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Thyroid UK
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Seeking advice please Thyroid

Seeking advice please Thyroid

Hi I am new to this forum and I have had problems with hypothyroid symptoms for the past 3 years. They include heart resting heart rate of between 40-50bpms bloated stomach pains. very heavy periods, missed periods. episodes of fainting due to low blood pressure. episodes of feeling depressed and low energy. Low libido.

I have been to NHS go several times and they keep saying the same things that thyroid is in range etc.

I went to a private clinic to have my blood results taken and the private GP believes I have Hypothyroidism and would like to get my T4 upto higher range 22.

He prescribed me 50mcg levothyroxine and will take blood tests in 6 weeks and also test t3 and antibodies for autoimmune disease. Also he said I had to cut out Gluten from diet. I had to pay private prescription and also the medication.

I booked an appointment with NHS GP to show results of private bloods. However he said that he did not agree about the Hypothyroid diagnosis and would like to do a 24 hour ECG test and for me to take iron and take bloods again in 3 weeks as he was concerned about my high ESR result of 68mm/hr range 1-20

Because of this I didn't feel like I could tell the NHS GP that I have been taking 50mgs of Levothyroxine for the past week I felt I have been doing something wrong now because of this and do not know what do now.. Stop taking the Levothyroxine and await what NHS GP says after blood test and ECG results or keep seeing the private GP and getting Levothyroxine private prescription.. If i do this what happens if I can no longer see the private GP for whatever reason..

Or I go back to the NHS gp after blood tests and tell them I have been prescribed the Levothyroxine which I feel they will be strongly upset about??

The results of my bloods are:

FULL BLOOD COUNT

Result Name

Result Value

Result Units

Reference Range

Status

HAEMOGLOBIN (g/L)

116

g/L

115 - 155

HCT

0.344

0.33 - 0.45

4 Replies
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Kloppsandrobbers,

I think your private GP is right to prescribe 50mcg Levothyroxine to raise FT4. Low-normal TSH with FT4 at the bottom of range indicates secondary/central hypothyroidism which is caused by pituitary or hypothalmic dysfunction failing to issue sufficient thyroid stimulating hormone (TSH) to produce T4 and T3 hormone.

Ask your NHS GP to consider secondary hypothyroidism and refer you to endocrinology as NICE recommends cks.nice.org.uk/hypothyroid... Endocrinology should investigate whether TSH deficiency is isolated or whether sex and growth hormones are also deficient. Levothyroxine is the correct treatment for secondary/central hypothyroidism.

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Doctors are like many other professionals, you will get conflicting opinions, there is no one absolutely correct course of action. There is the best course of action for you. Your current nhs doctor doesn’t perceive that there is a problem, whilst your private gp is prepared to take a different view. You cannot continue to follow both sets of advice simultaneously, as both will feel professionally slighted that you were not following their advice and doing something different behind their back. It will also invalidate any of the tests that the other does. You need to decide who you are going to give a chance too then stick with it for a period of time. If after 3-6 months you feel no improvement by all means then go back to the other doctor, be honest about the treatment you have had, and then try a different approach. I’m sorry there is no straightforward answer. Please search this site as there is some fabulous information from many experienced people. I wish you better health.

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

Essential to test for thyroid antibodies and FT3

Your FT4 was very low, possibly FT3 was too low. It should have been tested

Low vitamins can cause similar symptoms to low Thyroid and should have been tested first really

You could see if you can get thyroid antibodies and vitamin testing from GP.

But you might want to keep a low profile until you get more results

The problem is you don't want to do any thyroid tests until 6 weeks after being on the 50mcg.

Or, if you did decide to stop the Levothyroxine, you would need to wait at least 6-8 weeks before retesting to get a base level

You could just test antibodies and vitamins now. Though it's probably cheaper to get TSH, FT4 and FT3 tested anyway. Plus you never had FT3 tested

If you could wait to 4-5 weeks on Levothyroxine you would get a good idea if it's helping and a reasonably accurate result

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

Link about antibodies

thyroiduk.org.uk/tuk/about_...

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Heavy periods are classic sign of being hypothyroid and will very often cause low ferritin

List of hypothyroid symptoms

thyroiduk.org/tuk/about_the...

If you have high antibodies, this is Hashimoto's also called autoimmune thyroid disease

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

Ideally you would GP for coeliac blood test first but you can get coeliac blood test online for about £25

Persistent low vitamins with supplements suggests coeliac disease or gluten intolerance

gluten.org/resources/health...

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...

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thank you so much for your replies

the private gp said exactly that clutter that my tsh should be higher which indicates an issue with the gland

also told me t go gluten and dairy free

and i am having an antibodies test in a few weeks

i think maybe i should stick with the private gp as this has been going on for years and he seems to know what he is doing and more than that shows a real interest

hopefully things will improve i already am brighter i was so unwell

many thanks x

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