaking

[Puska in reply to SeasideSusie]

Yes. Death by a thousand cuts. And even when low thyroid results were found they would never pin point the endo as being responsible. I can certainly imagine sadly that some might revert to suicide. It’s that kind of illness.

[Gr8Nica in reply to SeasideSusie]

I was days away from myxedema coma and it took 2,5 years from the moment my levo was stopped. I was completely swollen, severely depressed, my thinking was severely affected, not sleeping, in constant pain, my cholesterol was off the roof and kidneys were showing signs of malfunction. The only reason I didn't die or get into coma was a friend which I haven't seen in months and decided to visit me. The stupid GP was doing blood tests and I was always assured they were fine. Just recently I requested access to full past medical records and can see how far from fine they were.

[Ami8 in reply to SeasideSusie]

I have iron deficiency at the moment

[SeasideSusie Remembering in reply to Ami8]

Then you need the appropriate treatment, so ask your GP to follow the guidelines - see 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.