Thyroid

[Pebble7]

Hi

I had my dose reduced from 150mcg levo to no levo based on below bloods is this right?

TSH 4.60 (0.2 - 4.2)

FT4 14.4 (12 - 22)

FT3 3.2 (3.1 - 6.8)

Diagnosed 2011 with hypothyroid thankyou

[Spareribs]

Absolutely not! What is your doctor thinking?

Your high TSH indicates your thyroid is struggling, although your FT4 & FT3 are within range they are low. Thyroid medication should never be withdrawn - you must go back & see another GP to continue your prescription - prescriptions are free as they are essential medication.

Report your GP to the practice manager or Endo to the CGP.

This is awful practise. J x

[Pebble7 in reply to Spareribs]

Ok thankyou will do this, it is because I am thin, have trouble sleeping, sweating a lot, getting diarrhoea. It was the GP who stopped my levothyroxine, endo was reluctant to change brands or dose

[Spareribs in reply to Pebble7]

OK your symptoms are similar to being hyperthyroid but your FT4 and FT3 would be high. Have you had B12/folate, iron/ferritin and vitamin D tested too?

[Pebble7 in reply to Spareribs]

Thankyou yes, I have. I was diagnosed iron deficient in 2013, folate deficient in 2016, vitamin B12 low in 2016, vitamin D deficient in 2013. My GP prescribed me 800iu but I did not get on with this. Can post results from beginning to end or just recent ones?

[Spareribs in reply to Pebble7]

recent results would help folk to help you, also antibody tests if you have them.

Low vital minerals are extremely common here and thryoid medication needs them to work properly, especially iron.

Your GP should also investigate if it is anything else, not withdraw it, perhaps change brands as you say, I suppose he's checking if it is the Levo causing symptoms - but lowering the dose would be safer, besides he probably has no alternative to Levo. Many members (including myself) report both sets of symptoms, because it is an autoimmune disease with ups & downs as the thyroid is gradually destroyed.

[Pebble7 in reply to Spareribs]

Thankyou have got high antibodies

Thyroid peroxidase antibodies 607.5 (<34)

Thyroglobulin antibodies 356.3 (<115)

[Spareribs in reply to Pebble7]

You have autoimmune thyroiditis (commonly Hasimoto's) - members report that going gluten free helps lower antibodies. Doctors' treatment will be the same, Levo.

I agree with Clutter - you are undermedicated, you need optimal vitamin levels for the medication to work, vitamins/iron must be taken 4 hours away from Levo.

[Clutter in reply to Pebble7]

Welcome to the forum, Pebble7.

You don't need your endo or GP to change brand. Discuss your symptoms with your pharmacist and ask pharmacist to dispense another brand.

Undermedication can cause insomnia, diarrhoea and sweating. Could also be due to coeliac disease. Endo or GP should arrange a tissue transglutaminase test to rule it out.

Why is your GP interfering with your thyroid medication when you are under the care of a specialist? GP should reinstate your prescription immediately. Contact your endo if GP doesn't do so immediately.

[Pebble7 in reply to Clutter]

Thankyou the endo is not being very helpful with changing dose or brand which is why I am going through GP who then said the results suggest overmedication so it was stopped since the endo was not offering much support

[Clutter in reply to Pebble7]

Pebble7,

Your GP is wrong. Your results indicate undermedication.

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.

[Pebble7 in reply to Clutter]

Ok thankyou

[SlowDragon Administrator]

Definitely do not stop your Levothyroxine. You need higher dose, not less

TSH should be around one (or slightly less) and FT4 towards top of range and FT3 at least half way in range

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: at

[e-mail]

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

Sweating and tremors are often due to low vitamin levels

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 gut connection is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally 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...

Persistent low vitamins with supplements suggests coeliac disease or gluten intolerance

gluten.org/resources/health...

Professor Toft recent article saying, T3 may be necessary for many

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

But with Hashimoto's we must get vitamins optimal first

Levo dose increased until TSH is around one and FT4 towards top of range

Gluten free diet helps or may be essential for many

If FT3 still remains low then, like many with Hashimoto's, you may need a small dose of T3.

Dionne at Thyroid Uk has list of recommended thyroid specialists, some are T3 friendly

[Hidden]

Hashimotos can cause the symptoms you talk off. When your antibodies are high and therefore attacking your thyroid, a lot of thyroid hormone can be dumped into your system causing these kinds of symptoms. Read Izabella Wentz book, the Hashimotos Protocol, it has helped me so much. I hope you start to feel better soon x

[Hormone-mess]

I had horrendous sweating before I was diagnosed hypothyroid. Many people have a multitude of symptoms and they’re not always text book symptoms. You may want to have your adrenal glands checked. Order your own saliva cortisol test. Many times an increased TSH results in a cortisol increase as well.

ncbi.nlm.nih.gov/pmc/articl...