New diagnosis

[sad_and_blue]

I am new and given a new diagnosis of depression/anxiety due to bloods of

TSH 4.65 (0.2 - 4.2)

FT4 14.5 (12 - 22)

FT3 3.3 (3.1 - 6.8)

TPO antibody 3470 (<34)

I am tired, anxious, sad, aching, have headaches and pains in bones.

Taking 50mcg Levo, diagnosed 2011 with hypothyroid.

Comments welcome.

[SlowDragon Administrator]

You are extremely under medicated

50mcg is standard starter dose. It should be increased in 25mcg steps until TSH around one and FT4 towards top of range and FT3 at least half way in range

Make an urgent appointment to see GP and ask for 25mcg dose increase

Bloods retested 6-8 weeks after each dose increase

Ask for vitamin D, folate, ferritin and B12 to be tested. Highly likely to be extremely low

See this Detailed advice on Low vitamins due to under medication from SeasideSusie

healthunlocked.com/thyroidu...

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]

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...

[sad_and_blue in reply to SlowDragon]

Ferritin 11 (30 - 400) on 1 iron tablet

Folate 1.5 (4.6 - 18.7)

Vitamin D 16.6

Vitamin B12 191 (190 - 900)

[SlowDragon Administrator in reply to sad_and_blue]

When were these done

What has GP prescribed?

If nothing see a different GP

They are terrible because your Hashimoto's is not correctly treated

[sad_and_blue in reply to SlowDragon]

Jan 2018. I only take 1 iron tablet.

[SlowDragon Administrator in reply to sad_and_blue]

You need full iron panel

At least 3 x daily ferrous fumerate but really insist on iron infusion

Loading dose of vitamin D required

Testing for Pernicious Anaemia before starting B12 injections

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

[SlowDragon Administrator]

Here's detailed reply to another similar case this afternoon

healthunlocked.com/thyroidu...

You are now about the 10th just today

The NHS either can't cope or has collapsed

[crimple]

Isn't it about time there was a campaign to teach doctors how to read bloods results. It can't just be thyroid patients who are suffering. When results come back from the lab who sees them? Is it A receptionist who inputs the results when dealing with patients at reception. When does the GP see them? It is really getting desperate for everyone. What is the point of doing tests if the results are ignored/ no action taken. It's criminal negligence and it has to stop. Any suggestions anyone?