thyroid? advice please: hi I am a 23 yr old... - Thyroid UK

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thyroid? advice please

hi I am a 23 yr old female and I have the following symptoms - tiredness goitre constipation heavy periods fatigue in muscles burning in arms cold intolerance headaches memory loss is it thyroid issue? thank you

TSH 5.6 (0.2 - 4.2)

TPO antibody 98 (<34)

Free T4 12.8 (12 - 22)

Free T3 4.0 (3.1 - 6.8)

27 Replies
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Hi there,

Your symptoms along with your blood results may indicate that you are hypothyroid. Your tsh indicates underactive thyroid and your free t4 is also quite low in range.

Have you been referred to an endocrinologist and started on treatment?

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hi thanks I haven't been started on any treatment or referred to an endocrinologist yet because my gp says my tsh isn't high enough. I have gone to my gp 4 times about my symptoms and they just give me antidepressants

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Katv

Email dionne.fulcher@thyroiduk.org for a copy of the article by Dr Anthony Toft in Pulse Onine Magazine. Print it and highlight question 2 which is where he says if antibodies are present then Levothyroxine should be started to 'nip things in the bud'. Show this to your GP and request that you be started on Levo.

Dr Toft is past president of the British Thyroid Association and leading endocrinologist.

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You should have been started on levo thyroxine by now. Also has gp examined your neck and said anything about treating your goitre?

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hi gp examined my neck and said my thyroid felt enlarged and I had an ultrasound and the report for that said the thyroid was enlarged and not a lot of soundwaves were coming back from it. the goitre comes and goes, is the goitre treated with levothyroxine? thanks

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Hi, your enlarged thyroid could be due to hashimotos.

Levo thyroxine could ease the symptoms of hashimotos especially due to the fact that hypothyroidism causes hashimotos.

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thank you very much :)

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It is Hashi's that causes Hypothyroidism. Hashi's is where antibodies attack the thyroid and gradually destroy it.

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About goitre, Hashimoto's and hypothyroidism.. my ultrasound consultant said the thyroid function will gradually reduce till I reach nonfunctional. But with levothyroxine it'll probably slow down. And try not to be too stress.. stress will trigger immune response.

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Are you taking the anti-depressants? I am angry on your behalf if so, they aren't going to suddenly switch off any pain or turn you into an overactive person! Honestly, if he seriously thought this was centred on depression, why didn't he refer you for counselling etc? Because the queues for MH support are round the block several times so hey, hand out ADs, they'll do. When is the NHS going to either spend the money they waste on pills on proper MH services or update their knowledge about the conditions that really affect us, the poor diets people have for example and the impact that has on their health. My daughter's friend has been taking ADs for 10 years+ and medication for GERD for longer. He's seriously overweight but the GP has never suggested he lose weight. I despair.

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Yes taking the antidepressants, GP said they'll help. I will stop them

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Don't do it on my say so, but consider how long you've been taking them (they apparently take at least 2 weeks to start kicking in), what type they are (are they addictive for example) and if you feel any better, less pain, better mood etc. If you're over the 2 weeks, still in pain, still feel tired, unmotivated and are struggling, you'd have to question whether there's any benefit in taking them. If you feel you haven't had any improvement then I'd be back to the GP to discuss what you can do next.

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Katv

You have over range TSH and raised antibodies, you have autoimmune thyroiditis - Hashimoto's - which is where antibodies attack the thyroid and gradually destroy it. Hashi's isn't treated, it's the resulting Hypothyroidism that is.

Some doctors wait until TSH reaches 10 but with raised antibodies confirming Hashi's then you should be started on Levothyroxine now.

Most doctors attach little or no importance to antibodies but they can cause fluctuations in symptoms and test results. You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members. Gluten contains gliadin which is a protein thought to trigger antibody attacks. Supplementing with selenium L-selenomethionine 200mcg daily can also help reducing antibodies, as can keeping TSH suppressed.

chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

Hashi's and gut/absorption problems tend to go hand in hand and very often low nutrient levels are the result. You should have the following tested

Vit D

B12

Folate

Ferritin

And if ferritin is low then:

Iron panel

Full blood count

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can I post these results as my folate is low and so is my vit d thanks

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Yes, post results with ranges and mention if you are supplementing with anything and what dose.

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ferritin 25 (30 - 400)

folate 2.2 (2.5 - 19.5)

vitamin d total 34.6 (25 - 50 vitamin D deficiency. supplementation is indicated) I take 800iu for this

vitamin b12 251 (190 - 900)

I also have low mcv and high mchc?

