Fluctuating results: Hi So I have hashimoto’s... - Thyroid UK

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Fluctuating results

Newbyface profile image
15 Replies

Hi

So I have hashimoto’s and Started on thyroxine in September

On the 7th September TSH was 65 and T4 2.2

On the 11th October TSH was 17.9 and T4 12.5 after beginning on 50mcg of Levo and swiftly increased to 75mcg. Based on those results I stared taking 100mcg

On the 2nd November TSH 3.1...no T4 as it was a random test at the hospital. I felt and looked much better then I had in ages and currently on 100mcg of Levo

On the 16th November my routine bloods showed TSH 5.1 and T4 12.5. Still taking 100mcg. My doctor has yet to discuss these with me

The range is TSH 0.3-6.0

Free T4 is 10.4-24.5

Why has my TSH increased? I know it’s not much but it’s enough to make me feel tired and lethargic. I feel like I had taken a step back as I was doing so well.

About two weeks ago I had a terrible tummy bug and missed a dose due to vomiting it up...since then I had gastritis and the doctor prescribed me omeprazole twice a day? Could that be responsible for the increase in TSH?

Am I panicking? Like I say, I was doing so well and feeling much better.

Also can excessive amounts of alcohol also affect levo? As the weekend before my test I did have a little too much on a night out

When I was first diagnosed in September my other results were as follows

Ferritin 36 range 10-291

Vit D 65 acceptable

B12 338 range 160-1000

Folate 6.2 range 3.0-20.0

Thanks for any advice in advance.

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Newbyface
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15 Replies
Clutter profile image
Clutter

Newbyface,

Are you taking Levothyroxine with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen?

You are undermedicated to have TSH 5.1. Hashimoto's causes progressive destruction of the thyroid gland so that could be why you need dose increasing or it may be that Omeprazole is reducing absorption of Levothyroxine. In either case, the remedy is to increase Levothyroxine dose. Losing one dose of Levothyroxine and drinking alcohol won't have caused TSH to rise.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 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 dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.

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.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

Ferritin is optimal halfway through range and generally needs to be >70 for wellbeing. You can raise ferritin by supplementing iron. Take each tablet with 1,000mg vitamin C to aid absorption and minimise constipation. Take iron 4 hours away from Levothyroxine.

VitD 65 is inadequate. 75 is replete and 100-150 optimal for most people. Supplementing 5,000iu D3 x 8 weeks will raise vitD and supplementing 5,000iu alternate days until late March will maintain levels. Take vitD 4 hours away from Levothyroxine.

B12 338 probably isn't deficient but if you have symptoms of deficiency in b12deficiency.info/signs-an... go to healthunlocked.com/pasoc for advice as they are experts re B12 and folate deficiency.

Folate could be a little higher. You could supplement a B Complex vitaim to raise folate.

Newbyface profile image
Newbyface in reply toClutter

Hi

Thankyou for this information.

I always take the Levo an hour before food and only take it with water. Maybe I have got a little complacent with the time scale so that’s something to keep an eye on.

At the moment the only things I take with regards supplements are sublingual B12 and selenium. I will now take your advice and introduce the others you have recommended.

I have stopped the omeprozole just in case that was the culprit but still have knawing pains in my tummy.

I am strictly gluten free and dairy free

With regards to the hasimoto’s. I have started with neck pain and tenderness in my glands which I haven’t experienced before.

I have the article you are referring too and will definitely show it to my Gp next week. I think it’s section 6 if I’m thinking of the right one. I emailed Louise Roberts.

Thanks for your help x

Clutter profile image
Clutter in reply toNewbyface

Newbyface,

You can still take Omeprazole but need to take it 2-4 hours away from Levothyroxine. There is evidence to show that taking Levothyroxine at bedtime leads to be better absorption.

The neck discomfort may be due to your thyroid being swollen due to high TSH flogging the thyroid.

Yes, I am referring to the Pulse article which Louise used to send out.

Newbyface profile image
Newbyface in reply toClutter

Ok. I’ll make sure I take the omeprazole well after the thyroxine.

Oh good. I’ll have it ready for the Gp this week.

I’m not waiting to hear from the Gp. I have enough medication and will increase to 125mcg tomorrow.

Thanks for you help x

Clutter profile image
Clutter in reply toNewbyface

Newbyface,

Discuss reducing Omeprazole dose with your GP when the time is right. I believe it is better to wean off PPIs rather than stop dead.

Newbyface profile image
Newbyface in reply toClutter

Yeah perhaps you are right.

Maybe I should get some apple cider vinegar? Isn’t that meant to help?

Clutter profile image
Clutter in reply toNewbyface

Newbyface,

ACV raises low stomach acid. I would wean off Omeprazole and see how I feel without PPIs before going the other way and adding ACV.

Newbyface profile image
Newbyface in reply toClutter

Ok

Thanks for your help x

radd profile image
radd

Newbyface,

TSH can be variable & over all you are heading in the right direction.

However, TSH is too high & FT4 too low & medicating omeprazole may impair absorption of thyroid meds & other as doctors often misdiagnose low stomach acid for high ....... but stomach acid can decrease with low thyroid hormone (and age).

In the stomach cells called parietal cells produce hydrochloric acid (HCl) allowing us to digest and absorb our food. They also produce something called intrinsic factor which allows us to absorb vitamin B12 and folic acid. If the adrenals glands fail (due to low thyroid hormone), this reduces our ability to produce acid and then as we can’t digest out food properly, absorb the nutrients we need (especially minerals), or convert the percentage of T4-T3 conversion that happens in the gut so the body slips deeper into a state of deficiency and fatigue.

Symptoms such as bloating, heart burn, indigestion, and increasing intolerance to foods are common with low HCl production and doctors may interpret this as too high stomach acid.

Clutter has already given excellent answers regarding the rest of your post.

.

drmyhill.co.uk/wiki/hypochl...

Newbyface profile image
Newbyface in reply toradd

Thankyou for your reply.

I had no gastric problems until I had an awful stomach bug a couple of weeks ago.

I used to have terrible bloating but since changing my diet to gluten free that has stopped.

Yeah I’m glad you think i’m heading in the right direction. I think I panicked a little but I have been feeling much better and feel like I’ve taken a step back

Thanks for your help and advice x

SlowDragon profile image
SlowDragonAdministrator

Gluten free should help your gut

You have to ween off Omeprazole very slowly

Few more links about low stomach acid

thyroidpharmacist.com/artic...

drmyhill.co.uk/wiki/hypochl...

scdlifestyle.com/2012/03/3-...

healthunlocked.com/thyroidu...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

Newbyface profile image
Newbyface in reply toSlowDragon

Hi

Thanks for the advice

I here so much stuff about bone broth.

What exactly is it?

Does it smell bad?

JadisFox profile image
JadisFox in reply toNewbyface

Bone broth does not smell - you can make it yourself - I use chicken wings - you basically simmer them for around 12 hours on a low heat so that all the gelatin is released from the bones - it will resemble jelly when cold but when heated it turn to liquid again - there are loads of recipes on line which include carrots, onion and celery chopped up and my often a few herbs - I add a bit of Himalayan pink salt too. Did marvels for my digestive discomfort that had put me in hospital and left the meds scratching their heads! (along with pre and pro biotics, slippery elm and liquorice root).

JadisFox profile image
JadisFox

Forgot to add that I add this to soups and gravies - it can be drunk a bit like a Bovril type drink but I did not need to resort to that!

Newbyface profile image
Newbyface in reply toJadisFox

Thanks got the advice!

This seems pretty easy. I’ll give it a whirl x

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