Thyroid results

[Kyla19]

Hi

30 years old and newly diagnosed hypothyroid, when will I feel better on 25mcg levothyroxine? Thanks!

TPO antibody 376 (<34)

TG antibody 255.3 (<115)

TSH 22 (0.2 - 4.2)

Free T4 10.8 (12 - 22)

Free T3 3.1 (3.1 - 6.8)

[SlowDragon Administrator]

Normal starter dose is 50mcg.

How long have you been on 25mcg dose? It takes at least 10 days to get in our system and 6 weeks to reach full effect. 25mcg is very small dose and can make you feel worse.

You should have retest 6 weeks after starting, always get all thyroid tests as early as possible in morning and fasting, don't take Levo in 24 hours prior to blood test, delay and take straight after. This gives highest TSH and most consistent results.

Dose should be increased in 25mcg steps, retesting each time after 6-8 weeks. Aiming for TSH around one and FT4 at top of range

See this reply by SeasideSusie

healthunlocked.com/thyroidu...

Have you had vitamin D, folate, ferritin and B12 tested. You have autoimmune thyroid - also called Hashimoto's

Hashimoto's affects gut, causes low stomach acid, low vitamins and very likely gluten intolerance

See excellent video series - free for next few hours

thethyroidsecret.com/specia...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

[Kyla19 in reply to SlowDragon]

Hi I have been on the 25mcg levothyroxine since end of August. Will post vitamin and mineral results. I have B12 injections every 4 months and restarted folic acid last week. Also taking 800iu vitamin D and 1 ferrous fumarate for anaemia. Thanks.

Vitamin D total (25 OH) 60.3 (50 - 75 vitamin D may be suboptimal, and long term may lead to clinical effects. Advise on safe sun exposure and diet. Supplementation may be indicated)

Ferritin 53 (30 - 400)

Folate 2.2 (2.5 - 19.5)

Vitamin B12 337 (190 - 900)

[SeasideSusie Remembering in reply to Kyla19]

Kyla19

Vitamin D total (25 OH) 60.3 - taking 800iu vitamin D

The Vit D Council recommends a level of 100-150nmol/L.

800iu D3 will take a very long time to get you to that level, you need a lot more.

As you have Hashi's, for better absorption you should use an oral spray, SlowDragon recommends Batter You. I would take 3000-4000iu daily for 3 months then retest. When you've reached the recommended level 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 do a combined D3/K2-MK7 spray which you might want to consider.

**

Ferritin 53 (30 - 400) - 1 ferrous fumarate for anaemia

Have you been diagnosed with iron deficiency anaemia? If so you need more than 1 x FFdaily. The proper treatment is 2 or 3 x FF daily.

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.

For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, precommended is 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...

**

Folate 2.2 (2.5 - 19.5)

Vitamin B12 337 (190 - 900) B12 injections every 4 months and restarted folic acid last week

What is the reason for your B12 injections? Folate or B12 deficiency anaemia? Diet related or non-diet related? You might possibly not be getting your injections fequently enough.

You've obviously had folic acid prescribed before, what level did you get up to? Were they just stopped altogether? Were you given any advice on how to maintain your level?

[Kyla19 in reply to SeasideSusie]

Thanks diagnosed with iron deficiency anaemia. I take B12 injection for B12 anaemia and it is non diet related.

I got up to >20 before and it was stopped until I took my first B12 injection then I restarted them

[SeasideSusie Remembering in reply to Kyla19]

Kyla

So for non-diet related B12 anaemia, according to NHS Choices nhs.uk/Conditions/Anaemia-v... you aren't getting your B12 injections often enough - the treatment is

Not diet-related

If your vitamin B12 deficiency isn't caused by a lack of vitamin B12 in your diet, you'll usually need to have an injection of hydroxocobalamin every three months for the rest of your life

and the NICE Clinical Knowledge Summary states cks.nice.org.uk/anaemia-b12...

For people with no neurological involvement:

◦Initially administer hydroxocobalamin 1 mg intramuscularly on alternate days for 2 weeks.

◦Maintenance dose (where the vitamin B12 deficiency is not thought to be diet related): administer hydroxocobalamin 1 mg intramuscularly every 3 months for life (standard dose). Note that the manufacturers' licence is for every 2–3 months.

so you need to go and see your GP and get your B12 injections at the right intervals. Many people even find that 3 monthly injections aren't enough and 'top up' in between with either self injecting or supplementing with sublingual methylcobalamin.

For the iron deficiency anaemia - 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.

So that's something else you should be discussing with your GP.

[SlowDragon Administrator in reply to Kyla19]

So have you got blood test form for retest ?

It's time to get test, highly likely to need 25mcg dose increase.

Few more links about gut and gluten

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...

scdlifestyle.com/2012/03/3-...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

Can be triggered by gut infections or glandular fever too

hypothyroidmom.com/hashimot...

Great film definitely shows why just testing TSH is inadequate and how complex and gut involved

drbradshook.com/understandi...

[eeng]

When you got for your thyroid blood test, get it done first thing in the morning. Don't take your Thyroxine for 24 hours before the test, and don't have breakfast until after the test (you can drink water). This helps your TSH (which the doctors adjust your dose by) to be as high as possible (high TSH = higher dose of Levothyroxine) and prevents you being under-medicated.

When you are hypothyroid your pituitary makes your thyroid work harder by increasing the TSH level in your body. When you start taking Levothyroxine at a low level your poor tired thyroid can take the opportunity for a bit of a rest and produce less FT4 than it was before, so some people feel no better or even worse when they take a 'starter' dose.

You are positive for both types of thyroid antibodies, so your thryoid will be increasingly damaged as the years go by, so get to know your own body and symptoms so that you can go back to your GP for a blood test and a dose increase when you need one. Doctors should get you in for a blood test every 6-8 weeks when you are first diagnosed and every year once you find a dose you are happy on. Your doctor clearly doesn't do this, so you will have to take the initiative.

You say you are 30 - maybe in your lifetime it will be possible to get a 3d printed thyroid implanted under your skin so that you won't have to take Levothyroxine for ever. It sounds futuristic but look at this: openbiomedical.org/russian-...