Thyroid symptoms?

[JJ_0222]

Hi I have symptoms of sweating, dry skin and eyes, bowels being sluggish, tiredness, losing hair and I am wondering if my thyroid would be causing this? I take 100mcg Levo and I was found to be hypothyroid in 2012, thank you

[greygoose]

Not exactly your thyroid, no, but low T3 could be causing all those symptoms. When were you last tested? How long have you been taking 100 mcg?

[JJ_0222 in reply to greygoose]

I was tested for thyroid a week ago and my GP has asked to speak to me about my low thyroid levels next week. I have been taking 100mcg for 2 weeks.

[greygoose in reply to JJ_0222]

Why did he do a test after only one week on the dose? You should wait for at least six weeks to get true levels.

[JJ_0222 in reply to greygoose]

I increased it because I felt unwell after being on 50mcg Levo for 9 weeks

[greygoose in reply to JJ_0222]

Well, you increased it by too much. Changes in dose should only be by 25 mcg every six months. That could have something to do with your symptoms. And, your results are now meaningless. You must tell your doctor what you did, so that he understands your results are probably skewed.

Did you have your test early in the morning, after fasting over-night, and leaving a 24 hour gap between your last dose of levo and the blood draw?

[JJ_0222 in reply to greygoose]

Sorry I got it wrong my GP told me to increase to 100mcg a week ago. Bloods done 2 weeks ago on 75mcg

[greygoose in reply to JJ_0222]

Well, that is an entirely different story! So, he increased your dose by 25 mcg, after seeing the results of your last test. Well, that's exactly how it should be. Now you have to give the extra levo time to be absorbed and metabolised, which will take about six weeks, and then you test again.

[JJ_0222 in reply to greygoose]

Early morning fasting and leaving 24 hours between Levo and draw

[SlowDragon Administrator]

For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

Do you have raised Thyroid antibodies? This is Hashimoto's also called autoimmune thyroid disease. You need to know

See if you can get full thyroid and vitamin testing from GP. Unlikely to get FT3

Private tests are available

thyroiduk.org.uk/tuk/testin...

Vitamindtest.org.uk - £28 postal kit

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

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

Link about antibodies

thyroiduk.org.uk/tuk/about_...

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Print this list of symptoms off, tick all that apply and take to GP

thyroiduk.org/tuk/about_the...

See Box 1. Towards end of article

Some possible causes of persistent symptoms in euthyroid patients on L-T4

You will see low vitamin D, folate, ferritin and B12 listed

onlinelibrary.wiley.com/doi...

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 print it and highlight question 6 to show your doctor

please email Dionne:
[e-mail]

[JJ_0222 in reply to SlowDragon]

TPO antibodies 621.3 (<34)

TG antibodies 458.1 (<115)

Was tested for thyroid a week ago, GP said my levels are low.

[SlowDragon Administrator in reply to JJ_0222]

Very definitely Hashimoto's with those antibodies

Highly likely to have low vitamin levels

What, if anything do you supplement?

Have you had vitamins monitored before this?

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...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

[JJ_0222 in reply to SlowDragon]

Can post vitamin and mineral levels before and after supplementing.

Ferritin

(Before supplementing - 2013)

Aug 2013

Ferritin 15 (30 - 400)

(When taking ferrous fumarate 3 times a day 2013 - 2016)

Nov 2013

Ferritin 22 (30 - 400)

May 2014

Ferritin 23 (30 - 400)

Jan 2015

Ferritin 19 (30 - 400)

Mar 2015

Ferritin 38 (30 - 400)

Sep 2015

Ferritin 17 (30 - 400)

Nov 2015

Ferritin 19 (30 - 400)

Feb 2016

Ferritin 23 (30 - 400)

(Post infusion 2016)

May 2016

Ferritin 189 (30 - 400)

Jul 2016 (no iron)

Ferritin 146 (30 - 400)

Sep 2016 (no iron)

Ferritin 110.5 (30 - 400)

Nov 2016 (no iron)

Ferritin 101.5 (30 - 400)

Jan 2017 (no iron)

Ferritin 103.3 (30 - 400)

Jul 2017 (no iron)

Ferritin 98.5 (30 - 400)

Aug 2017 (no iron)

Ferritin 45 (30 - 400)

Supplementing folic acid

Dec 2017

Folate 2.2 (2.5 - 19.5)

Supplementing vitamin B12 with injections every 3 months due to low B12 symptoms, first one June 2017

Feb 2017

Vitamin B12 231 (190 - 900)

Supplementing vitamin D with 800iu D3 (started 2013) then increased to 3000iu in 2014 onwards

Dec 2013

Vitamin D total 43.3 (25 - 50 vitamin D deficiency. Supplementation is indicated)

May 2014

Vitamin D total 59.6 (50 - 75 vitamin D may be suboptimal and long term may lead to clinical effects)

Nov 2014

Vitamin D total 71 (50 - 75 vitamin D may be suboptimal and long term may lead to clinical effects)

May 2015

Vitamin D total 56.1 (50 - 75 vitamin D may be suboptimal and long term may lead to clinical effects)

Jan 2016

Vitamin D total 70.2 (50 - 75 vitamin D may be suboptimal and long term may lead to clinical effects)

Jan 2017

Vitamin D total 71 (50 - 75 vitamin D may be suboptimal and long term may lead to clinical effects)

[SlowDragon Administrator in reply to JJ_0222]

Well these are all far too low, with exception on vitamin D, which is borderline. Increase vitamin D dose through winter, aiming for around 100nmol. Vitamin D mouth spray is good as avoids poor gut function.

Retesting twice year via vitamindtest.org.uk £28 postal test

You need to be supplementing iron, and possibly press for another infusion. Eating liver once a week should help too

As you are getting B12 injections and supplementing B12 sublingual lozenges you also need to take good vitamin B complex. This will help folate too

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

You should ask GP for testing for coeliac disease before considering trying strictly gluten free diet

Getting thyroid correctly treated is essential and low vitamins stop thyroid working

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

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...

The fact GP has flagged your thyroid as needing dose increase is good. You will need to increase by 25mcg steps, retesting after 6-8 weeks.

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

Some posts showing low vitamin levels and how to improve

Low vitamins due to under medication

healthunlocked.com/thyroidu...

Low vitamins causing low TSH high FT4

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

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 print it and highlight question 6 to show your doctor

please email Dionne:
[e-mail]

Getting thyroid correctly treated, vitamins improved and likely to need strictly gluten free diet. If FT3 still remains low then you may need to consider adding small dose of T3

Thyroid UK have list of recommended thyroid specialists, some are T3 friendly

Prof Toft - article just published now saying T3 is likely essential for many

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