Hi I saw a GP today who put me straight onto 50mcg levothyroxine with a retest in 6-8 weeks! Also been given iron to take 3 times a day, B12 loading dose injections as well as vit D loading injections and advised not to start folic acid until tests for pernicious anaemia have come back.
Ferritin 25 (30 - 400)
Folate 1.8 (2.5 - 19.5)
Vitamin B12 138 (180 - 900)
Vitamin D 14.3
TPO antibodies >1000 (<34)
TSH 62.33 (0.2 - 4.2)
Free T4 10.2 (12 - 22
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Blue9
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For maximum absorption Levothyroxine should be taken 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.
It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose.
Arrange an early morning and fasting (water only) blood test when TSH is highest, and take Levothyroxine after your blood draw. You will almost certainly need a dose increase, perhaps more than one, before you are optimally dosed.
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_...
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.
Congratulations! A GP who put you on the right track from day 1. The impressive bit is that he's someone who knows about PA, an autoimmune condition that affects your stomach, and about the correlation of B12/folate.
The one thing that was missing, I am not sure if he told you, was the fact that your TPO antibodies are very high which is indicative of Hashimoto's, an autoimmune condition of the thyroid.
A gluten-free diet along with 200 mcg/day of selenium for 3-6 months will help to reduce your antibodies. Before doing so perhaps it's a good idea with having a supportive GP is to ask him to test you for Celiac's.
A severe deficiency as such in your ferritin, B12, and folate levels along with one auto-immune disorder could also point towards Celiac's.
Wow, I think that's the first post I've seen detailing a GP who knows how to treat vitamin deficiencies properly!!! I hope this is the beginning of a tidal change in treatment for thyroid patients.
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