TSH 8.3 (0.2 - 4.2 mIU/L) Free T4 13.8 (12 - 22 pmol/L) Free T3 3.5 (3.1 - 6.8 pmol/L) Thyroid peroxidase antibody 271 (<34 IU/mL)
Hi I am 32 and just come from the pernicious anaemia forum. Is there scope to increase dose? I take 50mcg levothyroxine diagnosed 2012. Thanks
Welcome to Thyroid UK, Donnae.
Yes, you are very undermedicated, ask your GP for a dose increase to 75mcg. You should have a follow up thyroid test 6-8 weeks after increasing dose as you may need a further dose increase.
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 louise.roberts@thyroiduk.org if you would like a copy of the Pulse article to show your GP.
Thyroid peroxidase 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.
So do you have PA causing B12 Deficiency or B12 D without PA ? It would be a good idea to have other tests like Folate - Ferritin and VitD ....
PA causing B12 Deficiency
Yes - if you have the results - do post 
Ferritin 18 (30 - 400)
Folate 2.1 (2.5 - 19.5)
Vitamin B12 198 (190 - 900)
Vitamin D 16.2
Oh Dear - what has your GP said about these awful results ? If you have PA and on injections then the B12 testing is of little value - so am wondering why it is so LOW ??
Clcik onto SeasideSusie - then click onto her Replies to read her DAILY advice on results similar to yours. Docs know so little and SS knows so much ...
Thanks nothing has been said and have only had first B12 injection 2 months ago
Have you managed to read through SeasideSusie's replies ? We have to read and take care of ourselves in order to be well - sadly 😊
Donnae
Your GP has been extremely negligent in not saying anything about these results, and I think you should make that fact known at the surgery.
Maybe see another GP and get things sorted.
Ferritin 18 (30 - 400)
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. 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...
You need an iron supplement and as your level is so low you should ask for an iron infusion which will raise your level within 24-48 hours, tablets will take many months. However, there is more to it than just ferritin level so you need an iron panel and full blood count to see if there is iron deficiency anaemia, if confirmed then the treatment for that is 2 or 3 x ferrous fumarate daily and each iron tablet should be taken with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.
**
Vitamin D 16.2
You have severe Vit D deficiency and should be on loading doses, don't accept 800iu D3 as that is a very small maintenance dose for someone who has a decent level already, it must be the loading doses - see NICE treatment summary for Vit D deficiency:
cks.nice.org.uk/vitamin-d-d...
"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. Go and see your GP and ask that he treats you according to the guidelines and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu so post your new result as the time for members to suggest a dose) to bring your level up to what's 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
vitamindcouncil.org/about-v...
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
naturalnews.com/046401_magn...
Check out the other cofactors too.
As you have Hashi's, once you start buying your own D3 you should get an oral spray for better absorption, eg BetterYou. They do D3 alone or a combined D3/K2-MK7
**
Folate 2.1 (2.5 - 19.5)
Vitamin B12 198 (190 - 900)
I imagine that you get advice on the PA forum regarding these.
**
I'm guessing you may not have been on 50mcg only since diagnosis, and may have had dose changes, possibly due to the fluctuations in test results and symptoms that Hashi's is responsible for.
Very few doctors consider antibodies important, and most don't understand how Hashi's affects the patient. Read and learn 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.
Gluten/thyroid connection: chriskresser.com/the-gluten...
stopthethyroidmadness.com/h...
stopthethyroidmadness.com/h...
hypothyroidmom.com/hashimot...
thyroiduk.org.uk/tuk/about_...
**
Hashi's and absorption problems tend to go hand in hand with resulting dire nutrients. The absorption problems need addressing and there's lots of information in SlowDragon 's reply to this post healthunlocked.com/thyroidu...
Thank you SS 😊
Next week make an on the day appointment.
As well as asking for a levo dose increase, ask your GP to:
1. Sort your vitamin D level out. Make sure you ask for a loading dose. Read the prescription BEFORE leaving the room. If the GP gives you a prescription for 800IU per day ask him/her to read the local area guidelines and follow them. (If you have to collect the prescription afterwards phone up and complain.)
2. To do a full blood count and iron panel to confirm whether you have iron deficiency aneamia. They then need to put you on 2 or 3 iron supplements per day OR refer you to a specialist e.g. endo
Tell him/her the advice came from thyroid UK, a support group for those with thyroid conditions recommended by NHS Choices.
DO NOT mention the words "internet" or "internet forum" if you want to be taken seriously.
After Some Super Advice on This Forum
Test Results from Blue Horizon
Come from pernicious anaemia site
Has anyone here come OFF levoxy?
Blood results from Blue Horizon
