Serum Free T4 level 14.8 pmol/L (12 - 22) GP comments - normal no action
Serum Free T3 level 3.3 pmol/L (3.1 - 6.8) GP comments - normal no action
Serum TSH level 4.9 mIU/L (0.2 - 4.2) GP comments - pls make phone appointment
My GP has said my thyroid hormone results are normal, no action. I take 75mcg Levothyroxine and I was diagnosed in 2008. Symptoms are cold hands, dry skin, flaking and splitting nails, constipation, hair loss, puffy eyes, tiredness, memory loss, lack of concentration, no motivation, muscle aches and pains, weight gain. Also symptoms of possible hyperparathyroidism. Thyroid antibody results taken December 2017.
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Pixi89
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can you add your results and ranges for TSH, FT4 and FT3
Your high antibodies conform you have hashimoto's also called autoimmune thyroid disease
Also if you have results and ranges for vitamin D, folate, ferritin and B12 too - add these too - these are often very low with hashimoto's and may need supplementing
Serum ferritin 22 ug/L (15 - 150) GP comments - known fe deficiency pls discuss in clinic
Serum folate 2.35 ug/L (2.50 - 19.50) GP comments - no action required taking folic acid
Serum vitamin B12 241 pg/L (190 - 900) GP comments - no action required receiving B12 injections
Vitamin D total 15.2 nmol/L
(<25 severe vitamin D deficiency. Patient may require pharmacological preparations
25 - 50 vitamin D deficiency. Supplementation is indicated
50 - 75 vitamin D may be suboptimal and long-term may lead to clinical effects. Advise on safe sun exposure and diet. Supplementation may be indicated
>75 adequate vitamin D). All results taken December 2017. I take loading doses for the vitamin D, folic acid 5mg for the folate deficiency, started on B12 injections every 3 months.
Your vitamins are dire because you are under treated for your Hashimoto's (autoimmune thyroid disease)
Your high antibodies confirm you have Hashimoto's
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
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
See a different GP and ask for 25mcg dose increase of Levo
Also ask for coeliac blood test
Bloods will need retesting after 6-8 weeks on new Levo dose
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results
Dose should be increased in 25mcg steps (retesting 6-8 weeks later each time) until TSH is around one and FT4 towards top of range and FT3 at least half way in range
Essential to improve vitamins to optimal levels with supplements
Ferritin must be treated
Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime
Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.
It's not unknown to have pain supplenting vitamin D, it's a sign you have been very deficient.
Magnesium and vitamin K2 are recommended when on high dose vitamin D
Detailed supplements advice from SeasideSusie on Low vitamins due to under medication
Hyperparathyroidism symptoms I have are weakness and fatigue, depression, bone pain, muscle soreness, decreased appetite, feelings of nausea and vomiting, constipation, polyuria, polydipsia, cognitive impairment, kidney stones
Hypoparathyroidism symptoms I have are paresthesia, an unpleasant tingling sensation around the mouth and feet, muscle cramps and severe spasms, fatigue, headaches, bone pain and insomnia, crampy abdominal pain
Have you had your calcium level tested ? Your symptoms can all be a result of low B12, Vitd and you needing a raise in your Levo dose. Some people, me included, cannot tolerate high doses of vitd so best to stay on a low dose you can manage
You cannot have both hyper and hypoparathyroidism. I think you need to sort your deficiencies and thyroid dose, if you are concerned about calcium get that tested.
So definitely not hyperparathyroidism, it's slightly low so you could ask your gp to do a parathyroid and calcium test to check for hypoparathyroidism otherwise if you can increase your vitd and calcium intake the level should improve.
When I was taking a high dose of vitamin D (6000iu with K2 MK-7) a few weeks into the dose my ribs began to ache and I was doubled over in pain. Found it hard to empty my bladder and pass any stools. I suspect I had a build up of calcium in my body. This scared me into no longer taking the vitamin D and so I went back onto the 800iu I was prescribed.
The thing is, you’re undertreated for your hypothyroidism. You need more levothyroxine. Ideally, your doctor should increase your dose every 6 weeks until your TSH is around 1 and your FT4 and FT3 are well up their respective ranges. In range just isn’t good enough but many doctors just don’t seem to know this.
You’re not a hypochondriac - you’re undertreated and therefore that’s why you feel dreadful. Is there another doctor you can see in the practice?
Those symptoms you’re putting down to parathyroid issues are almost certainly a combination of anaemia, low B12, low folate and undertreated hypothyroidism. Please don’t give up - there are better doctors out there but they can be hard to find.
Your FT4 and FT3 is very low. It must be in high range. You have to take more Levothyroxine and ad some T3.
You have to take
- selenium 200mg TOGETHER with vit E (it is working only together!!!)
- high dose of vit D as small doses will not help... I am taking Vitamin D3 5000 IU per day (Solgar) during one year and now it is in normal range.
- vitamins B1,B2,B3,B5,B6,B12
- Vitamin C 1000mg
- Magnesium
- Chromium
- CoQ10
- Omega3 in high dose. You did not make test but for sure it is very low. I take Omega3 950mg EPA & DHA (Solgar) twice a day during one year and now it is in normal range.
Ashwagandha, Ginseng, Ginger root, Curcumin help to reduce antibodies. I take them also. Gluten and lactoza free diet is very important to reduce antibodies!!!!
For leaky gut I take L-glutamine, probiotics, Lactoferrin.
With such results FSH, T4,N3, high antibodies for sure you have problem with adrenal glands. You have to make tests and to heal it together with thyroid!!!! You can not heal just thyroid as it will not help...
Please read also information in below links and it will help you to understand a lot of things
You have to educate your doctor as many seem to have been trained by the same person.
Once diagnosed and given levothyroxine the aim is a TSH of 1 or lower. Unfortunately in the UK doctors have been told to only diagnose if TSH is 10+ but in other countries patients are diagnosed when TSH is 3+.
Doctors make a huge mistake in believing that if the TSH is 'somewhere' in the range their job is done but it isn't until the patient's TSH is 1 or lower. You can tell him this and say you've had advice from the NHS's Healthunlocked Thyroiduk.org.uk.
Also the job of replacement hormones is not to get the results 'somewhere' in range. TSH should be 1 or lower and FT4 and FT3 nearer the top of the range, your FT3 is abysmal and you need dose increases of 25mcg every six weeks till FT3 is closer to 6. Because your FT4 is higher - could it be due to you not converting it sufficiently into T3?
You have an Autoimmune Thyroid Disease called 'hashimoto's.
Do you allow a gap of 24 hours between your last dose of levo and the test? Do you have the earliest possible appointment? TSH is highest then. It should also be a fasting test.
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