Callee Unfortunately your story is one we're reading every day here, multiple times. Your GP and endo are clueless, they haven't got any idea how to treat hypothyroidism so they cover their ignorance up by blaming the patient somehow.
Have you ever been on more than 50mcg Levo, surely you haven't only been on that dose since 2013?
TSH 6.5 (0.2 - 4.2)
Free T4 13.7 (12 - 22)
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. You need an immediate increase in your Levo and here is some information you can take to support your request - from 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. However, I don't know if this is in the current edition as it has been reprinted a few times.
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 email@example.com print it and highlight question 6 to show your doctor.
Thyroid peroxidase antibody 475 (<34)
Thyroglobulin antibody 355.3 (<115)
Your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.
Read and learn about Hashi's because you'll need to help yourself. Most doctors dismiss antibodies as being of no importance and know nothing about how Hashi's affects the patient.
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...
Hashi's and gut/absorption problems go hand in hand and very often result in low nutrient levels. Nutrients need to be at optimal levels for thyroid hormone to work, so we have a viscious circle and need to address all the problems.
We already know you're deficient in Vit D -
Vit D was 32.2 (25 - 50 vitamin D deficiency. Supplementation is indicated) and that was tested in January 2017 - 800iu D3
Well, 800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level. Unfortunately, you were just over the level where you should have been given loading doses. You could ask for a retest and see where your level lies now, I doubt it will have increased but if it has decreased to 30 or lower then you could ask for 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.
If you can't get loading doses then you will need to buy your own supplement and treat yourself. You will need 10,000iu daily for 3 months then you'll need to retest. If the new level is below 70 I would then take 5000iu daily for a couple of months then reduce to 5000iu alternate days and retest again 3 months after starting the 5000iu daily. 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
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
Check out the other cofactors too.
Normally I would recommend D3 softgels but as you are Hashi's you should find that an oral spray is better absorbed. BetterYou do 1000iu and 3000iu doses and you could start with the 3000iu dose and triple it to start with (so 9000iu in place of 10,000iu), then lower to 6000iu, then 3000iu. They do a D3/K2-MK7 combined spray if you prefer to not to have separate D3 and K2 supplements.
You say you are taking 1 x iron tablet a day. Is this prescribed? What is it treating? Low Ferritin or Iron Deficiency?
We really need to see the results of all the vitamin and mineral tests as I imagine all levels will be low and will need supplementing more than what you are prescribed. When you have the results, please post again with the levels and say what you are taking.