Hi all I am 28 years old and female, I have recently been told I have autoimmune thyroiditis due to elevated antibodies. Just wondering how long it will take to feel better on 25mcg levothyroxine? Thank you
TSH 20.6 (0.2 - 4.2)
Free T4 10.3 (12 - 22)
Free T3 3.1 (3.1 - 6.8)
TPO antibodies 547.3 (<34)
TG antibodies 277.5 (<115) private test result
25mcg is a sub therapeutic dose, it is a starting dose for the elderly or those with an underlying heart condition. Your doctor should have started you on 50mcg. Best practice is to start on 50 mcg levothyroxine, repeat bloods after 6 weeks and raise levothyroxine in 25 mcg increments repeating blood tests until symptoms improve and blood tests show TSH low in range ( close to 1) and ft4 high in range. It can often take 6 months to reach a stable dose.
It is also important to look at vitamins and minerals, especially vit d, vit b12 ferritin and folate. These all help with conversion to the active hormone. There is also research that going gluten free reduces antibodies and flare ups in hashimoto’s disease.
Thanks GP said because of low weight I am only entitled to 25mcg
Welcome to the forum, Nikki8701.
25mcg is an inappropriately low dose unless you are >50 or have heart disease. NICE CKS recommends intial dose of 50-100mcg with dose increases every 4 weeks until appropriately dosed. cks.nice.org.uk/hypothyroid...
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.
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. I doubt you will see much improvement on 25mcg. Symptoms may lag behind good biochemistry by several months.
You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.
Medics seem to not understand that we can be thin and very hypothyroid
You are very under medicated. Dose should be increased in 25mcg steps, retesting 6-8 weeks after each dose change.
Dose increase until TSH is around one and FT4 towards top of range and FT3 at least half way in range
Ask GP to test for coeliac disease and also to test vitamin D, folate, ferritin and B12
Hashimoto's affects the gut and leads to low stomach acid and vitamin levels
You can be under weight BECAUSE of Hashimoto's.
Coeliac blood test is notoriously unreliable and endoscopy only reliable test. Coeliac patients often struggle to gain weight. Same can be true for gluten intolerance
You do not need to have any gut symptoms
Low vitamin levels stop Thyroid hormone working
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...
drknews.com/changing-your-d...
For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested
See if you can get vitamin testing from GP.
Private tests are available
thyroiduk.org.uk/tuk/testin...
Medichecks or Blue Horizon are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
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
Link about antibodies
thyroiduk.org.uk/tuk/about_...
Link about thyroid blood tests
thyroiduk.org/tuk/testing/t...
Print this list of symptoms off, tick all that apply and take to GP
Just seen your other post with your absolutely dire vitamin levels on.
Your GP has been grossly negligent. See a different GP urgently TODAY
Newly diagnosed and feeling awful.
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