Central hypothyroidism

[Fjkari]

Hi I'm newly registered and looking at possibility of having central hypothyroidism. I have low energy, backs of legs ache, losing hair, feeling low, digestion slowed down. Taking 150mcg Levothyroxine. Diagnosed 2011. Thanks

[Clutter]

Fjkari,

If you had high TSH with FT4 and FT3 in range or below range at diagnosis you were diagnosed with primary hypothyroidism. If you had secondary hypothyroidism you would have been diagnosed with low-normal TSH and low or below range FT4 and FT3. Treatment for both types of hypothyroidism is Levothyroxine.

If you post your recent thyroid results and ranges I can advise whether you are optimally dosed on 150mcg. If you have results and ranges for ferritin, vitamin D, B12 and folate post them too.

[Fjkari in reply to Clutter]

TSH 8.3 (0.2 - 4.2)

FT4 11.4 (12 - 22

FT3 3.2 (3.1 - 6.8)

[Clutter in reply to Fjkari]

Fjkari,

You are undermedicated to have TSH 8.3 and FT4 below range while taking 150mcg. 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 0.2 - 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. The Thyroid UK office opens on 3rd January.

[Fjkari in reply to Clutter]

Ferritin 22 (30 - 400)

B12 196 (190 - 900)

Folate 2.2 (2.5 - 19.5)

Vitamin D 26.6 (25 - 50 deficiency)

[Clutter in reply to Fjkari]

Fjkari,

Ferritin is deficient which can indicate iron deficiency anaemia. Has your GP ordered an iron panel and full blood count to check?

B12 196 is probably deficient. If you have symptoms in b12deficiency.info/signs-an... your GP should check intrinsic factor antibodies in case pernicious anaemia is causing B12 deficiency. B12 injections should be initiated 48 hours prior to starting 5mg folic acid for folate deficiency. If you want more advice on B12 and folate deficiency go to healthunlocked.com/pasoc who are the experts on PA, B12d and folate deficiency.

Vitamin D is deficient. Your GP should refer to local guidelines or the cks.nice.org.uk/vitamin-d-d... Do NOT accept a prescription for 800iu which is a mainte-nance dose prescribed after vitD is replete >75. My sister's GP prescribed 2 x 20,000iu per week when her vitD was 40. Vitamin D should be taken 4 hours away from Levothyroxine.

[Fjkari in reply to Clutter]

I was hoping the GP would tell me what my iron and complete bloods indicated.

Iron 6.2 (6 - 26)

Transferrin saturation 13 (12 - 45)

RBC 4.40 (3.8 - 5.8)

WBC 7.11 (4 - 11)

Haemoglobin 115 (115 - 150)

MCV 78.2 (80 - 98)

MCHC 377 (310 - 350)

MCH 28.2 (28 - 32)

Platelets 251 (140 - 400)

Thanks

[Clutter in reply to Fjkari]

Fjkari,

Deficient ferritin, MCV and low haemoglobin, MCH, transferrin and iron indicates iron deficiency anaemia. Usual treatment is 3 x 210mg Ferrous Fumarate. Take 1,000mg vitamin C with each iron tablet to aid absorption and minimise consipation. Iron should be taken 4 hours away from Levothyroxine.