Chronic fatigue

[jenna49]

Can you have chronic fatigue with Hashimotos

TPO antibodies 1300 (<34)

Diagnosed hypothyroid 2010

Thanks

[Clutter]

Jenna49,

Do you have TSH, FT4 and FT3 results and ranges? You will certainly be fatigued if you are undermedicated.

[jenna49 in reply to Clutter]

TSH 5.6 (0.2 - 4.2)

FT4 14.7 (12 - 22)

FT3 3.3 (3.1 - 6.8)

[Clutter in reply to jenna49]

Jenna49,

You are undermedicated to have TSH 5.6 and FT4 and F3 low in range. Ask your GP to increase dose.

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 [e-mail] if you would like a copy of the Pulse article to show your GP.

Thyroid peroxidase 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_...

[jenna49 in reply to Clutter]

Thank you endo does not want to increase dose, he says I take enough

[Clutter in reply to jenna49]

Jenna49,

How does he explain TSH over range? Why don't you feel well if you are adequately dosed?

I suggest you insist on a dose increase or find a new endo. Your fatigue is due to undermedication not chronic fatigue.

The last thing you want is a diagnosis of chronic fatigue. If you have CF on your notes it's like being thrown in a medical dustbin and everything wrong with you for the rest of your life will be dismissed and attributed to CF.

[SlowDragon Administrator]

Your TPO antibodies are very 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...

For full evaluation you ideally need TSH, FT4, FT3, TT4, plus vitamin D, folate, ferritin and B12 tested

See if you can get full thyroid and vitamin testing from GP. Unlikely to get FT3

Private tests are available

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

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

[jenna49 in reply to SlowDragon]

TSH 5.6 (0.2 - 4.2)

FT4 14.7 (12 - 22)

FT3 3.3 (3.1 - 6.8)

FERRITIN 16 (15 - 150)

FOLATE 2.2 (2.5 - 19.5)

VITAMIN B12 237 (190 - 900)

VITAMIN D TOTAL 36.1 (25 - 50 deficient)

[SlowDragon Administrator in reply to jenna49]

You need to email Thyroid UK and ask for list of recommended thyroid specialists

Your current endo is most likely a Diabetes specialist, doesn't know how to treat Hashimoto's

Your results show you are extremely under medicated

How much Levo are you currently taking?

Are you by any chance thin or petite - medics find it harder to belive that thin people are hypo

Dose should be increased in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Bloods should be retested 6-8 weeks after each dose increase

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

Your vitamin levels are really terrible, because you are so under medicated

Your GP should be treating these.

What if anything have you been prescribed

Here is post showing Low vitamins due to under medication and detailed supplements advice from SeasideSusie

healthunlocked.com/thyroidu...

Make an appointment with GP and ask for 25mcg dose increase and for vitamins to be correctly treated and for coeliac blood test.

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]

[jenna49 in reply to SlowDragon]

50mcg levothyroxine, I am petite yes

[jenna49 in reply to SlowDragon]

Endo says 50 is adequate dose

[SeasideSusie Remembering in reply to jenna49]

Endo is an idiot. You need as much as you need. 50mcg is a starter 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 reference ranges if that is where you feel well. Endo is very likely a diabetes specialist (most of them are) who is clueless about treating Hypothyroidism.

[mauschen]

In my experience, yes, Hashimoto can cause extreme fatigue (probably due to the inflammatory nature of the disease) as well as many other symptoms such as increased heart rate and concentration disturbances.

I was diagnosed primary hypothyroid in 2011 and Hashimoto in 2016. my doctors now ignore the primary Hypothyroidism diagnosis and only write about Hashimoto‘s in their reports. These are two separate conditions but someone needs to explain this to the doctors we are supposed to trust to treat us.

Others have given you good advice. Your bloods are extremely abnormal and no doubt your body is responding to this abnormal situation, take their advice and discuss it with your doctor, get a second opinion if necessary. However, most importantly, take charge and get yourself on the road to recovery.

Good luck, take care and get better soon!