Thyroid UK
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Hypothyroidism - causes

Hi,

Does anyone know whether Hypothyroidism is always caused by Hashimoto's?

My last TSH reading done by GP was 5.75. I had a MediChecks test done which showed one set of antibodies (TGAb) as quite high (331) but TPO, which is the only one the NHS looks at, was fine.

I haven't had surgery or any other kind of thyroid treatment. Just wondering really if I can assume that it is definitely caused by Hashimoto's. When I look at the NHS symptoms list I don't get cold, don't have constipation, although I do have a lot of other problems on the list such as weakness, fatigue etc. etc.

Sorry this is a bit rambly - just wondering if I really need to do the gluten-free etc. Or even if it hypo can be caused by vitamin deficiences.

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No, it isn't. But either TG or TPO antibodies suggest Hashis (autoimmune thyroiditis). It can also be caused by physical damage or a malfunctioning pituitary or hypothalamus, and I'm sure there are also other causes. Low T3 can be caused by vitamin deficiencies, and they often go hand in hand with Hashis. I'd go gluten free.

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Yes thanks, have recently started gluten free, just wondering if I really need to.

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healthunlocked.com/api/redi...

Link to Izabella - mentioned lower down :-)

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What I've been reading lately suggests around 90% of hypothyroid cases have Hashimotos, so it's possible to have thyroid problems without the auto-immune cause.

I think the statistics are around 85-90% of those with Hashimotos see improvement from cutting out gluten, so it's worth trying. Some also see improvement from cutting out dairy and soya.

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I wish Doctors would explain better, I'm seeing mine on Wed. to follow up on latest test, might ask her but not expecting much info. to be honest.

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Doctors don't tend to see diet as medicine though. It's like people have been saying for years that diet can reverse type 2 diabetes, but doctors don't suggest this as a possibility. Some do, but the majority don't.

Isabella Wentz has some good information on how certain food can be triggers for Hashimotos. It's worth you looking at some of her posts. Lately she's been suggesting we try an auto-immune paleo diet - it eliminates most triggers for about 2 months, and you then reintroduce food groups slowly to see how you get on. It's tough going though, you're basically only allowed to eat meat and vegetables for the whole period.

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Yes, thanks, have heard of this. I'll have a look at what might trigger things. Perhaps Dr's don't like to pursue the diet side of things because everyone is so individual when it comes to how food affects them. Dr's only like the 'one rule for everyone' type stuff.

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They also don't like the idea that gluten is relevant to anything except coeliac or Crohns or that vitamins are relevant to anything at all - each disease belongs in its own little box with its own medicine as a cure.

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I was restricted on the Crohns and Colitis forum for mentioning the benefits of gluten free eating and testing for VitD and B12 .... Only one Administrator there who works for the NHS - ummmm ! Not even allowed to PM people :-(

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Hmmm, they seem to be forgetting the 'forum' part - it's for people to discuss things surely and share experiences etc.

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I was diagnosed over 43 years ago and am drug free - so yes thought I had something to offer - obviously NOT :-(

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You are so right...

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If TPO antibodies are high this is alway Hashimoto's

If TG antibodies are only slightly raised this can be other causes

healthline.com/health/antit...

If very high almost certainly Hashimoto's

Have you had vitamin D, folate, ferritin and B12 tested?

A TSH of 5.75 is much too high.

Are you on Levothyroxine? If so most patients feel when TSH is around (or just under) one and FT4 towards top of range and FT3 at least half way in range

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

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Thanks, yes am on Levo. 75mcg - have just been retested and seeing Dr this Wed. so she may put it up depending on results. They've also done a full blood count so will see what they say about the rest. Medichecks test showed Ferritin to be within normal range but at the lower end.

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VitD needs to be around 100nmol

Ferritin at least 70

B12 at high end

Folate too

How high was TG antibodies?

Gluten free diet is easier than you might think and can be astonishing improvement

Worth a try

If not had dose increased since TSH of 5+ then you need to really push to get 100mcg daily

Watch out for brand change

Always stick on same brand of Levo if possible

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TGab antibodies were 331. Yes, am hoping GP increases to 100mcg. If not TSH will just go into the underactive range yet again so they are just deferring upping the dose!

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TG antibodies that high is likely it's Hashimoto's

You need dose increased

If they are reluctant, ask for a 3 month trial at 100mcg

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Thanks, that’s a good idea.

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