Hi, I'm looking for some advice on these levels?
Dec 2017
Thyroid peroxidase antibody 488.5 IU/mL (<34) ? thyroid disease
Thyroglobulin antibodies 671.4 IU/mL (<115) ? thyroid disease
Symptoms are goitre, dry skin and eyes, tiredness, headaches, weight gain, feeling cold, muscle cramps and spasms, heavy periods, breathlessness, low appetite. Thanks!
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's
Have you had TSH, FT4 and FT3 tested too? Post results and ranges if you have them
Essential to test vitamin D, folate, ferritin and B12.
Always get actual results and ranges.
Post results when you have them, members can advise
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...
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Dec 2017
TSH 6.1 mIU/L (0.2 - 4.2) pls arrange phone appointment
FT4 14.7 pmol/L (12.0 - 22.0) normal no action
FT3 3.2 pmol/L (3.10 - 6.80) normal no action
50mcg levothyroxine diagnosed 2013
Weston, what date were these blood tests done?
You need an increase in dose. Have you seen your doctor since having these results?
Did you have the nutrients tested also?
Vitamin D, Calcium, B12, Folate and Ferritin.
Always give dates of blood tests and any comments.
Dates added for both
And comments added now too
For some reason doctor won't increase.
Other levels are
Dec 2017
Ferritin 17 (15 - 150) normal no action
Folate 2.1 (2.5 - 19.5) slightly under range no action required
Vitamin B12 220 (190 - 900) normal no action
Vitamin D total 54.2 (50 - 75 vitamin D suboptimal. Advise on safe sun exposure and diet) normal no action
Calcium 2.25 (2.20 - 2.60) normal no action
Calcium adjuted 2.25 (2.20 - 2.60) normal no action
I take 800iu D3 and ferrous fumarate
See a different GP you need dose increase by 25mcgs, retesting after 6-8 weeks. Likely to need further increases
Your vitamins are all far too low, because you are under medicated
Hypothyroid leads to low stomach acid and then low vitamins
Detailed supplements advice from SeasideSusie for Low vitamins due to under medication
healthunlocked.com/thyroidu...
Ask second GP for full iron panel and coeliac blood test
Vitamin D you need to self supplement
B12 they should test for Pernicious Anaemia before offer B12 injections, but patients are waiting months for B12 so you may as well just supplement if they won't
drgominak.com/sleep/vitamin...
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
Prof Toft - article just published now saying T3 is likely essential for many
rcpe.ac.uk/sites/default/fi...
With Hashimoto's we need to correct low vitamin levels first
Increase Levo until TSH is around one and FT4 towards top of range
Very likely strictly gluten free diet helps or is essential
If after all these steps FT3 remains low then, like many with Hashimoto's you may need addition of small dose of T3
Haemoglobin 115 (115 - 150) normal no action
MCH 28.1 (28 - 32) normal no action
Iron 5.7 (6.0 - 26.0) slightly below range no action required
Transferrin saturation 12 (12 - 45) normal no action
MCV 83.1 (83 - 98) normal no action
MCHC 365 (310 - 350) abnormal action required
I don't know much about iron
Will tag in humanbean and SeasideSusie
Hopefully they can comment
Westonj,
You are undermedicated to have TSH 6.1 on 50mcg and need a dose increase.
The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 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_... Email dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.
Thyroid peroxidase and thyroglobuline 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_...
Most of your symptoms will be due to undermedication but heavy periods can also be due to low iron so ask your GP to check ferritin, vitamin D, B12 and folate which are commonly low in hypothyroid patients.
Muscle cramps can be caused by low magnesium. You can supplement magnesium citrate (take at night 4 hours away from Levothyroxine) to relieve cramps and/or use magnesium oil spray on your skin or take Epsom Salt baths.
Dec 2017
Ferritin 17 (15 - 150) normal no action
Folate 2.1 (2.5 - 19.5) slightly under range no action required
Vitamin B12 220 (190 - 900) normal no action
Vitamin D total 54.2 (50 - 75 vitamin D suboptimal. Advise on safe sun exposure and diet) normal no action
I take 800iu D3 and ferrous fumarate
Westonj,
Ferritin is optimal halfway through range. If your GP won't prescribe iron I would buy Ferrous Fumarate and supplement 2 x 210mg. Take each iron tablet with 1,000mg vitamin C to aid absorption and minimise constipation. Take iron 4 hours away from Levothyroxine.
VitD 800iu is a maintenance dose to be prescribed when vitD is replete ie >75. I would supplement 5,000iu D3 daily x 6 weeks then reduce to 5,000iu alternate days and retest in April. Take vitD 4 hours away from Levothyroxine too.
Folate is deficient. Your GP should prescribe 5mg folic acid for 2-3 months.
B12 is low. If you have symptoms in b12deficiency.info/signs-an... go to healthunlocked.com/pasoc for advice and if B12 injections are recommended hold off taking folic acid until 48 hours after the first B12 injection.
Have you had the phone appointmentioned with GP?
Has a presription been left for you to increase dose to 75mcg.
You will need another test in 6 weeks and may be increased further.
You could also ask GP to tests those nutrients refered to. You may have deficiencies which require supplementation.
Hi I tried to get levo increased but doctor won't do it. I have posted nutrient levels somewhere. Thanks
Ask GP to test for Pernicious Anemia.
Ask GP for an urgent referal to an Endocrinologist - you have symptoms.
Take someone with you if possible when you see GP.
Also take a written list of your symptoms.
Hi I am under an endocrinologist and he has given me a diagnosis of general anxiety disorder. I do not agree with this diagnosis. He has also told my GP of the diagnosis, too
We hear that c***p all the time
See a different endo this one is probably a Diabetes specialist, clearly knows nothing about Hashimoto's
Email Thyroid UK for list of recommended thyroid specialists
please email Dionne: tukadmin@thyroiduk.org
How long does ferrous fumarate take to replenish levels. Have been on it since 2011. Maybe best to post as another question?
Level doesn't recover because your Hashimoto's is not correctly treated
Changing to strictly gluten free diet will likely help
WestonJ,
If it hasn't managed in the past six years, I wouldn't expect it to in the next six years. 
There are several possible reasons:
Not taking enough;
Not absorbing enough;
Losing too much.
It is frequently recommended that you take vitamin C (ascorbic acid) along with anything like ferrous fumarate as it helps with absorption.
I often suggest trying other iron-containing supplements like ferritin (yes, as a supplement) and/or haem (heme) iron. Or ordinary liver (I prefer lambs liver).
Have a quick look at this document:
I would fight having generalised anxiety put on your records
Similar c***p diagnosis to others just in last few weeks
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
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