Newbie. Hashi? Advice please

[Kerr779]

TPO 900 (<34)

TSH 4.69 (0.2 - 4.2)

FT4 14.9 (12 - 22)

FT3 3.4 (3.1 - 6.8)

Taking 25mcg levo thankyou

[greygoose]

Yes, you have Hashi's, and you are hypo. Are you on thyroid hormone replacement?

[Kerr779 in reply to greygoose]

25mcg levo

[greygoose in reply to Kerr779]

How long have you been on 25 mcg levo? You are under-medicated. The TSH should be one or under once you are taking levo. You need an increase in dose.

[Kerr779 in reply to greygoose]

I have been on 25mcg levo since diagnosis, 2012

[greygoose in reply to Kerr779]

That is disgusting! Your doctor has been very negligent. 25 is only half a starter dose - unless you are very young, very old or have a heart condition. Why hasn't he increased it in 6 years?

[Kerr779 in reply to greygoose]

Thankyou I am 32 years old and trying to get pregnant. No heart disease. No idea why not increased

[greygoose in reply to Kerr779]

Probably because your doctor knows nothing about thyroid. Or else he's a sadist! Does happen.

[Kerr779]

Symptoms -

dry skin

acne

hair loss

puffy eyes

tiredness

feeling cold

sweats

joint pain

breathlessness

pale skin

feeling ill

constipation

weight gain

pins and needles

[greygoose in reply to Kerr779]

Not surprising you have symptoms. Taking too low a dose for two long can make you worse than you were before you started! I think you need a new doctor, and report the old one for negligence.

That said, pins and needles are often a symptom of low B12. Have you had your vit D, B12, folate and ferritin tested?

[Kerr779 in reply to greygoose]

I have had them done but don't know results, can I post when I have them?

[greygoose in reply to Kerr779]

Yes, of course you can.

[Kerr779 in reply to greygoose]

Taking vit D and B12 and folic acid

[greygoose in reply to Kerr779]

How much of each?

[Kerr779 in reply to greygoose]

800IU Vit D, 5mg folic acid once a week, B12 injections once every 3 months

[greygoose in reply to Kerr779]

OK, well, you don't give your results for these tests, but 800IU is a tiny dose, and unlikely to do anything for you.

Folic acid is not the best thing to take, and taking it once a week, is not likely to help, either. As you are having B12 injections, you should be taking a daily B complex, because all the Bs work together, and need to be kept balanced. If you get one with methylfolate, and methylcobalamin, that will be much better for you than a weekly dose of folic acid, which isn't very well absorbed.

[Kerr779 in reply to greygoose]

Also thinking about taking iron and zinc and selenium and magneisum?

[greygoose in reply to Kerr779]

You can take zinc, selenium and magnesium without testing first, but you must test your iron/ferritin before taking iron.

[Kerr779 in reply to greygoose]

Thankyou my ferritin is 15 (15 - 150)

[greygoose in reply to Kerr779]

OK, so that does need supplementing!

The problem with a ferritin that low is that it needs quite a high dose, which means taking it three times a day. But, iron needs to be taken two hours away from everything else - including food, unless it says otherwise on the PIL. And, four hours away from levo. So, it doesn't slip easily into a routin containing zinc, selenium, etc. I would advise getting your ferritin level up before embarking on anything else.

[Kerr779 in reply to greygoose]

FOLATE 1.6 (2.5 - 19.5)

FERRITIN 15 (15 - 150)

VITAMIN D TOTAL 31.1 (25 - 50 VITAMIN D DEFICIENCY SUPPLEMENTATION IS INDICATED)

VITAMIN B12 228 (190 - 900)

[greygoose in reply to Kerr779]

OK, so you've had your ferritin tested, but you haven't given the ranges.

[Kerr779 in reply to greygoose]

Added

[greygoose in reply to Kerr779]

Yes, that dose of vit D is never going to raise your level!

[SlowDragon Administrator]

You need to see a different GP urgently and request immediate 25mcg dose increase in Levothyroxine

I imagine your vitamin levels are dire. These must be improved by supplementing. Post your results and ranges and members can advise

We have had numerous similar cases over last few weeks

A standard starter dose is 50mcgs of Levothyroxine. Bloods should be retested 6-8 weeks after each dose change. Dose increased by 25mcgs steps (retesting 6-8 weeks later each time ) until TSH is around one and FT4 towards top of range and FT3 at least half way in range

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.

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

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 impair 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...

NICE guidelines recommend TSH under 2.5 for pregnancy, and as you have Hashimoto's it will need to be lower than that

Your GP has been negligent

Thyroid UK are collecting evidence GP mismanagement, with view to getting guidelines improved

Please consider sending a brief outline of your terrible inadequate treatment. I would include the dire vitamin levels

thyroiduk.org.uk/tuk/get_in...

[Kerr779 in reply to SlowDragon]

FOLATE 1.6 (2.5 - 19.5)

FERRITIN 15 (15 - 150)

VITAMIN D TOTAL 31.1 (25 - 50 DEFICIENCY SUPPLEMENTATION IS INDICATED)

VITAMIN B12 228 (190 - 900)

Also thinking about taking iron and zinc and selenium and magneisum?

[SlowDragon Administrator in reply to Kerr779]

Can you add the ranges (all labs are different)

But I can see they are dire

See a different GP today if possible

You need loading dose of vitamin D

Ferritin is so low you almost certainly an iron infusion, followed by daily ferrous fumerate supplements.

More frequent B12 injections, plus daily vitamin B complex with folate in

Ask for testing for coeliac

Detailed vitamin supplements advice for Low vitamins due to under medication on this post

healthunlocked.com/thyroidu...

[Kerr779 in reply to SlowDragon]

Ranges added thankyou

[SlowDragon Administrator in reply to Kerr779]

Folic acid supplements should be increased to daily.

Vitamin D increased to at least 2000iu daily, but ideally given loading dose (e.g. 5000-10000iu daily) over few weeks

Look up your local CCG guidelines

Eg Oxfordshire

oxfordshireccg.nhs.uk/profe...