Newbie

[JADYZ]

Hi I have pernicious anaemia and also take vit D. Could someone please advise what these are. Haematologist says I have autoimmune thyroiditis?

TPO antibody 198 (<34)

TG antibody 258.3 (<115)

Thanks in advance.

[Mary-intussuception]

They are Thyroid Antibodies Thyroid Peroxidase and Thyroglobulin.

Yes -

It's called Hashimoto's Autoimmune Thyroiditis - named after the Japanese doctor who discovered it.

Have you any symptoms?

Are you having Thyroid Function Blood tests ie: TSH, FT3 and FT4?

The body's immune system (antibodies ) is attacking the healthy tissue of the Thyroid Gland, which means the Thyroid gland doesn't work as well as it should - becomes Underactive. Doesn't produce enough of the hormone Thyroxine. So the Pituitary Gland overworks producing more Thyroxine Stimulating Hormone than it should.

Hashimoto's Autoimmune Thyroiditis is the cause of Hypothyroidism in most cases.

Every cell in the body needs Thyroxine to function properly. That's why we suffer many symptoms.

Are you having symptoms?

Is Haematologist refering you to the Endocrinologist?

[JADYZ in reply to Mary-intussuception]

Oh sorry I forgot to include TSH and FT4 and FT3.

TSH 4.7 (0.2 - 4.2)

FREE T4 12.4 (12 - 22)

FREE T3 3.1 (3.1 - 6.8)

Symptoms I have lived with for as long as I can remember. Cold intolerance, numb feet, dry skin, hair loss, tiredness, puffy eyes, weight gain, sweats, depression, memory loss.

Haematologist is not referring me to endocrinologist.

[Mary-intussuception in reply to JADYZ]

Why not? Is Haematologist going to treat you , if not -

Could you ask Haematologist to refer you.

Are your Pernicious Anemia and Vitamin D deficiency being successfully treated?

Ask GP to address your symptoms .

Also ask for tests to check your Adrenal Function.

[JADYZ in reply to Mary-intussuception]

As far as I know, I am being correctly treated for the vit D deficiency. I am having weekly vitamin D loading doses before being moved to a maintenance dose. I have B12 injections every 3 months since my B12 is ok-ish. Will ask tests for adrenal function and ask my haematologist to refer me.

[Mary-intussuception in reply to JADYZ]

Once you have been told your Adrenals are OK you should be started on 50mcg Levothyroxine. Thyroid tests should be repeated in 6 weeks and dose increased by 25mcg. This should be repeated again after another 6 weeks until you are stable, your TSH down below 2 and your symptoms improved.

You also need Folate, Ferritin and Calcium tested. Were these done with the others? Are they OK?

[Nanaedake in reply to JADYZ]

TSH 4.7 (0.2 - 4.2) Your TSH is above the top of the laboratory range showing that you need a levothyrxoine dose increase. You are undermedicated and some of your symptoms could be attributed to this. Increase your levothyroxine dose by 25mcg and retest in 6 weeks time and adjust dose then retest in 6 weeks and so on until you reach a TSH of around 1 or a little lower which is where most people feel well. TSH is a pituitary hormone. When we have insufficient thyroid hormone in our body the pituitary gland signals the thyroid to produce more and so TSH rises as in your case here.

FREE T4 12.4 (12 - 22) As you can see your FT4 is right at the bottom of the range. This shows you do not have enough T4 to convert into T3 which is the active thyroid hormone that our cells, heart and brain need. FT4 is best in the top third of the range.

FREE T3 3.1 (3.1 - 6.8) Your FT3 is insufficient as it is right on the bottom of the range showing that your body is unable to convert enough T3 from T4. You will inevitably have symptoms and feel ill with FT3 this low. This evidences your need for more thyroid hormone.

Please do post your vitamin levels if you would like helpful suggestions. You may not be optimally treated and low vitamin levels prevent effective conversion of T4 to T3. Problems absorbing vitamins from food are common with thyroid conditions. Autoimmune thyroiditis also makes people more prone to other autoimmune conditions.

[Gambit62]

if you are on B12 shots then you probably have Pernicious Anaemia - an autoimmune condition - lot more about it on the PASoc forum

healthunlocked.com/pasoc

40% of people with PA seem to go on to develop autoimmune thyroiditis

[SlowDragon Administrator]

You need to start on Levothyroxine. Your results show you have Hashimoto's also called autoimmune thyroid disease

Standard starter dose is 50mcgs. Bloods retested after 6-8 weeks and dose increased in 25mcg steps until TSH around one and FT4 towards top of range and FT3 at least half way in range

Your vitamins are terrible because of Hashimoto's

You need ferritin sorted. Probably need more frequent B12 injections, ask on PAS healthunlocked

Folic acid supplements

Adding a good vitamin B complex daily is recommended

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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]

Prof Toft - article just published now saying T3 is likely essential for many

rcpe.ac.uk/sites/default/fi...

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...