Thyroid UK

Advice on dosage please + general help

Advice on dosage please + general help

I had a private blood test done and my antibodies have risen from 40 to 155 in the past 7 months although my TSH, T3 and T4 have gone up from a previous test but I still feel terrible, I have absolutely exhausted plus I’ve had yet another bladder infection (the last infection took 6 lots of antibiotics to clear). I saw the Dr for this infection but as it was an emergency appointment and could only talk about one problem. My thyroid issues was out of the question, plus we had words about what antibiotics to give me as I won’t take trimethoprim it just doesn’t work on me. I won that battle 😏. I have made an afternoon appointment with a dr I quite like but the 1st available appointment was in the first week of January.!!!

Soi, as my Vit D is low and my iron is poor I am now taking the 800iu from the Dr as maintenance dose (borderline osteoporosis) and added another 1000iu I bought myself. Is this enough and are there good/bad times to take it?

As for iron, I’m not sure what to do about that as I suffer with constipation and lately, piles so over the counter bog standard pills aren’t really an option, is there anything suitable out there please that might work?

Joan

Xx

6 Replies
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Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

Has GP ever explained this?

Hashimoto's affects the gut and leads to low vitamin levels

Low vitamin levels stop Thyroid hormone working

Your vitamins are all on low side

See SeasideSusie many replies giving detailed vitamin supplements advice

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime

verywell.com/should-i-take-...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Is this how this test was done?

Your results show TSH is a bit high and FT4 and FT3 too low. You probably would benefit from a dose increase. But you may find GP reluctant to agree

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email dionne.fulcher@thyroidUK.org. print it and highlight question 6 to show your doctor.

Repeated bladder infections are common hypo symptom

healthunlocked.com/thyroidu...

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Joan

I can't read some of your results as the Medichecks print is so pale.

What is your Vit D level?

I couldn't take iron pills either but I raised my ferritin over time from 35 to 119 by eating liver once a week, usually around 140g but the maximum is 200g due to it's high Vit A content. You can also include lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

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You could try SPATONE for your iron deficienty. You can buy it in any Boots store. It doesnt constipate

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Joant24,

TSH is a little higher than a lot of people taking Levothyroxine are comfortable with and FT4 is low in range although FT3 isn't too bad. You could request a dose increase to raise FT4 and FT3.

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.

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.

chriskresser.com/the-gluten... Gluten-free may also improve your digestive symptoms and constipation.

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

Ferritin is optimal halfway through range so 54 isn't very low but >70 is generally deemed necessary for hair regrowth. Taking 1,000mg vitamin C with each iron tablet aids absorption and minimises constipation. If you have hard stools ask your pharmacist for Lactulose which is a stool softener. Strangely it is often diarrhoea not constipation which causes piles.

VitD 80 is replete but maintenance is required Oct-Mar otherwise levels will drop. 1,800iu seems a good dose. VitD should be taken with the fattiest meal of the day as fat aids absorption.

Make sure vitD and iron are taken at least 4 hours away from Levothyroxine.

Reply

Thank you for your quick reply. I’m not on any medication for thyroid.

In April my levels

TSH 0.197 (0.27 -4.20)

Free T 13.95 (12-22)

T4 67 (59-154)

T3 3.66 (3.10-6.8)

Tg antibodies 14.500 (0-115)

TPA 40.28

Then in November they were as in my post you replied too

My levels look better now but I feel more exhausted, fed up, irritable, and aching all over. I exercise regularly and walk a lot but then I’m good for nothing for the rest of the day. I feel like all I want to do is climb into bed and stay there! I’ve got a Drs appointment in January so need to battle on til then and see what happens.

I shall put up the Christmas tree tomorrow, I love the lights so that will cheer me up.

Thanks for listening

Joan

Reply

Joant24,

Apologies, I tend to assume everyone is taking Levothyroxine. Your results are euthyroid (normal) for someone not taking Levothyroxine. NHS won't diagnose hypothyroidism until TSH is over range or FT4 below range.

TPO antibodies are positive, as I said above, so you should have annual thyroid tests because it is likely you will become hypothyroid in a few years. If you adopt the 100% gluten-free diet it may delay progression to hypothyroidism.

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