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Katv

Your ferritin is below range and your low MCV and high MCHC indicate iron deficiency anaemia. You need treatment according to 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."

Ask your GP for the appropriate treatment and take each iron tablet 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, although yours is a very wide range and I think 100-130 may be adequate.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content. It can be a meal of liver, or you can 'hide' it by mincing/chopping very small and adding to casseroles, curries, cottage pie, spaghetti bolognese, etc. Also include lots of iron rich foods in your diet

**

Folate is deficient and B12 low in range. Do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an... then you should post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc

You may need testing for Pernicious Anaemia, you may need B12 injections. You definitely need folic acid prescribing but that must not be started before further investigation has been carried out and B12 started.

I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

**

For a Vit D level of 34.6nmol/L you need a lot more than 800iu D3 daily, that's barely a maintenance dose for someone with a decent level already.

Then Vit D Council recommends a level of 100-150nmol/L.

You could do with supplementing 10,000iu daily for 4 weeks, which equals the loading doses which would be prescribed for someone with a level less than 30. Then reduce to 5000iu daily and retest 3 months after starting.

Once you've reached the recommended level, you'll need to find your 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/index.html

As you have Hashi's, when you buy your own D3 then for better absorption, because it bypasses the stomach, an oral spray is best eg BetterYou. It comes in 3000iu dose so you would need to take the closest to the doses I've mentioned above, ie take 9000iu to start with then reduce to 6000iu and retest at the 3 month point.

Your doctor wont know, because they are not taught nutrition, but 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.

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This is great advice. I've been working on controlling my Graves Disease and seeking remission for the past 2 years. Our foggy auto immune brains can always use the reminders of all the many, many details. Education is the road to wellness and this is all very good information. Thanks for the reminders and the links!

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I first had a tsh over 20 and free t4 below 11 but I wasn't told about this result and it was only when I got a copy of my bloods did I notice and that was a month later

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Katv

In that case, refer back to those results, say with a TSH of over 20 and below range FT4 then you should have had a diagnosis back then and started on Levo at the time. The reason your TSH is different now is due to the Hashi's causing fluctuations in results.

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thank you will do this tomorrow and insist on starting treatment

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Make sure you say you got the advice from thyroid uk, a charity for those with thyroid disorders recommended by NHS Choices.

Do not say you got the advice of the internet otherwise you won't be taken seriously by the GP.

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ok thanks bluebug

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Saw the rest of the messages. What did the ultrasound consultant say when you had your scan? I was diagnosed with Hashimoto's thyroiditis by the consultant after my GP referred me for a scan. After that, due to my other symptoms which pointed towards subclinical hypothyroidism, she started me on levothyroxine after phone consultation with endocrinologist. I never saw an endocrinologist but my case is consulted. Just wondering if you could request to see another GP the next time you go?

U r having symptoms pointing towards hormonal imbalances due to lower thyroid hormone level. Did they check your estrogen/progesterone n other stuff?? Hmm... Ur tsh is above normal range. Negotiate with your GP. Request to start some levo for 6-8weeks and see how u feel.

I do have a very accommodating GP but the last time she went on maternity the other locums messed up with my meds and blood tests. I requested for increase dosage coz I felt awful and tired, the locum reluctantly agreed but was pretty insulting. And another gave me one-off prescription for 8 weeks and to see her again after a blood test but set blood test schedule for 12 weeks instead so it messed my prescription. They wouldn't let me have my meds because I wasn't "due for it" according to that locum GP. I was in tears when I got there and I couldn't get my prescription, I couldn't make appointment for blood test. I was already feeling awful with too low dosage of levothyroxine back then, plus all these unnecessary issues caused by idiotic locums. Sigh.

So I learned this: Nobody but you will care for your health. If your current GP refuses to treat you after you try negotiating with him/her, try requesting to see another GP. Be nice when negotiating but be very firm with your need. Big hugs. It'll be alright..xxx

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ultrasound consultant said there are not many soundwaves coming back from thyroid, it is enlarged and vascular. estrogen normal progesterone never tested, dhea below range

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did he explain what does that mean? when's ur next GP appointment? can you request to see another GP?

thyroidpharmacist.com/artic...

i'll send u a clinical paper published about subclinical hypothyroidism.

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thanks no he was talking to a student doctor in the room with him and said there were not many soundwaves coming back from thyroid and it was enlarged and vascular. it was never explained to me. next gp appointment is wednesday next week thanks

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