I think I have a vitamin deficiency but my Endocrinologist wasn't concerned. Am I being over concerned?
I finally believe I'm on the correct levothyroxine dose (62.5) . (A dose of 75 gives me heart palpitations and 50 gives me fatigue). However, I'm still experiencing really bad fatigue. Also the anxiety that appeared at the same time I started having thyroid issues is worse now. But I think that just might be because I am so tired. It's taken two years to get on the right dose of levothyroxine. I've been under medicated although I was over medicated for about three months at the beginning of 2017.
Here are my blood test results ( I was taking a daily multi vitamin)
Iron - in range
but ferritin was at 16 ( range 10-232ng/mL
T4 free 1.1 ( 0.8-1.8ng/dL)
T3 free 2.6 (2.3-4.2pg/mL)
TSH 1.73
Vitamin D 30 (30-100)
Vitamin B12 was well in range
Thyroid peroxidase antibodies 128
MCH 27.9 (27-33 pg)
MCHC 32.7 (32-36g/ dL)
I am concerned about taking more iron supplements as I read you can over dose on iron and my Endo did not suggest it.
Any advice welcome.
Thanks
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Chickenlady2009
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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
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
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
You are under medicated to have FT3 so low. You probably find it difficult to increase dose due to low vitamin levels and/or gluten intolerance
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.
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
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
Hi - as SlowDragon has already said, you are under-medicated and your nutrients are far too low. Your palpitations on 75mcg levo will probably have been due to your low nutrients rather than being over-medicated, especially the ferritin. You can overdose on iron but you are an awfully long way off that point.
"In range" simply isn't good enough for anyone and especially not with hypothyroid - I agree that you should follow SeasideSusie's suggestions as recommended.
I'm relieved that I actually have something legitimately wrong with me and I'm not just crazy. I actually thought people would respond by telling me I was over concerned. I'm on my second Endo and I stressed to both that i was concerned about vitamin levels and asked for vitamins to be part of my blood tests, they did the tests, first endo never shared my blood test results with me and neither endo was concerned about low levels. The first endo told me i needed heart medication and clonazepam.
I started gluten, soy and dairy free about two weeks ago. Hopefully I can add dairy back in later. I'm still reading all the links you sent, slowdragon. Thank you!! The only supplement I was advised to take by the endo was brazil nuts.
I am now researching supplements. Hopefully, my terrible joint pain will diminish, too.
I would start supplementing vitamins straight away but not as multi but individual ones. Those will help your thyroid so much but they do take time to get things optimal and then sort out if your thyroid meds are then at the right dose for you. We have all had to help ourselves at some point which is probably why you didn't get the response you were expecting!
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