Newbie with thyroid results

[Nekko]

Thyroid peroxidase antibody 971 IU/mL (<34)

Serum TSH 5.36 mIU/L (0.27 - 4.20)

Serum Free T4 12.9 pmol/L (12 - 22)

Serum Free T3 3.2 pmol/L (3.1 - 6.8)

How long till I feel better on 50mcg levothyroxine have been on this since 2013 and I have symptoms of feeling cold, tiredness, hard stool, hair loss, weight gain, pins and needles, cramps, bone pain, dry skin thanks

[Clutter]

Welcome to the forum, Nekko.

You are undermedicated to have TSH 5.36 and FT4 and FT3 low in range. Ask your GP to increase dose.

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 [e-mail] if you would like a copy of the Pulse article to show your GP.

Ask your GP to check ferritin, vitamin D, B12 and folate which are commonly low/deficient in hypothyroid patients. Low ferritin can cause hair loss, vitD deficiency can cause joint and bone pain, and low B12 and folate can cause pins and needles in hands and feet.

Buy magnesium citrate for muscle cramps and make sure you take it 4 hours away from Levothyroxine. Bedtime is best because it aids relaxation. You can also buy magnesium oil spray and take Epsom Salt baths to relieve muscle cramps.

[Nekko in reply to Clutter]

Thanks will post latest vitamin and mineral levels now.

[SlowDragon Administrator]

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

The aim of Levothyroxine is to increase the dose until TSH is around one and FT4 towards top of range and FT3 at least half way in range

You are very under medicated

Ask GP for 25mcg dose increase. Bloods should be retested 6-8 weeks after any dose change

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

Essential to test vitamin D, folate, ferritin and B12.

Always get actual results and ranges. Post results when you have them, members can advise

Hashimoto's affects the gut and leads to 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

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...

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 [e-mail]. print it and highlight question 6 to show your doctor.

Prof Toft - brilliant article just published

rcpe.ac.uk/sites/default/fi...

[Nekko in reply to SlowDragon]

Thanks will post latest bloods for vitamins and minerals now

[Nekko]

I won't feel overmedicated if I increase dose?

[Marz in reply to Nekko]

I think if you have felt over medicated in the past it will be due to your AWFUL results for Vitamins and Minerals. T4/Levo canno convert into T3 in the body when vits are so low. This makes you feel unwell. You need the dose increase to improve uptake of nutrients - a slow process I'n afraid - but worth it 😊