Thyroid - newbie

[Yulia1819]

Hi

How long to feel better on 25mcg levo?

Diagnosed 2011

Been taking 25mcg for 9 weeks

Symptoms are hard stool, dry skin, tiredness, low concentration, internal shaking

Thankyou

[greygoose]

It's very unlikely that you will get well on 25 mcg, it's less than a starter dose. You should have been retested after 6 weeks, and your dose increased to 50 mcg.

It sounds as though you were on a higher dose, and had it reduced. If so, why? Do you have high antibodies? Do you have copies of your latest labs? if so, post them here, with the ranges, and let's have a look.

[Yulia1819 in reply to greygoose]

Thankyou I had dose reduced from 125mcg by endo who said I was thyrotoxic

Serum thyroid peroxidase antibody *349 (<34)

Serum thyroglobulin antibody 593.5 (<115)

[Yulia1819 in reply to greygoose]

TSH *0.02 (0.2 - 4.2)

FT4 20.8 (12 - 22)

FT3 4.0 (3.1 - 6.8)

I have been told by GP my results now show undermedication

[greygoose in reply to Yulia1819]

Your FT3 most certainly does! And that's the most important number. Your endo is another of those idiot endos that doesn't know one end of a thyroid from the other!

You have Hashi's, and are a poor converter - which often happens with Hashi's. So, 25 mcg certainly isn't going to make you well! When were those labs done? After your 9 weeks on 25 mcg?

What you really needed was a slight decrease in levo, and some T3 added to it.

[Yulia1819 in reply to greygoose]

They were done when I was on the 125mcg levo

[greygoose in reply to Yulia1819]

So, you were actually under-medicated when you were on 125 mcg levo. I dread to think what your FT3 will be like now. It will probably be under-range. I think you should forget that useless, dangerous endo, and see if you can get help from your GP.

[SlowDragon Administrator]

Make an urgent appointment to see GP and ask for vitamin D, folate, B12 and ferritin to be tested.

Your high antibodies confirm you have Hashimoto's also called autoimmune thyroid disease

Your were NOT over medicated on 125mcg. You had poor conversion (high FT4 and low FT3) thus is typical in Hashimoto's, especially when vitamin levels are too low.

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...

After 6 weeks on just 25mcg I would expect your vitamin levels to be absolutely dire.

The endocrinologist was probably a Diabetes specialist. Certainly doesn't understand Hashimoto's

See these two posts that almost certainly illustrate your same situation

Low vitamins causing low TSH high FT4 - endo insists on dose reduced

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Now you are seriously under medicated, vitamins will be terrible

Levothyroxine dose will need to increase in 25mcg steps, retesting 6-8 weeks after each increase.

Repeated until TSH is roughly between 0.2-1 and FT4 towards top of range and FT3 at least half way in range

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

Strictly gluten free diet very likely to help or be essential

If FT3 remains low after all this is corrected, in say 6 months, you may, like many with Hashimoto's need to consider addition of small dose of T3

But essential to get vitamins correct FIRST, plus correct dose Levo, and most need to be gluten free as well

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]

Also request 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...