I am 29, new and feeling very unwell. I have symptoms of angina, sluggish bowels, loss of appetite, sugar cravings, sweats, dry skin, anxiety, depression, low memory and concentration, losing hair, heavy periods, puffy eyes, tiredness, weight gain, goitre.
I think I am undermedicated but GP wants to leave me on the 175mcg levothyroxine dose despite me being on it for 2 months. She says I am on a high enough dose as it is. Should I get my endo involved in this matter?
I am also looking to get pregnant as well. Diagnosed hypothyroid in 2011. Thank you
TPO antibody 990.5 (<34)
TG antibody 375.3 (<115)
TSH 4.70 (0.2 - 4.2)
FT4 14.6 (12 - 22)
FT3 3.5 (3.1 - 6.8)
Written by
Adanna19
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Hi and Welcome ! Do you have any results with ranges you could share with us - then people will be able to help you more with helpful suggestions. Perhaps your T3 is low.
Also have you had B12 - Folate - Ferritin - VitD tested ? All need to be optimal and not just OK - as often described by GP's. You are legally entitled to have copies of your test results so you can monitor your progress - pick up on things missed and post here with good information.
You are only on a high enough dose if your FT4 and FT3 results suggest you are Do you have Hashimotos ?
OK so you have Hashimotos and your results are not good. Your TSH needs to be 1 or under - so how do you take your medication ? FT4 and FT3 need to be towards the top of the range.
There are loads of websites dealing with Hashimotos and thousands of posts here on this Forum. Check out Izabella Wentz - her protocol is tough but it may give you some ideas.
So how are your levels of B12 - Folate - Ferritin - VitD ?
Check out the website HypothyroidMom for information on thyroid and pregnancy ...
Thanks I take my medication on an empty stomach about 2 or 3 hours away from supplements (which I haven't taken in many months) as well as food and drink.
I have low B12 and folate, iron deficiency and vit D deficiency. I am getting results today
Having LOW everything is very common with Hashimotos. When you have your results start a new thread so more people will see them and comment. So how is your GP treating your low levels of everything ?
So the Low Iron needs treating. Taking VitC with each dose will improve absoprtion - but I would test your Iron levels first.
If you feel 3 monthly B12 injections are not adequate you could ask for more regular ones - especially if you have neurological issues. You could top-up with sub-lingual lozenges or under the tongue sprays. Also taking a good B Complex would keep all the B's in balance and give you folic Acid/Folate too.
When taking high doses of VitD it is advised to take Magnesium and VitK2-MK7 .... they are important co-factors Docs rarely mention
GP says if I wasn't planning to have children she wouldn't have suggested my thyroid test be repeated. Also this FT3 result is the lowest I have ever seen it
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
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: tukadmin@thyroiduk.org
NICE guidelines recommend TSH below 2.5 for pregnancy, but with Hashimoto's you will need it lower than that
Your GP isn't very bright, is she - not the sharpest scalpel on the instrument trolley! It doesn't matter how high your dose is, it's your results that count, and yours say you are under-medicated. It's not like telling a child they've had enough chocolate and more will make them sick! Your TSH needs to be lower whether you're trying to get pregnant or not. And your FT3 certainly needs to be higher, because it's low T3 that causes symptoms.
I really don't think that an increase of 25 mcg will cause you to be over-treated. You're only over-medicated if your FT3 is over-range - and you're a long way off that! Besides, it's no big deal if it does go temporarily over-range, you just reduce the dose slightly after the next blood test. You're not going to instantly drop dead or anything.
I think you should go over her head, and get your endo to increase your dose as soon as possible.
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