Hyperthyroid & Graves - depleted vitamin and mineral levels?

[MissZP]

Hi

Diagnosed Hyperthyroid July 2017 Results at diagnoses were Free T4 88! (Range 11-25), still not seen an endo. Levels currently at Free T4 27.9. I haven’t had a lot of information and only two appointments with GP (who is now on maternity leave). All information has been gleaned from this forum and online. I’ve heard a lot of talk of depleted vitamin and mineral levels after being hyperthyroid. I don’t want to start taking supplements without knowing for sure which ones might be needed. Just wondering if GP would be willing to test levels or if I’d have to go through Blue Horizon? What experience has anyone else had if this? Thanks

[Rmichelle]

Hi there i had my iron levels requested at gp appointment back in july and also vit d, also requested another full iron panel today from gp, ferritin, serum folate etc. I think everyone will tell you that iron levels need testing and vitamin d but others will be along who are more ecperienced.x😊

[Hennerton]

Are you on Carbimazole? Have you been diagnosed as having Graves'disease? Did they check antibodies? Is there another GP in your practice who can take control of this? Sounds as though your current GP is useless. Yes, they should definitely do tests for you, in particular iron and ferritin are probably depleted, plus ask for Vit D, B12 and folate. They should test your free T3, as well as the usual TSH and T4 and all antibodies, just to be sure you really do have Graves and not Hashimotos. When you have results, post here with reference ranges and members can help. If I were you I would be chasing up the endo appointment. It is very wrong that you have not been seen yet.

[MissZP in reply to Hennerton]

Hi Hennerton,

Thanks for your reply, yes I am on Carbimazole, 30mg daily at the moment. As far as I am aware no antibodies have been tested. My optician diagnosed Thyroid Eye Disease (TED) in a routine appointment after I reeled off a list of symptoms and said I was worried about my bulgy eye. To be fair he wrote to my GP asking about referral guidelines because he hadn’t seen anyone with the condition in a long time. GP responded by saying that they wouldn’t refer to an ophthalmologist until thyroid levels are under control. My argument with that is I still have eye symptoms that need addressing. So the Graves’ disease is what I think I have, not the diagnoses of a professional. Obviously I could be wrong and it needs further investigation.

I’m seeing another GP in a couple of weeks and I’ve got a list of questions that I want answered.

Thanks for replying, take care.

[Valarian in reply to MissZP]

I would definitely see whether the other GP can get you bumped up the list with the endo. TED is most commonly associated with Graves’, so it does seem likely this is what you’ve got. An endo would have tested T3 and antibodies. T3 can take longer to come down than T4, so needs to be monitored independently, and antibodies will confirm Graves’, although the existence of TED makes this more likely anyway .

I don’t know whether they would actively begin treating TED before your thyroid levels are in range, but I get asked about my eyes at every endo appointment, so I think they would at least be monitoring them . If you post again (or amend the title of this post) with TED in the title, someone with TED may respond. One thing that seems clear with TED (or indeed, Graves’) is the need to give up smoking, so if you do smoke, it would be worth asking your GP for support for giving up

Re the vitamins - the biggest hit to Graves’ sufferers from the nutrition perspective is probably fast “transit time” due to increased metabolism, which may have caused you to lose weight. The next biggest hit is possibly that you can develop a huge appetite to keep up with your metabolism, and begin eating loads of junk. It can be difficult to revert to good habits as your metabolism comes back to normal, so making sure you are eating a well- balanced diet should be a priority. There is a suggestion that selenium supplements help with TED, but someone with TED will be better-placed to advise on this btf-thyroid.org/information... . They don’t routinely offer vitamin tests to hyper patients, but you could go down the private route if your GP won’t order them .

[MissZP in reply to Valarian]

Hi Valarian

Thank you so much for your detailed response.

I am going to push the GP to chase the endo, also see if there are any drops or anything that can help with the eye symptoms, I understand that treatment might not be appropriate at the moment while T4 levels aren’t stable. I don’t smoke.

I have had my T3 tested twice since being diagnosed, it’s still high and over range.

I’m working on the diet! I have gained all the weight I lost before being diagnosed even though my appetite has decreased and I’m eating a lot less than I was. I’m trying to make sure it’s a balanced diet.

Thanks for the advice, take care.

[Rmichelle]

7 months on is a long time but not unusual in my area of shropshire it is around that length of tim, i asked to go out of area, i was also diagnosed in july and my 1st app was october and just had my 2nd but having said that, i got in quick and seen 2 endos who are rubbish, so being referred to another area. Good luck and chas your appointment as it may have got missed.xx

[MissZP in reply to Rmichelle]

Hi Rmichelle,

Thank you for your replies, I have been chasing GP but to no avail. I’ve got an appointment in the next couple of weeks with another GP, so hopefully I’ll have more luck with them. Take care.

[Gambit62]

Being hypothyroid can lead to absorption problems for a number of minerals and vitamins - generally iron seems to be the first one to surface.

Personally I'd try to work with your GP if possible to ensure that you get monitored regularly rather than jumping to supplementation - particularly very high dose supplementation - as it could mask other developing problems (and possibly even create problems in a few cases).

You also need to be aware of the limitations and interpretation of results if you are trying to monitor yourself (though there is no guarantee that your GP will necessarily have a good understand. Ferritin is generally a good measure of iron deficiency but really it's a flag to gathering more information to diagnose a deficiency. Serum B12 has similar caveats.

Lots more information on B12 and folate on the PAS forum

healthunlocked.com/pasoc

[MissZP in reply to Gambit62]

Hi Gambit62

Thank you for replying. I’m actually HypErthyroid, not hypo. I’m not looking to go off piste and start supplementing myself, my original question was if the NHS guidelines advise GPs to run these tests or if a request to have these tests done will be met with resistance. That’s what I meant, sorry maybe I wasn’t clear.

Thanks for the info and the link, my mother has pernicious Anaemia so it’s sonething I’ve been looking into recently.

I’ve got an appointment with another GP soon so hopefully I’ll be able to get some more information from them.

Thanks and take care.

[Gambit62 in reply to MissZP]

the mechanisms by which thyroid causes absorption problems seems to be several and may or may not apply to different individuals

- hyperthyroidism, can, I believe result in fast transit which, I also believe, can have the same consequences in terms of an increased risk of SIBO as hyperthyroid.

Another possible cause is PA - auto-immune gastritis - nobody is quite sure why there is such a high overlap but one theory that I quite like because it sounds really sensible is that because the cells that form the gut start out being the same as those that form the thyorid - if you have an auto-immune thyroid condition it doesn't take much modification for the anti-bodies to start attacking your gut as well.

As far as I am aware the current NHS guidelines don't recommend monitoring of mineral and vitamin levels as a matter of course in the case of thyroid problems. Given how poorly most GPs understand the tests and interpretations not sure that it would be a cost effective way for the NHS to go at the moment - the benefits would only come if GPs really knew how to interpret the tests - and think the labs have a long way to go in supporting that ... let alone the education process.

[MissZP in reply to Gambit62]

Hi Gambit62

Thanks for your detailed response. Very interesting info regarding the gut cells, seems sensible.

Take care