Secondary hypothyroidism?

[Tamsynn]

Hi I am newly registered, by the looks of things I have secondary hypothyroidism despite being diagnosed with primary hypothyroidism 4 years ago?

TSH 1.65 (0.2 - 4.2)

FREE T4 15.7 (12 - 22)

FREE T3 4.3 (3.1 -6.8)

Symptoms are difficulty swallowing, goitre, constipation, fatigue, feeling cold, pins and needles. Taking 50mcg levo.

Thankyou

[Clutter]

Tamsyn,

Secondary hypothyroidism is diagnosed by low-normal TSH and low FT4 and FT3 at diagnosis. If your TSH was high at diagnosis you have primary hypothyroidism. If you are still symptomatic there is scope for a dose increase to raise FT4 and FT3 and reduce TSH.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 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_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

Pins and needles aren't a typical hypothyroid symptom but can be a symptom of low B12. Hypothyroid patients are commonly low/deficient in vitamins and minerals which can cause symptoms similar to hypothyroidism so you may want to ask your GP to check ferritin, vitamin D, B12 and folate.

[Tamsynn in reply to Clutter]

B12 98 (180 - 900)

FERRITIN 11 (15 - 150)

FOLATE 2.3 (34.6 - 18.7)

VITAMIN D TOTAL 16.2

[Clutter in reply to Tamsynn]

Tamsynn,

You are severely deficient in all of them. Hasn't your GP initiated treatment?

[Tamsynn in reply to Clutter]

No I haven't been given anything

[Clutter in reply to Tamsynn]

Tamsynn,

If your GP has seen those results and ignored them s/he is a monster.

You need to see a GP as soon as possible and start B12 injections. 5mg Folic acid can be initiated 48 hours after the first B12 injection. GP should investigate whether pernicious anaemia is causing the B12 deficiency. Go to healthunlocked.com/pasoc for advice as they're the experts on PA, B12 and folate deficiency.

Vitamin D is severely deficient. Your GP should refer to local guidelines or the NICE CKS recommendations for treating vitamin D deficient adults cks.nice.org.uk/vitamin-d-d... Do NOT let your GP prescribe 800iu D3. My GP prescribed 40,000iu daily x 14 followed by 2,000iu daily x 8 weeks which raised vitD from <10 to 107. Vitamin D should be taken 4 hours away from Levothyroxine.

Ferritin is also deficient and this may indicate iron deficiency anaemia. Your GP should do an iron panel and full blood count to check. If you are prescribed iron it should be taken 4 hours away from Levothyroxine.

[shaws Administrator]

Welcome to our Forum.

According to your blood test results you are on an insufficient amount of levothyroxine. Also 50mcg is a very small dose and is usually a starting dose.

The aim should be a TSH of 1 or lower with a FT4 and FT3 towards the upper part of the range. Your's isn't so you need an increase in levothyroxine.