Hi, thanks for replies to last thread. Have been given levothyroxine to take once a day 50mcg with a retest in 6-8 weeks.
Oct-2017
TSH 45.5 mIU/L (0.2 - 4.2)
Free T4 10.7 pmol/L (12.0 - 22.0)
Free T3 3.1 pmol/L (3.10 - 6.80)
TPO antibody 905.4 IU/mL (<34)
TG antibody (private result) 275.3 IU/mL (<115)
Domi1304
Well it's a start, albeit rather late after reading your last thread.
Take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc, for an hour either side as absorption will be affected. Take any other medication and supplements 2 hours away from Levo, some need 4 hours.
When booking thyroid tests, always book the very first appointment of the morning, fast overnight (water allowed) and leave off Levo for 24 hours. This gives the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction. TSH is highest early morning and lowers throughout the day. It also lowers after eating. This is a patient to patient tip which we don't discuss with doctors or phlebotomists.
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With regards to the Hashi's, most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
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 gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies which has obviously happened in your case looking at the results in your other thread although it doesn't appear that you've had any comments on that.
August 2017
Ferritin 15 ug/L (15 - 150) 1 x iron tablet
Ferritin that low often suggests iron deficiency anaemia. Have you had an iron panel and full blood count? If not ask for them to be done. If you have had a diagnosis of iron deficiency anaemia then the correct treatment is 2 or 3 x ferrous fumarate daily. Take each iron tablet 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.
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. Aas 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. 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...
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Folate 2.3 ug/L (2.5 - 19.5) Vitamin B12 226 pg/L (190 - 900) 5mg folic acid B12 injections
That seems to be in hand. If you need further advice you can ask on the Pernicious Anaemia Society forum healthunlocked.com/pasoc
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Vitamin D 25 OH total 33.8 nmol/L (25 - 50 deficient) 800IU D3
Well, 800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level. If your level was less than 30 you would be given loading doses. Personally, I would self treat for this because you wont get any more prescribed by your GP.
The Vit D Council recommends a level of 100-150nmol/L.
If it was me I would be supplementing according the the NICE Clinical Knowledge Summary 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)."
And I would be taking 10,000iu daily for 4 weeks (total 280,000iu) which will equal the loading doses, then reduce to 5000iu daily then retest 3 months after starting. Once you've reached the recommended level 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, for better absorption an oral spray is best as it bypasses the stomach. BetterYou does a 3000iu dose spray and you could work out how many doses to take to get as close as possible to the doses mentioned above.
I have iron anaemia and take iron and have loading dose of vit D thanks
Domi
As you have iron anaemia then you are not getting gntje correct amount t of ferrous fumarate - see cks.nice.org.uk/anaemia-iro...
"How should I treat iron deficiency anaemia?
Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).
Treat with oral ferrous sulphate 200 mg tablets two or three times a day.
If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.
Do not wait for investigations to be carried out before prescribing iron supplements.
If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.
Monitor the person to ensure that there is an adequate response to iron treatment."
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Do you mean you have had loading doses of vitamin D totalling 300,000iu and now are on 800iu? If so what is your current level? 800iu is not enough for a maintenance dose, as mentioned above.
Domi1304,
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 but you will almost certainly need a number of dose increases to achieve these levels.
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...
thyroiduk.org.uk/tuk/about_...
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. 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.
At last!
Great News
What about the rest? Nutrients ???
I would retest asap. That is in 6 weeks not 8.
xx
I have iron anaemia and take iron and have loading dose of vit D thanks
Hyper/Mania after starting Levothyroxine
should I take t3 as well as levothyroxine
Private thyroid results
I recently was given 25mg levothyroxine, told to come back in two weeks to see how i was doing.
