Also coeliac symptoms? - diarrhoea mixed with constipation, weight loss mixed with weight gain, ulcers in mouth/on tongue/on corners of mouth, vomiting
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Samys
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Hello and welcome Samys, yes, post as much information as you can for best advice. Post thyroid blood tests along with laboratory range as we need those to interpret results. Lab ranges vary. Also, say what dose of levothyroxine, any other medications or conditions that may affect results. what your symptoms are and if you've got thyroid antibodies. Post any vitamin blood test results as these can often affect how thyroid hormone functions.
TSH 5.01 (0.2 - 4.2) You are undermedicated to have a TSH of 5.01. Most people do not feel well until their TSH is around 1 or a little lower. You need a dose increase. Levothyroxine should be increased by 25mcg and retest in 6 weeks time then increase again and so on until you reach your optimal level.
FT4 14.7 (12 - 22) FT4 is low in range confirming you are undermedicated. It's best in the top third of the range. You need enough FT4 to convert T4 to T3.
FT3 3.3 (3.1 - 6.8) FT3 is very low in range and this will likely give you symptoms of hypothyroidism. FT3 is best in the top third of the range.
Thyroid antibodies are elevated showing that you have autoimmune thyroid disease otherwise known as Hashimotos. Others will explain more.
Ferritin is lowish, it's best around 70 or mid range for best thyroid hormone use. You could increase levels through diet and keep taking the supplements.
Raising iron levels through diet
You can help raise your iron level by a maximum 200g per week of liver, no more, due to its high Vit A content, and include lots of iron rich foods in your diet, weblink posted by SeasideSusie below.
Folate is much too low. Vitamin B12 and folate act together, what has your GP prescribed for below range levels?
Vitamin D is best around 100 or mid-range. GP is unlikely to prescribe more vitamin D3 as you are in range so add some of your own. You could double up for 3 months and retest. Also, take magnesium which helps absorption of D3 and the co-factor K2-MK7.
Thankyou I will, maybe I will push for a gastro referral too due to the fact I am not gaining a lot of weight and when I go gain weight I just lose the weight again
Your antibodies are very 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
Obviously your are dire
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
Regardless of coeliac results most/many of us with Hashimoto's find strictly gluten free diet helps significantly
You must get vitamin levels optimal and your test results show Thyroid is under medicated
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
tukadmin@thyroiduk.org
Also request the list of recommended thyroid specialists
Professor Toft recent article saying, T3 may be necessary for many
You should have been on higher dose vitD. 800iu is a maintenance dose prescribed after vitD is replete >75. I would buy some vitD and supplement 5,000iu daily for 6 weeks and then reduce to 5,000iu alternate days and retest in May. Take vitD 4 hours away from Levothyroxine.
Your GP should order tissue transglutaminase blood test (tTg) to rule out coeliac disease. You must eat normal amounts of gluten in 2 meals daily for up to 6 weeks prior to testing or result will be negative.
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 dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.
Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.
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