TSH and ferritin

[NikkiB90]

I am new and have been told my TSH and ferritin are now normal. I take 25mcg thyroxine diagnosed with hypothyroidism in Nov 2017 thank you

JAN 2017

Ferritin 15 (15 - 150)

TSH 4 (0.2 - 4.2)

[Nanaedake]

Neither of these are in a good range for someone with a thyroid condition taking Levothyroxine. You need a Levothyroxine dose increase and retest in 6 weeks. The adjust and retest and so on until your TSH is around 1 or a little lower which is where most people feel well. Ferritin needs to be 70 or mid range for good thyroid hormone function.

[NikkiB90 in reply to Nanaedake]

Thank you my GP is reluctant to increase since I am thin and that I no longer need iron despite having heavy periods

[Angel_of_the_North in reply to NikkiB90]

Your doctor is an idiot. Having good thyroid function doesn't make you thinner in fact it may make you nearer to a normal weight if you are skinny as you need it to absorb nutrients from your food. How can ferritin right t the bottom of the range be OK? If he won't prescribe, buy 210mg ferrous fumarate from a pharmacy (you don't need a prescription from most pharmacies including Tesco) and take 3 a day. Show your doctor a copy of the Dr Toft Pulse article or try to see a different doctor.

[NikkiB90 in reply to Nanaedake]

Also ears ringing, tiredness, cramps in legs, bone pain, dry skin, hair falling out, dizziness, depression and memory loss

[Clutter]

NikkiB90,

You are undermedicated to have TSH 4 and should ask for Levothyroine dose to be increased to 50mcg.

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.

Low ferritin can indicated iron deficiency anaemia. Has your GP checked full iron panel and full blood count? Heavy periods are a symptom of iron deficiency anaemia.

[NikkiB90 in reply to Clutter]

MCV below range MCHC below range haemoglobin below range iron below range

[Clutter in reply to NikkiB90]

NikkiB90,

They confirm iron deficiency anaemia. Your GP should arrange an iron infusion or prescribe 3 x 210mg Ferrous Fumarate. Take each tablet with 1,000mg vitamin C to aid absorption or minimise constipation. Take iron 4 hours away from Levothyroxine.

[SlowDragon Administrator]

On Levothyroxine we need TSH towards the lower part of the range, usually between 0.2-1.0

You are extremely under medicated to have TSH so high

You are likely to have high thyroid antibodies. Have you had these tested? If not ask GP to do so.

If antibodies are high this is Hashimoto's also called autoimmune thyroid disease

Ears ringing is likely low B12 - also very common when under medicated

Hypothyroidism affects gut function, and can result in gluten intolerance or coeliac

Both can cause weight loss or difficulty maintaining weight

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

Your ferritin is dire. Vitamin D, folate and B12 likely far too low as well

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

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...

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]

Typical Low vitamins due to under medication and detailed supplements advice on how to improve

healthunlocked.com/thyroidu...

See a different GP in practice if necessary.