Hi everyone. I was diagnosed with hypothyroid in 2011. No idea what to do really. I feel so emotionally exhausted all the time, feel like I am losing a battle with the GP and endo. I have symptoms such as anxiety, constipation, joint pain, feeling cold, dry skin, mouth ulcers. Do I post results.
Also diagnosed with the following:
Folate deficiency 2017
Vitamin B12 low 2017
Iron deficiency 2013
Vitamin D deficiency 2014
No idea what to do about levothyroxine dose, if I need T3 adding, etc.
Many thanks.
(25mcg levothyroxine, being cautious and to not overdo it with dosing as it has happened so many times before, oddly enough when not taking any levothyroxine at all!)
TSH 4.66 (0.2 - 4.2)
Free T4 14.7 (12 - 22)
Free T3 3.3 (3.1 - 6.8)
Thyroid Peroxidase antibodies 477.3 (<34)
Thyroglobulin antibodies 904.5 (<115)
Ferritin 32 (30 - 400) - taking 1 iron tablet a day since Feb 2017
Folate 2.4 (2.5 - 19.5 ) - taking 5mg folic acid once a week since Nov 2016
Vitamin B12 unknown as I take B12 injections every 3 months since June 2017
Vitamin D total 60.3 (50 - 75 suboptimal. Advise on safe sun exposure and diet) taking vitamin D 3000iu from 800iu prescription, also taking magnesium and K2 MK7
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Faye2018
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Hi Faye2018 and welcome Yes, post your latest results (with ranges too) and your dose. so that people can give you their advice. The nutritional deficiencies go hand in hand with hypothyroidism. Have you been treated for these and if so do you have current test results?
This forum is great - you'll get advice and support here
25mcg is a very low dose. Typically people are started on 50mcg by their doctor. A lower dose of 25mcg is usually only used on young children, old adults, or people with heart problems, I think. Have you been on that dose since 2011?! No wonder you are feeling so awful, you poor thing
Ideally with treatment your TSH should be 1 or under, I believe. Although your free T4 and free T3 are in range, it seems that people only really feel well when they are nearer the top of the range, particularly free T3. Free T4 is a 'storage' hormone, and has to be converted in the body to free T3. Some people say it has to be at the top of the range, others say it should be around mid range.
I think you definitely need a dose increase. I'm surprised, very, that your doctor hasn't suggested this.
Some people find an increase in levothyroxine is enough to make them feel better.
Some people feel better on NDT (natural dessicated thyroid from pigs or cows) - these contains a mix of T4, T3, plus some other types of thyroid hormone.
Others feel better by adding some T3.
It's a bit of an experiment to find out what works best for you as an individual. You are likely to only get thyroxine via your doctor, so taking the other options usually requires you to self medicate. This can be a big leap when you're used to trusting your doctor, but there are lots of people here who will help you along the way if you decide to try these routes. For now though I would suggest you talk to your doctor about increasing your dose of levothryoxine.
Please do not feel bad about seeking help in this group. You will get lots of really helpful advice which, hopefully, will get you to a much better place. What you have said is very similar to many of us here.
There are others with considerably more knowledge than me ... but the first thing everyone gets asked is about posting their blood test results (complete with ranges). Most GPs only seem to test for TSH and T4. If you can get them to test for T3 and vitamins and minerals too ... that will provide much more useful info. Your GP is obliged to give you a copy of your results - so don’t get fobbed off.
Others will tell you the full list of vitamins and minerals that are implicated. In the meantime do look at Thyroid UK website ... also loads of useful info there.
It’s a learning process for everyone here. You’re amongst friends - who will offer as much help and support they can. Good luck
Thank you, yes I have added TSH, FT4, FT3. The reason being I am on a low dose is because I am being cautious about not overdoing it on dosage as I have had occasions where results have shown overmedication despite being on low doses, having hypothyroid symptoms and sometimes being on no levothyroxine at all
To me that sounds like you possibly have thyroid antibodies. The antibodies gradually destroy the thyroid, and as they do the thyroid releases thyroid hormones, which can make you seem like you are over medicated. Have you had thyroid antibodies tested at all?
Then I would bet money that that's what's causing you to feel over-medicated. I'm not that knowledgeable about Hashimoto's but others will give you some good advice. You do need to keep taking your levothyroxine though.
You’re severely under medicated. How much Levo did your Gp or Endo suggest? 25mcg is the lowest starting dose. Most start on 25-50mcg. Your TSH should be 1.0 or under. And FT3 mid to top and FT4 near the top of the range. Are you supplementing any vitamins? Do you have your TPO :antibody results? Can you post them.
You’ve a lot to learn on your illness. 25mcg is a drop in an ocean if that’s all you’ve been taking for 6/7 years.
I think we’d all suggest getting a blood test first thing in the morning. Do not take your Levo until after your test. And fast over night with only water if needed. If then suggest adding another 25mch Levo for six weeks although I personally would wait only three. Have another blood test each time you add 25mcg with the fasting instructions above.
Thank you, the endo suggested I take 175mcg levothyroxine. He and the GP don't know I reduced my dose. I have elevated TPO and TG antibodies, and posted vitamin/mineral levels. I always have bloods done early first thing, fasting and skipping levothyroxine for 24 hours
High antibodies suggests Hashimotos. Have you looked into a gluten free diet ? It helps most people as the protein in gluten promotes attacks on the thyroid which is what you are trying to prevent.
