Thyroid UK
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Hi I am 30 years old. I think I have Hashimotos, not entirely sure. I am currently taking 50mcg levothyroxine from 175mcg levothyroxine and I was diagnosed with hypothyroidism in 2012 when I had a TSH of 55.6 (0.2 - 4.2) and FT4 10.7 (12 - 22) my symptoms are dry skin, losing eyelashes, goitre, dry eyes, feeling cold, flaky nails, weight gain, constipation, heavy periods. Current results my receptionist say are normal.

Thank you

TSH 5.01 (0.2 - 4.2)

FT4 14.7 (12 - 22)

FT3 3.0 (3.1 - 6.8)

THYROID PEROXIDASE ANTIBODY 884 (<34)

THYROGLOBULIN ANTIBODY 275.3 (<115)

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Raised TPO and/or TAG antibodies will confirm Hashimoto's. Have yours been tested?

If you post your latest test results with reference ranges members can comment on whether or not you are optimally dosed. 'Normal' just means they are somewhere within the range.

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Added thank you

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Yes, you have Hashimoto's.

Your results aren't 'normal' as TSH is over range. FT3 is below range. You are undermedicated and need an immediate increase in dose. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective ranges if that is where you feel well.

Ask your GP for an increase using the following information to support your request thyroiduk.org.uk/tuk/about_... > Treatment Options

"Dr Toft 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)."

Dr Toft is past president of the British Thyroid Association and leading endocrinologist. You can obtain a copy of the article by emailing Dionne at tukadmin@thyroiduk.org and highlight question 6 to show your GP.

You can help reduce antibodies by adopting a strict gluten free diet and supplementing with selenium L-selenomethionine 200mcg daily.

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Receptionist is a) not a doctor and b) needs to go to Specsavers

TSH is above range and FT3 is below range. You are extremely under medicated

Who reduced your dose from 175mcg to 50mcg?

Dose should only ever be changed by 25mcg maximum

Do you have results from when on 175mcg

You probably were not over medicated

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

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...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

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 make sure Vitamin levels are optimal first. Levo dose increased enough to bring TSH down to around one and FT4 towards top of range

Highly likely to find gluten free diet helps or essential

If FT3 remains low after these steps, then, like many with Hashimoto's, you may need the addition of small dose of T3

Thyroid UK has list of recommended thyroid specialists, some are T3 friendly

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I agree that receptionists sometimes overstep the mark, indeed I have come across quite a few that could put the fear of god into a Rottweiler but having said that a recent blood result of mine actually had tell patient normal under every result. I don’t know who put the instructions on there doctor or lab. (They weren’t by the way.) So sometimes they are reading instructions not results. I now have a lovely receptionist that tells me when my new doctor is on and my life is moving forward at last

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