Brain fog

[SammieP87]

I am new is it possible to have brain fog on 25mcg levo I was diagnosed in 2011 with hypothyroid also hard stool and feeling ill and tiredness thank you

[Clutter]

SammieP87,

Sure it is, especially if you are undermedicated which is likely if you've been on 25mcg since 2011. If you post recent thyroid results and ranges I'll advise.

[SammieP87 in reply to Clutter]

No have been on various doses up to 200mcg

TSH 7.2 (0.2 - 4.2)

FT4 8.1 (12 - 22)

FT3 2.2 (3.1 - 6.8)

[Clutter in reply to SammieP87]

SammieP87,

You are very undermedicated on 25mcg and are overtly hypothyroid with TSH 7.2 and FT4 and FT3 so much below range. When was dose reduced and why?

[SammieP87 in reply to Clutter]

Dose reduced in September 2017 because endo says my ongoing symptoms are not thyroid and he asked GP to refer me to psychologist

[Clutter in reply to SammieP87]

SammieP87,

I suggest you complain to the head of endocrinology or the hospital PALS that your endo is not competent to diagnose psychological issues and that such reckless reduction of dose has severely undermedicated you and made you very unwell. Ask to be referred to a different endo.

You need an immediate dose increase via your GP unless you can get an immediate endo appointment.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 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 [e-mail] if you would like a copy of the Pulse article to show your GP.

[cjrsquared]

Have you always been on 25 mcg of levothyroxine? Do you have any recent blood tests with ranges that you can post? Have you had antibodies tested to see if you have hashimoto’s?

25 mcg is a sub therapeutic starting dose for the elderly or those with a pre existing heart condition. Normally people are started on 50mcg then repeat blood tests after 6 weeks and then levothyroxine raised by another 25mcg then repeat bloods after 6 weeks, this cycle is repeated until TSH is around one or symptoms have resolved. So yes I would expect you to have brain fog on such a low dose of levothyroxine.

[SammieP87 in reply to cjrsquared]

No have been on various doses up to 200mcg

TSH 7.2 (0.2 - 4.2)

FT4 8.1 (12 - 22)

FT3 2.2 (3.1 - 6.8)

TPO antibodies 556.3 (<34)

TG antibodies 2000 (<115)

[SammieP87 in reply to cjrsquared]

I think my antibodies are elevated I am not sure

[Marz in reply to SammieP87]

Yes they are - you have Hashimotos.

[Hollygrail]

Well, I m hypothyroid with a right lobe ablated. I was on Synthroid, but it was making me sick. So I've read a lot of scientific research on pubmed.com and followed the recommended solutions for hypothyroid:

1. change of diet to gluten-free/dairy-free and

2. change of lifestyle from inactive (TV, computer) to active (aerobics 3 x w; weight lifting 2 x w; swimming and walking any times a week) and it's work in progress. Altogether with proper supplementation: vit. C, vit. E, fish oil, magnesium, NAC, and more. It works for me!

No more hard stools, bloating, foggy mind, fatigue, weird blood test results that only serve Big Pharma. Losing weight (and swelling), learning how to take care of my body cells needs and coming into health....works!

Try it for a week. Google Gluten and dairy free recipes and start cooking your meals. Get outside and walk every day. Detox with Green Smoothie. Food is good if its alive, fresh and/or lacto-fermented (google it!).

Don't count on your doctor to make you happy and healthy most often he is a sick puppy himself. After all they don't learn about health in med school. They learn about disease!

[SammieP87 in reply to Hollygrail]

Thank you gluten free food is quite expensive and I am doing gluten challenge for coeliac

[SlowDragon Administrator in reply to SammieP87]

Has your GP given you a date for endoscopy?

Maximum you should wait between positive blood test and endoscopy is 6-8 weeks

Did you have a positive coeliac blood test?

If 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 very likely to help reduce symptoms, help gut heal and slowly lower TPO antibodies

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...

You are extremely under medicated make an urgent appointment with GP and request 25mcg Levo dose increase and will need blood retested in 6-8 weeks.

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

You will need to repeat this increase, and retesting several times until TSH is around one and FT4 towards top of range and FT3 at least half way in range

You are extremely likely to have terrible low vitamins being so under medicated

Ask GP to test vitamin D, folate, ferritin and B12 now.

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:
[e-mail]

Also request list of recommended thyroid specialists

Your current endo is useless

Prof Toft - article just published now saying T3 is likely essential for many, otherwise we need high FT4 and suppressed TSH

rcpe.ac.uk/sites/default/fi...

But with Hashimoto's it's essential to get vitamin levels optimal first and very likely essential to be strictly gluten free, even if NOT diagnosed as coeliac

Gluten free diet does not need to be expensive

There's an enormous range of non gluten foods to choose from and supermarket "free from" ranges are growing all the time.

Similar disastrous treatment

healthunlocked.com/thyroidu...

[SammieP87 in reply to SlowDragon]

TPO antibodies 556.3 (<34)

TG antibodies 2000 (<115)

Hashimotos?

[SlowDragon Administrator in reply to SammieP87]

Yes very definitely

TPO is way above 34

[SammieP87 in reply to SlowDragon]

I have positive coeliac blood test no date for endoscopy

[SlowDragon Administrator in reply to SammieP87]

Ring up GP practice and chase.

How long since positive blood test?

If they can't offer a date then perhaps tell them you will just go gluten free regardless

[Clarrisa]

In the states going gluten free is a lot less expensive in the long run than the considerable expense of going to health care providers because of feeling rotten. I have learned that the hard way.

[SammieP87]

This reply is not aimed at anyone and I don't feel completely well right now to complain but how do I do it and get a good outcome? I tried to complain before but I did not get a very nice response from the service I was complaining about