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
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
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
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?
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