I recently had a private blood test done because I still feel unwell despite my GP's saying that my results are within range for Hypo. I'm on 50mcg Levo and have been since diagnosis 2/3 years ago. I was increased a few weeks ago to 75mcg because I practically begged, but felt worse so went back to 50mcg. I'm wondering if I had a boost of T3 if this would help. I feel tired, lacking energy, breathless, often irritable, overweight, nausea, swing between constipation or being very loose. Until these private results I didn't know that my antibodies were high, indicating Hashimoto's which I hadn't been told by my GP. My private results are as follows: Blood taken on 27 Aug 2017. I didn't realise that it was best not to take my Levo or eat so I don't know how it affects the results.
TSH 1.44 0.27 - 4.20 mlU/L
T4 Total 103.0 64.5 - 142.0 nmol/L
Free T4 17.40 12 - 22 pmol/L
Free T3 3.39 3.1 - 6.8 pmol/L
Immunology
Anti-Thyroidperoxidase abs H381.0 <34 kl/UL
Anti- Thyroidglobulin Abs H623 <115
My previous annual result from GP taken 1 June 2017 was as follows in it's totality.
The increase to 75mcg should have raised FT4 and FT3 and reduced TSH. You should really have a follow up test 6-8 weeks after dose was increased.
The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.27 - 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_...
Ask your GP to check ferritin, vitamin D, B12 and folate which are commonly low in hypothyroid patients and cause symptoms similar to hypothyroid symptoms.
Many GPs are unable to prescribe Liothyronine (T3) without recommendation from a NHS endocrinologist and unfortunately some CCGs have banned prescribing of T3 due to excessive price charged by the manufacturers.
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. It may also improve your digestive issues and constipation/diarrhoea.
Thank you Clutter. What you say makes sense and I probably didn't give the extra Levo a fighting chance. I think I felt so ill at the time and I put it down to the increase so stopped it. I will discuss it again with my GP later today and maybe give it another chance. I just dread the days when I feel so ill that I don't want to get out of bed. It affects every aspect of life and in turn that affects those around me too. Probably a familiar story to others too.
I have tried going gluten free but I find it so expensive and makes quite a difference to my shopping bill. My partner and I (both pensioners) are Pescetarian and generally eat a healthy diet of fish, fruit, veg etc but I would welcome any advice of a gluten free diet.
If you found it difficult to tolerate a 25mcg dose increase you can stagger it by trying an additional 25mcg alternate days for a couple of weeks and then increase to the full 25mcg dose daily.
I don't follow a gluten-free diet so I suggest you post a new question asking for advice. I know some people don't buy g-f products because they have a lot of sugar in them.
Thank you Clutter. I am just off to see gp so I may ask him if he thinks it would be a good idea to increase the extra 25 gradually. And I will post a separate question re gluten free later. Your replies are very much appreciated and give me a clearer understanding of how to approach the gp now.
Thank you so much. I suppose I automatically think of bread and flour based products but it would be much healthier not to have them at all. And they usually taste pretty disgusting too lol
Thank you Muffy. I've just returned from GP even more confused than before. I made him stop and listen. in fact my 5 minute appt. stretched to half hour. He checked the private results, tried to interpret them for me and still insisted that all seems okay. He did admit that he wouldn't want to see my T3 any lower and would refer me to an endo if it does. I am going to give the extra 25mcg Levo another try which increases my dose to 75mcg, and get retested in 6 - 8 weeks. Will post results again then. He has prescribed Omeprazole for the acid reflux/heartburn. Does anybody have anything positive to say about these? Sometimes I feel like a hamster on a wheel just going round and round looking for answers lol
You have Hashimoto's, GP will call it autoimmune thyroid disease, diagnosed by the high antibodies
Extremely likely you have low vitamin D, folate, ferritin and/or B12
Ask GP to test and always make sure you get actual results and ranges
Nothing to do with how good your diet it.
With Hashimoto's our gut function is badly affected, due to low stomach acid, causing malabsorption and usually gluten intolerance
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.
Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime
Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Wow! Such a lot to absorb but I will certainly take a look at all the posts that you have recommended. Sometimes I wish that I had never even started down the thyroid road and just coped with the symptoms having been told that I was only borderline. Probably a very silly thing to say but I get the feeling that I've been worse in the last few years since I first went to the GP feeling unwell. I'm sure I didn't feel as bad as I do these days!
This is such a helpful site with so much information. Thank you very much.
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