Newly diagnosed

[SJS60]

Hi I'm new and newly diagnosed, when will I feel better on 50mcg levo? Thank you

THYROID PEROXIDASE ANTIBODIES 949 KIU/L (<34)

TSH 45.8 MIU/L (0.2 - 4.2)

FT4 10.2 PMOL/L (12 - 22)

[Nanaedake]

Hello SJS60, welcome. How long have you been taking 50mcg levo? It's a starter dose and you need a blood test every 6 weeks and then a dose increase until TSH reaches around 1 or slightly lower. If you did not have a blood test booked for 6 weeks after starting levothyrxoine then you need to ring up and arrange it.

If you can get online access to blood tests it will help you keep track of your blood test results and you can then take the initiative to contact your doctor for dose increases.

You have elevated antibodies which means you have autoimmune thyroiditis commonly known as Hashimotos. You can read information about Hashimotos on Thyroid UK's website.

[SJS60 in reply to Nanaedake]

Thank you, I have been on 50mcg levo for 6 weeks

[silverfox7]

Welcome to the forum. Always get a print out of your results with the ranges to get so you can see your progress, the ranges are important as they differ from lab to lab. Things in the Thyroid world work slowly. Don't try to speed it up as my may have to start again. Patience is often needed but you should get there.

[Beaniedog in reply to silverfox7]

Hi Silverfox.

Could you look at my results and give advice please. Diagnosed 8 weeks ago and put on 50 mcg daily. Just had more bloods after 8 weeks and some of my symptoms have improved but still feeling unwell.

FT4 was 10.1 and now 15.3 (12.00 -22.00pmol/L

FT3 3.9 (3.10 - 6.80pmol/L

Anti body’s Peroxidase was 228.9 <34.00IU/L. There’s no new result showing for this?

Folate 13.02 (2.50-19.50)

Ferritin 154.2 ug/L

Vit B12 436.6 (180-900)

Serum creatinine 86 umol/L (45.00-84.00)

My result sheet says normal or satisfactory but I am seeing the doctor tomorrow.

Vit D had not come back yet.

Hope u can make some sense of these results.

I think I prob need an increase in levo?

Thanks

Beaniedog

[Mary-intussuception in reply to Beaniedog]

Wouldn't it be best to start your own separate post thread Beaniedog?

But, before you do, there is no TSH result here ??

Also no range is given for Ferritin, however I think both Folate and Ferritin look ok.

Post full info on Vitamin D new post when you get results.

[SJS60 in reply to Beaniedog]

Why not post your results in a new thread rather than piggybacking someone else's? Thanks

[Mary-intussuception]

It may take a while.

How newly diagnosed. Could you give date these tests were done and date 50mcg of Levothyroxine started. Also date of your next appointment for blood tests? Should be 4 to 8 weeks after last test. Within 4 to 6 would be best I think.

Ask for the following nutrients levels to be tested also:

Vitamin D, B12, Folate and Ferritin. Also Calcium.

Did you have any other tests? Anything to check Adrenals?

[SJS60 in reply to Mary-intussuception]

Thank you, these bloods were done 6 weeks ago and that was when levo was started. I am due bloods tomorrow. I have had tests for adrenals, calcium, ferritin, folate, B12 and vit D

[Mary-intussuception in reply to SJS60]

Could you post all results and ranges plus any comments added.

So are your Adrenals OK then?

After tomorrow's test results you will probably be put on 75mcg. Then in another 6 weeks possibly 100mcg.

All that remains for you to do to help general well being is to eat and drink as healthily as possible and gradually increase gentle exercise (eg leisurely walking, swimming) but never strenuous exercise or work out.

[SJS60 in reply to Mary-intussuception]

No adrenal results show I have low cortisol, thank you

[Mary-intussuception in reply to SJS60]

Hi

So what is your doctor doing about low cortisol?

Sorry but I'm not familiar with this.

All I know is, that my Endocrinologist did a Short Synacthen Test to check my adrenals first - before starting my Levothyroxine. He phoned when he got redults to say mine were OK so OK to start Levothyroxine.

It seemed important to him to check Adrenals first.

Maybe someone on here can comment further.

Have a read through your Levo leaflet too.

[SJS60 in reply to Mary-intussuception]

Thank you, I was hoping the endo would have advised me about my cortisol and short synacthen results.

BASELINE CORTISOL 247 MMOL/L (140 - 700)

30 MIN CORTISOL 383 MMOL/L

60 MIN CORTISOL 402 MMOL/L

[Mary-intussuception in reply to SJS60]

Did the Endo or your GP say this is a Low result?

I haven't a clue , I'm sorry, all I can say is what I can see - and if that's the range then they are all within it! Not very helpful , I know.

Have you tried a Google search with these figures?

Hope someone with more knowledge of Adrenals / Adrenal fatigue comes along soon. xx

[SJS60 in reply to Mary-intussuception]

Hi, my GP said it was low normal. Endo just said as long as cortisol is rising my adrenal function is fine.

[Mary-intussuception in reply to SJS60]

Phew! That's good news ☺ .

So you're expecting your last results soon and a 25mcg increase. Next bloods 6 weeks after these last ones?

You will also be getting the results of your nutrients. Remember to post them and include ranges in brackets + any comments added by GP or lab and date of tests. Post your new Thyroid results at same time and please make reference to this post.

[SlowDragon Administrator]

It takes full 6 weeks on starting dose for Levothyroxine to have its full effect. It's a replacement hormone not a medication. Very important to take it everyday

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

verywell.com/should-i-take-...

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.

Bloods will need retesting after 6-8 weeks. Dose will be increased in 25mcg steps, retesting after 6-8 weeks each time

Aiming to lower TSH is around one and FT4 towards top of range and FT3 at least half way in range.

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

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 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

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...

Read as much as possible about Hashimoto's

[SJS60 in reply to SlowDragon]

Thank you, these bloods were done 6 weeks ago and that was when levo was started. I am due bloods tomorrow. I have had tests for adrenals, calcium, ferritin, folate, B12 and vit D

[SlowDragon Administrator in reply to SJS60]

Can you post the test results for vitamins, including ranges

It's likely you may need to supplement

Your dose of Levothyroxine likely be increased by 25mcgs

Post thyroid tests results when you get them

[silverfox7]

Sorry late picking up you message, spent hours with hospital appointment this morning then jobs to do when back so just settled down to do catch up. Loads of good advice already given. If you ever need vitamins advice search for SeasideSusie's posts as she has nailed it so read that and you will see not quite there yet. Make sure your Vit D comes through. Mine was very low so feel heaps better now.

So with those eventually getting optimal then results will keep improving but doctor withvprobsbly increas by 25 mgs when you see him. Always get a copy of your bloods and right on things of interest-dose, comments as to how you are feeling etc and don't forget the ranges. These are very important as they differ from lab to lab so we cannot really give you accurate advice without them.

What you are aiming for with FT4 and FT3 is for both to rise to the top third or even the top quarter of their respective ranges. So you are t there yet. Increases are done in 25's and better not to rush it by adding more. It's so easy to go over range when not that experienced and doing that means you have to drop back a bit then start going up again. Learn to listen to your body. It knows when things aren't going well before you do!