Is this Hashimotos

[JayeT]

TPO antibodies 3073 (<33)

TG antibodies 446.5 (<115)

Ferritin 47 (30 - 400)

Folate 2.2 (2.5 - 19.5)

Vitamin B12 199 (180 - 900)

Vitamin D 20.1

New member

Taking 210mg iron, 5mg folic acid, vit D 800iu

Thanks

[SeasideSusie Remembering]

Yes it is. Have you had a diagnosis of hypothyroidism and been started on Levo? What were your TSH, FT4 and FT3?

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. Have you had Vit D, B12, Folate and Ferritin tested? If not you need to ask about them.

[JayeT in reply to SeasideSusie]

Diagnosed 2013 with hypothyroid, taking no levo. I supplement vit D, folate and B12

TSH 4.55 (0.27 - 4.20)

FT4 14.8 (12 - 22)

FT3 3.6 (3.1 - 6.8)

Thanks

[SeasideSusie Remembering in reply to JayeT]

If you were diagnosed hypo in 2013 why aren't you taking any Levo.

If you post your nutrient levels and what you supplement, we can see if you are taking enough.

[JayeT in reply to SeasideSusie]

I was taking levo with the above results but have been getting sweats and insomnia. 25mcg

Thanks

[SeasideSusie Remembering in reply to JayeT]

The sweats and insomnia could be 'hyper type' symptoms you get with the fluctuations that occur with Hashi's due to the antibody activity. I believe it could also be due to undermedication and 25mcg is a minute dose, just a starter dose for children, the elderly or people with a heart condition.

Have you ever been on a higher dose?

[JayeT in reply to SeasideSusie]

Yes 175mcg can post these if needed

[SeasideSusie Remembering in reply to JayeT]

Yes please. Post as much as you have so we can try and understand what your doctor is playing at.

[JayeT in reply to SeasideSusie]

Ok they were

TSH 1.20 (0.2 - 4.2)

FT4 19.3 (12 - 22)

FT3 4.0 (3.1 - 6.8)

[SeasideSusie Remembering in reply to JayeT]

So on 175mcg Levo your results were

TSH 1.20 (0.2 - 4.2)

FT4 19.3 (12 - 22)

FT3 4.0 (3.1 - 6.8)

Was it these results that prompted the reduction in dose to 25mcg? If so what reason was given?

You haven't posted your vitamin and mineral levels and dose of supplements yet.

[JayeT in reply to SeasideSusie]

I posted vitamins and minerals into my post about 5 mins ago.

No my dose was gradually reduced to 25mcg, can give results of all dose changes

Thanks

[SeasideSusie Remembering in reply to JayeT]

I didn't know you had edited your original post. When I click on my notification it brings me direct to your reply, not the beginning of the thread.

Ferritin 47 (30 - 400) Taking

210mg iron

For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range.

If you are only taking 1 x iron tablet you could ask for more and see if your GP will prescribe. Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.

You can also help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

**

Folate 2.2 (2.5 - 19.5) Taking 5mg folic acid

Is your folic acid daily? How long have you been taking it?

Vitamin B12 199 (180 - 900)

Has anything been done about your B12 level? Were you asked about signs and symptoms of B12 Deficiency - check these now but bear in mind that taking B12 can mask these signs b12deficiency.info/signs-an...

You really should have intrinsic factor antibodies tested, you could have Pernicious Anaemia, you might need B12 injections such a low level, many people are having injections when their level is n the 300s.

I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

For any further investigations, and before B12 is started, folic acid must be stopped and restarted afterwards.

**

Vitamin D 20.1 vit D 800iu

800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level. Ask your GP why he hasn't followed the

NICE treatment summary for Vit D deficiency:

cks.nice.org.uk/vitamin-d-d...

"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the guidelines and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu so post your new result at the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

Your doctor wont know, because they are not taught nutrition, but there are important cofactors needed when taking D3

vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

naturalnews.com/046401_magn...

Check out the other cofactors too.

**

You very likely have the gut/absorption problems associated with Hashi's and this will have trashed your vitamins. You need to address this problem - absorption issues, leaky gut, etc - along with the Hashi's (information given above) so that your nutrient levels can be optimised, only then can thyroid hormone work properly. See SlowDragon 's reply towards the bottom of this thread for information and links on this healthunlocked.com/thyroidu...

[JayeT in reply to SeasideSusie]

3x iron since 2013, folic acid is daily and I have taken it since 2011.

Thanks

[SeasideSusie Remembering in reply to JayeT]

As you are taking 3 x iron tablets, have you been diagnosed with iron deficiency anaemia? If so are you still iron deficient? Do you have recent MCV and MCHC results?

folic acid is daily and I have taken it since 2011.