A raise in T4 /Levo will get your TSH down and have you feeling better. How did you lower your dose / over what period? And by how much. What was the highest dose you were most recently on?
And how / when do you take your Levo and how soon do you eat or drink after?
Thank you, I have not looked into a gluten free diet at all. I lowered my dose immediately from 175mcg to 25mcg. 150mcg was the most recent and consistent dose I was on. 175mcg very briefly because of the overmedicated results on this back in September 2017. This made me wary to take it at that dose.
I take my levothyroxine crushed with some water and I leave 2 hours before food/drink and 4 hours from supplements.
Ok, there's a way to work out how well you're converting T4 to T3 (I am severely mathematically challenged and always have to ask for help doing it myself!) But just from looking at your T4 and T3, it seems conclusive that you are not converting very well. Your T4 is reasonably high in range and yet your T3 is still quite low in range.
T4 gets converted in to T3 and in to rT3 (reverse T3). I would guess that you have too much rT3 in your system, which also might be why you've been feeling so dreadful. I kept increasing my levothryoxine and feeling worse and worse, and it was only when I reduced it right down and added T3 that I started feeling better.
You're welcome There are also supplements you can take that will help with T4 to T3 conversion, including selenium. SlowDragon is great on supplements and will give you some good advice.
Also, there is a genetic test called DIO2 - you can read more about it on the Thyroid UK website. Some people genetically are unable to convert. The test is quite expensive and not strictly necessary. But if you are the sort of person who likes to know exactly what's going on, it's something to bear in mind. I considered doing it, but actually changing my treatment has helped me feel better without it, so I saved the money instead lol.
Ok. Thanks. I would like to know more about what is going on. I did adrenal tests but no idea how to interpret them. I am looking into testing for candida. Maybe the DI02 test if not too expensive.
I got equally confused trying to interpret my adrenal and cortisol tests. I'm still struggling now, brain fog does not lend itself well to understanding things! You could post them on here for some feedback.
Going gluten free has helped a lot of people who have Hashimoto's (antibodies). That could be worth trying.
A lot of people feel better for cutting out sugar, reducing refined carbs, avoiding polyunsaturated fats, avoiding alcohol... There are a whole host of dietary measures that people have found helpful. Sometimes you'll get opposing views too lol, so it's a case of reading up as much as you can and trying different approaches.
Ok. I will post my adrenal results here as long as others can help with interpreting them. I am awful for cutting out sugar. I get terrible sugar cravings so I know this will be hard for me to do. I can't take anything with sweetener in either, sweetener can give me the runs (sorry if too much information!) As for alcohol, I never really drink it and if I do it's usually diluted - even diluted alcohol can make my head swim and that can happen on just one! After a couple I just end up hugging everyone.
haha, hiccy hugs! I used to be the same with the sugar/carb cravings. I changed my diet so that I was eating very low carb for a while, with lots and lots of fat. Not only did I lose 3 stone without eating any less at all, I also found my mood improved and I had more energy. It took a while but my tastebuds completely changed and now I find foods with a lot of sugar in really unpleasant to taste. It really sorted out my blood sugar levels too. I can go without food now if I have to without feeling crabby and light headed. It's rare that I go long without food though as I do love the stuff lol.
I've since added in more carbohydrate, because carbs are apparently essential for they thyroid, but I still keep them fairly low.
Don't be afraid of eating fat - coconut oil, butter, avocado, nuts, full fat yogurt, cheese, meat, fish etc. Just avoid polyunsaturated fats and hydrogenated fats. Saturated fats have been demonized for too long. They are healthy and good for you. artandscienceoflowcarb.com/...
Those results are good although having a T3 level would give a better picture, if T3 was in range then you weren't overmedicated unless you had raging hyper symptoms, fast heart, diarrhoea and so on. If you felt 175 was to much you should have just reduced the dose slightly, by 25mcg at most. Dropping from 175 to 25 is doing you no good.
Thank you, I felt a bit fobbed off because the endo did ask for FT3 but for some reason the lab never did it. I had no overmedicated symptoms at the time.
Thank you, I have been on 25mcg since September 2017
Ferritin 32 (30 - 400) - taking 1 iron tablet a day since Feb 2017
Folate 2.4 (2.5 - 19.5 ) - taking 5mg folic acid once a week since Nov 2016
Vitamin B12 unknown as I take B12 injections every 3 months since June 2017
Vitamin D total 60.3 (50 - 75 suboptimal. Advise on safe sun exposure and diet) taking vitamin D 3000iu from 800iu prescription, also taking magnesium and K2 MK7
Thank you, I take the 3000iu Better You oral spray under the tongue. This includes K2 MK7 and I use a magnesium spray. I changed to the other D3 after taking the original 3000iu for about 4 years and not noticing a change in levels but also because I had terrible symptoms of rib pain and breathlessness when on it.
Are there any supplements I can take which I can swallow easily?
Igennus Super B complex is small tablet, full dose is 2x per day, but could start with just one see how it goes
Magnesium spray is possibly enough. You can also do Epsom salt bath once week - that's magnesium too
Yes loads of us find Better You vitamin D mouth spray is best option as avoids poor gut function. Suggest taking 2 spray per day for few weeks to get level up
Your high antibodies confirm you have Hashimoto's, this 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 gut and gluten 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 and you need prescription increased for folic acid to daily too.
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