Undermedicated symptoms : Newby here, thyroid... - Thyroid UK

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Undermedicated symptoms

Amberpink
Amberpink

Newby here, thyroid results are

TSH 5.6 (0.2 - 4.2)

Free T4 13.5 (12 - 22)

Free T3 3.7 (3.1 - 6.8)

Diagnosed 2011. I have symptoms of tickly throat, goitre, tiredness, pins and needles, hair loss, feeling cold, bone pain, heavy periods. Feel like I will never get better. Taking 200mcg levo

Thanks

12 Replies
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SlowDragon
SlowDragonAdministrator

You are taking reasonable dose, but results suggest under medicated

Do you know if you have high thyroid antibodies, this is diagnosed as autoimmune thyroid disease also called Hashimoto's

Any test results for

TPO antibodies

TG antibodies

All hypothyroidism, but especially Hashimoto's affects the gut, upsetting vitamin absorption.

Very common to have very low vitamin D, folate, ferritin and/or B12. These can stop Thyroid hormones working

Have any of these been tested recently, if so can you add results and ranges

Pins & needles is often low B12, bone pain low vitamin D and heavy periods causes low ferritin

you are likely to need significant levels of supplements

Aim of Levothyroxine is to take high enough dose to bring TSH down to around one and FT4 to be towards top of range

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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 louise.roberts@thyroiduk.org print it and highlight question 6 to show your doctor.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

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

verywell.com/should-i-take-...

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.

Amberpink
Amberpink in reply to SlowDragon

Hi thanks I increased dose myself since what I was taking wasn't helping me feel better

Amberpink
Amberpink in reply to SlowDragon

I take levo as suggested as well

Amberpink
Amberpink in reply to SlowDragon

TPO antibody 274 (<34)

TG antibody 186.3 (<115)

SlowDragon
SlowDragonAdministrator in reply to Amberpink

Very definitely Hashimoto's

Do you have vitamin test results?

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.

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

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...

Amberpink
Amberpink in reply to SlowDragon

Yes will post vitamin and mineral results now thanks

I increased to 200mcg from 150mcg based on above results, when can I expect my levels to improve?

SlowDragon
SlowDragonAdministrator in reply to Amberpink

If your vitamins are too low it won't help.

Gluten free diet may help gut repair.

Read as much as possible about Hashimoto's. Medics know little and seem disinterested in learning

SlowDragon
SlowDragonAdministrator in reply to Amberpink

So results were from on 150mcg?

A 50mcg dose increase is large. You may find that too difficult to cope with. Often we need to increase in smaller steps. Large jump stresses adrenals

Amberpink
Amberpink in reply to SlowDragon

Yes results from when I was taking 150mcg.

Not sure of your timeline? Took me a very long time from a very low base to feel tip top but you should start to feel better within a few months. Remember to exercise even if gently and watch your diet at same time. I had to wear a crazy number of layers of clothing to feel warm but fine now.

I also gave it 2 weeks for the dose change as well

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