You really, really must discuss this with your GP. Almost 7 years of taking folic acid daily and you are still deficient with a below range result! Is he stupid? Actually I think he is going by your results and the supplements you are taking and the length of time you have been taking them and still to have such dire levels.

Chase up about the Vit D, you have the evidence that you should be on loading doses.

What about the B12?

[JayeT in reply to SeasideSusie]

MCHC 366 (310 - 350)

MCV 83.1 (83 - 98)

I have iron anaemia

Nothing being done about B12

Thanks

[SeasideSusie Remembering in reply to JayeT]

OK, so you are getting the correct treatment for your iron deficiency anaemia.

I have outlined above what should be done about your B12 above so you pursue that, your B12 level, even though in range, is dire.

[JayeT in reply to SeasideSusie]

Results before

(75mcg levo - January 2017)

TSH 1.77 (0.2 - 4.2)

FT4 16.1 (12 - 22)

FT3 4.0 (3.1 - 6.8)

(100mcg levo - Nov 2016)

TSH 3.98 (0.2 - 4.2)

FT4 18.3 (12 - 22)

FT3 4.2 (3.1 - 6.8)

(125mcg levo - Jul 2016)

TSH 3.97 (0.2 - 4.2)

FT4 14.3 (12 - 22)

FT3 3.9 (3.1 - 6.8)

(Mar 2016 – 150mcg levo)

TSH 6.8 (0.2 – 4.2)

FT4 13.1 (12 – 22)

FT3 4.2 (3.1 – 6.8)

(Jan 2016 – 175mcg levo)

TSH 7.1 (0.2 – 4.2)

FT4 12.7 (12 – 22)

FT3 4.0 (3.1 – 6.8)

[SeasideSusie Remembering in reply to JayeT]

Did your doctor give you any reasons for the reductions in dose of Levo? It doesn't seem to make sense.

Take

(Jan 2016 – 175mcg levo)

TSH 7.1 (0.2 – 4.2)

FT4 12.7 (12 – 22)

FT3 4.0 (3.1 – 6.8)

and it appears you had your dose reduced to 150mcg

(Mar 2016 – 150mcg levo)

TSH 6.8 (0.2 – 4.2)

FT4 13.1 (12 – 22)

FT3 4.2 (3.1 – 6.8)

Your January results showed an over range TSH which should have prompted a dose increase not a reduction. And it seems to be the same pattern all the way through - your TSH is high and a dose reduction is made????? It's very strange that your TSH is actually getting lower with each reduction, normally it would go higher.

You said that on 175mcg your results were

TSH 1.20 (0.2 - 4.2)

FT4 19.3 (12 - 22)

FT3 4.0 (3.1 - 6.8)

When was this?

[JayeT in reply to SeasideSusie]

August 2015, because of the sweats and weight loss the dose was reduced all the time

[SeasideSusie Remembering in reply to JayeT]

Well the sweats and weight loss will be due to the Hashi's. You have a GP who doesn't understand it, most don't, which is why Hashi's patients must educate themselves so they can understand it and, if necessary, present the evidence to their doctors.

Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

When the antibodies attack, the dying cells dump a load of thyroid hormone into the blood and this can cause TSH to become suppressed and Free T4 and Free T3 to be very high or over range. These are called 'Hashi's flares' or 'swings'. You may get symptoms of being overmedicated (hyper type symptoms) to go along with these results that look as though you are overmedicated. Unless a GP knows about Hashi's and these hyper type swings, then they panic and reduce or stop your thyroid meds.

The hyper swings are temporary, and eventually things go back to normal. Test results settle back down and hypo symptoms may return. Thyroid meds should then be adjusted again, increased until you are stable again.

[SlowDragon Administrator]

Your antibodies are incredible 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. Yours are so bad as you are so under medicated

Each time dose of Levothyroxine is reduced it gets harder for gut to function correctly

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...

Your results in 175mcg showed you were a poor converter to FT3

Very many of us are with Hashimoto's as poor gut function compromises conversion

You need to get coeliac test ASAP and go strictly gluten free diet regardless of the result. Majority of us are gluten intolerant or leaky gut, nether of which show in coeliac test

Getting dose of Levo increased back up in 25mcg steps until TSH is around one and FT4 towards top of range

Vitamins must be optimal - follow SeasideSusie excellent vitamin advice

Absolutely strictly gluten free diet very likely to slowly lower antibodies.

If FT3 remains low once Levo back up around 175mcg, then , like many of us you may need addition of small dose of T3

Email Dionne at Thyroid Uk for list of recommended thyroid specialists

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]

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

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