Tired of feeling ill!

[lucylou22]

Hi I am new and diagnosed hypothyroid 2012. I take 150mcg levo and feel terrible with tiredness headaches weight gain feeling cold with sweats. GP won't increase dose despite how I feel. Been told results normal. Advise please thanks

[Marz]

Please post any results with ranges for people to comment.

Do you have Hashimotos ? - taking any other meds ? - supplementing vits and minerals ? Sorry more info required 😊

[lucylou22 in reply to Marz]

TSH 9.2 (0.2 - 4.2)

FT4 14.6 (12 - 22)

FT3 3.3 (3.1 - 6.8)

TPO 2000 (<34)

[crimple in reply to lucylou22]

Another useless GP who doesn't realise you are very undertreated. TSH should be 1 or lower when you are taking levo You also have high antibodies (Hashimoto's disease. Your T4 and T3 are too low and your vitamins and minerals are likely to be trashed too. Have you any results for Vit B12, ferritin, folate, iron, Vit D. All likely to be low and that won't help you make best use of levo. Also i strongly recommend you go gluten free to reduce the antibodies. It helped me a lot. Hope your treatment improves soon

[Marz in reply to lucylou22]

Oh dear what awful results especially as you have been on Levo for 5 years. Are you taking any other medication that could be affecting the uptake of the Levo ? Gut issues ? I expect your B12 - Folate - Ferritin & VitD are on the floor too .....

[lucylou22 in reply to Marz]

No other medications

FERRITIN 4 (30 - 400)

FOLATE 1.8 (4.6 - 18.7)

VITAMIN B12 102 (190 - 900)

VITAMIN D 9.2 (<25 SEVERE)

[Marz in reply to lucylou22]

And so they are - you must be feeling quite poorly. What is your GP doing about these shocking below range results ?

[SlowDragon Administrator]

Is there a different GP you can see

These results show you are extremely under medicated

TSH should be around one and FT4 towards top of range and FT3 at least half way through range

Ask for immediate 25mcg dose increase

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]

Detailed supplements advice from SeasideSusie on Low vitamins due to under medication

healthunlocked.com/thyroidu...

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

Low vitamin levels affect 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

Ask GP for coeliac blood test first

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...

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

[lucylou22 in reply to SlowDragon]

FERRITIN 4 (30 - 400)

FOLATE 1.8 (4.6 - 18.7)

VITAMIN B12 102 (190 - 900)

VITAMIN D 9.2 (<25 SEVERE)

[SlowDragon Administrator in reply to lucylou22]

Can you see a different GP urgently, today or tomorrow

These are absolutely dire

How long has GP had them and what was prescribed?

Your ferritin is terrible, have you had full iron panel?

Insist on iron infusion ASAP

You need full testing for Pernicious Anaemia before starting B12 injections - post these results on PAS Unlocked

healthunlocked.com/pasoc

You probably need several B12 injections close together over few weeks - ask their advice

Folic acid supplements should not be started until after first B12 injections

You need Loading dose of vitamin D

Look up your local CCG guidelines

Eg Oxfordshire

oxfordshireccg.nhs.uk/profe...

See these detailed replies from SeasideSusie on how to improve

Low vitamins due to under medication

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

All this is because you are under medicated for Hashimoto's

You haven't had T3 started then stopped have you?

You are likely to need some T3 eventually, but get vitamins sorted first, Levo dose increased and strictly gluten free diet

Read as much as possible about Hashimoto's