New here why would endo say this please and when can I expect symptoms to improve on 50mcg levo diagnosed 2014 symptoms are tiredness, goitre, hard stool, heavy periods, feeling cold, weight gain could someone please advise
TSH 9.2 (0.27 - 4.20)
FREE T4 12.9 (12 - 22)
FREE T3 3.0 (3.1 - 6.8)
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Colagirl86
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Ooh how long have you been on 50mcg? With those results it looks like you’re majorly under-treated. No wonder you feel terrible. And of course being so ill makes one feel anxious, well derh. Do not be sucked into thinking it’s all in your head; you’ll be on antidepressants and off to counselling before yo know it, when the priority is getting your meds right and no symptoms. Everything you list are hypo symptoms. How long on 50mcg? Have you been on other doses?
I think you have an endo who doesn't have a clue. They're getting quite common from the number we read about here lately that like to say the patient is suffering from anxiety when they're clearly symptomatic of Hypothyroidism and low nutrients.
Have you had a diagnosis of anxiety put on your records? Who made that diagnosis?
Have you had thyroid antibodies tested, are they high - Hashimoto's?
Have you always been on 50mcg Levo since diagnosis or have you had dose changes? If so, what prompted the changes, do you have results from then?
Have you had vitamins and minerals tested? If so, post results, with reference ranges, and say if you are supplementing and the dose:
An endo is not qualified to diagnose anxiety. Ask for it to be removed from your records.
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.
When the antibodies attack, the dying cells dump a load of thyroid hormone into the blood and this can cause TSH to become suppressed and Free T4 and Free T3 to be very high or over range. These are called 'Hashi's flares or swings'. You may get symptoms of being overmedicated (hyper type symptoms) to go along with these results that look as though you are overmedicated. Unless a GP knows about Hashi's and these hyper type swings, then they panic and reduce or stop your thyroid meds and can even blame the patient for abusing their medication. The Hashi's swings are temporary, and eventually things go back to normal.
Most doctors attach little importance to antibodies and they don't understand them nor what Hashi's does so they are completely out of their depth when treating it and cover up their ignorance by blaming the patient in some way or other.
Read and learn all you can about Hashi's because you will need to understand so you can help yourself.
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.
Was happily on 200mcg levo and 10mcg T3 before reduction
TSH <0.02 (0.2 - 4.2)
Free T4 20.8 (12 - 22)
Free T3 5.6 (3.1 - 6.8)
There wasn't actually anything wrong with those results. Your endo saw your suppressed TSH and panicked, thinking you were overmedicated. However, when taking T3, TSH usually becomes very low, even suppressed, and if he is prescribing T3 then your endo should actually know this. Both your FT4 and FT3 were in range, and there is no way you can be overmedicated when FT3 is in range.
So by reducing your thyroid meds to 50mcg (please tell us he didn't do that in one go, that is ridiculous, reductions should be gradual) he has now made you extremely hypo as your new results show with a very over range TSH, barely in range FT4 and below range FT3.
TSH 9.2 (0.27 - 4.20)
FREE T4 12.9 (12 - 22)
FREE T3 3.0 (3.1 - 6.8)
You need an immediate increase in your Levo, 25mcg now then retest in 6 weeks, another increase of 25mcg, 6 weeks later another retest and increase in 25mcg, etc, until you feel well.
Ditch this endo and ask to be referred to another one. Email louise.roberts@thyroidUK.org for the list of thyroid friendly doctors, then ask for feedback from members on any in your area.
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Hashi's and gut/absorption problems tend to go hand in hand and low nutrient levels are often the result. If you haven't had those vitamin and minerals tested, ask for them to be done now. They are very important.
For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range. Your level is not low enough for your GP to prescribe iron tablets but 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...
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Vitamin D 58.2 (<25 severe deficiency 25 - 50 deficiency 50 - 75 suboptimal > 75 adequate)
The Vit D Council recommends a level of 100-150nmol/L. Again your level isn't low enough for your to be prescribed D3 but you need to improve your level. I would suggest around 5000iu daily for 3 months then retest. When you've reached the recommended level you'll need to find a maintenance dose, which may be 2000iu daily, maybe more, maybe less, it's trial and error.
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
As you have Hashi's, for better absorption an oral spray is best. BetterYou do a combined D3/K2-MK7 in 3000iu strength, or you can buy them separately. If using the 3000iu strength then take 6000iu for 3 months before retesting, which you can do with a a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
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Folate 3.5 (4.6 - 18.7)
Vitamin B12 163 (180 - 900)
What is happening about your folate and B12 deficiency?
Have you been tested for Pernicious Anaemia?
If your doctor has done nothing about these results then please go and post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc
Go and ask for advice on the PA forum on how to deal with this with your GP, mention your iron deficiency too and any signs of B12 deficiency from this link b12deficiency.info/signs-an...
Tell your endo that anxiety is a symptom, not a disease, and you can't diagnose someone with a symptom. That would be like 'diagnosing' someone with a sneeze, when the actually have a cold.
Anxiety is a symptom of under or over-medication. You are clearly under-medicated - 50 mcg is a starter dose, not enough to live on - so hardly surprising if you have symptoms of under-medication.
I agree. When I first was seen by a very very senior specialist, he examined my neck for the pain I had in my thyroid region (later confirmed as an inflammation).
He put camera down my nose and said there was nothing to worry. I was sent back and in few days I got a letter from him saying:
Diagnosis : Neck pain.
I could not believe that such a senior specialist (head and neck) could write that thing as a diagnosis which I went complaining with - neck pain!!!
If neck pain was to be my diagnosis, I already knew it. I believe he is a very reputable surgeon of this country earning at least a £1 million a year.
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