Which brands of Levothyroxine are there please? I was diagnosed hypothyroid in 2013 and have taken the following alone with the reason why I do not get on with each brand.
Mercury - thyroid levels not high enough on this
Actavis - thyroid levels not high enough on this
Teva lactose free - digestive upset on this
Symptoms are upset stomach, dry skin, cold and clammy hands, tiredness, feeling moody, hair loss, swelling in neck, periods very clotty and heavy, breathlessness, muscle cramps, bone pain, joint stiffness.
Thanks in advance
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Alekzandra
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Your TSH is above the range and your frees low or bottom of the range. You need a 25mcg dose increase, test after 6-8 weeks and another increase until your TSH reaches 1 or below or until you're relived from all symptoms. With those levels and levo of 175 you might have absorbcion problems. I'd ask GP to be tested for coeliac.
What about folate, ferritin, vitamin B12 and D? Have those been tested? If not ask to be tested.
800iu is supposed to be a maintenance dose prescribed after vit D is replete >75. Your GP should refer to local guidelines or the cks.nice.org.uk/vitamin-d-d...! My sister's GP prescribed 2 x 20,000iu per week when her vitD was 40. Take vitD 4 hours away from Levothyroxine.
3 x 210mg Ferrous Fumarate is the usual treatment for iron deficiency anaemia. Take each tab-let with 1,000mg vitamin C to aid absorption and minimise constipation. Iron should be taken 4 hours away from Levothyroxine.
Folate is deficient. Once it is established whether or not B12 is deficient your GP should prescribe 5mg folic acid to correct folate deficiency. If you need B12 injections they should be initiated 48 hours prior to taking folic acid.
Presumably you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies?
Your dose of Levothyroxine needs increasing. TSH should be around one and FT4 towards top of range and FT3 at least half way in range
In the past we were routinely given 200-400ncg. Just because GP thinks it's a high dose, doesn't mean it's necessarily high enough for you. You need what you need
Plus your vitamins are dire, this strongly suggests you have gut badly affected and malabsorption
Getting vitamins optimal is essential
Your vitamin D dose is not enough for a mouse. Better You vitamin D mouth spray is good as avoids poor gut function. Perhaps try at 3000iu or 5000iu
B12 and folate so low, you must insist GP tests for Pernicious Anaemia before starting on B12 injections and folic acid supplements. Folic acid supplements should not be started until after first B12 injection.
Ferrous fumerate supplements need vitamin C to aid absorption
Typical Low vitamins due to under medication and detailed supplements advice
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
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
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