Not yet diagnosed

[Mara_J]

What do these results show please

TPO antibody 1900 (<34)

TSH 33.9 (0.2 - 4.2)

FT4 10.5 (12 - 22)

Thankyou

[SlowDragon Administrator]

See a different GP if your says you didn't need treatment started

You are clearly extremely hypothyroid

Should be started on 50mcg Levothyroxine asap

Bloods retested 6-8 weeks after each dose change. Dose increased in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way through range

Ask for vitamin D, folate, ferritin and B12 to be tested

Also if these are low (pretty likely) ask for Coeliac blood test

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...

[Mara_J in reply to SlowDragon]

Ferritin 5 (30 - 400)

Folate 2.3 (4.6 - 18.7)

B12 78 (190 - 900)

Vitamin D total 7.1 (<25 severe)

[SlowDragon Administrator in reply to Mara_J]

This underlines how unwell you are

When were these done. What has GP prescribed?

See a different GP today or tomorrow

You need urgent help

[Marz in reply to SlowDragon]

Hi SlowDragon - another set of horrendous results. Have not replied as I see your excellent responses. Just so shocked that we have had so many people today with shocking results not being acknowledged by their GP's and not receiving the correct thyroid treatment. Surely something must be done about the lack of knowledge at GP level .... I find it all very upsetting - and of course frustrating at the same time.

Keep up the good work

[SlowDragon Administrator in reply to Marz]

It's completely and utterly appalling

There was piece on news this week about computers being brought in to diagnose patients.......the sooner the better.

Doctors apparently get it wrong in 1 in 5 cases

The number of completely useless medics mismanaging hundreds and hundreds of cases of Hashimoto's ......well it makes you weep

[SlowDragon Administrator]

See my reply to very similar results earlier today

healthunlocked.com/thyroidu...

You are about the 5th just this afternoon whose GP is not taking appropriate action

[Baobabs in reply to SlowDragon]

I have already written today about how horrified I am. Couldn’t we get a documentary programme such as Panarama to investigate this intolerable situation. I am past caring about how ridiculous a suggestion this may be.

[SlowDragon Administrator in reply to Baobabs]

I have written to everyone I can think of

I think we need a mass contact of Michael Moseley at "Trust me I am a doctor"

At least he understands the gut connection

And as is clearly demonstrated this afternoon, in many many cases of Hashimoto's we definitely should NOT trust the Doctor

[Baobabs in reply to SlowDragon]

Please, please let’s try to collectively do something. Although I no longer live in UK I can’t bear reading about all these ghastly cases and I know from my own experience how just how debilitating the lack of appropriate treatment can be coupled with having to suffer the ongoing symptoms. I am like a dog with a bone regarding issues close to my heart and I really would be prepared to do anything that would improve treatment for as many as possible. Since my own plight, a significant number of folk of various nationalities have approached me relaying the same situation exists in their country. I work in a multi- national environment. I don’t care who thinks my plea is naive. We have to have hope for a better future for sufferers of autoimmune thyroid disease.

[Clutter]

Mara_J,

You are overtly hypothyroid to have TSH 33.9 and FT4 below range. The high TPO antibodies means you have autoimmune thyroiditis (Hashimoto's). How much Levothyroxine has your GP prescribed?

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 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_...

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

thyroiduk.org.uk/tuk/about_...

Ferritin, vitamin D, B12 and folate are severely deficient.

What treatment has your GP prescribed.

[Mara_J in reply to Clutter]

Not on any levothyroxine or any treatment for ferritin or vit D or B12 or folate thanks

[Clutter in reply to Mara_J]

Mara_J,

How long have you had the results?

[Mara_J in reply to Clutter]

2 weeks

[Clutter in reply to Mara_J]

Mara_J,

You should see a GP ASAP for treatment. I would also make a formal written complaint to the practice manager that no-one from the practice has contacted you to make an appointment re treatment for hypothyroidism and severe vitamin and mineral deficiencies.

Initial Levothyroxine dose should be 50mcg - 100mcg. For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

thyroiduk.org.uk/tuk/about_...

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

B12 injections should be initiated 48 hours before starting 5mg folic acid. Your GP should also check intrinsic factor antibodies to confirm or rule out pernicious anaemia causing B12 deficiency. healthunlocked.com/pasoc are the experts on PA, B12 and folate deficiency.

Vitamin D is severely 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 GP prescribed 40,000iu daily x 14 followed by 2,000iu daily x 8 weeks which raised vitD from <10 to 107. Vitamin D should be taken 4 hours away from Levothyroxine.

Ferritin is severely deficient which can indicate iron deficiency anaemia. Your GP should do a full iron panel and full blood count to check.

[Mara_J in reply to Clutter]

IRON 5.8 (6 - 26)

TRANSFERRIN SATURATION 12 (12 - 45)

Only thing flagged up from complete blood count was MCV 80.2 (83 - 98) MCHC 398 (310 - 350) thanks

[Clutter in reply to Mara_J]

Mara_J,

They confirm iron deficiency anaemia for which the treatment is either an iron infusion or 3 x 210mg Ferrous Fumarate. If your GP prescribes Ferrous Fumarate take each tablet with 1,000mg vitamin C to aid absorption and minimise constipation. Iron tablets should be taken 4 hours away from Levothyroxine.