Any advice on my results please help xx

[Holza]

Hi I have suffered with a lot of symptoms for about 5 years now such as heart arrhythmias, muscle fatigue, pressure in chest, feelings of brain fog like concentration, etc. If anyone can help doctors keep telling me it's anxiety please help!!! 😘

[SlowDragon Administrator]

Your high TPO antibodies results confirm you have Hashimoto's also called autoimmune thyroid disease

However your TSH, FT4 and FT3 are in range.

But the general recommendation is to start treatment, especially as you have symptoms

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

thyroiduk.org/tuk/about_the...

Hashimoto's 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 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...

Your Active B12 is low, and below 70.

viapath.co.uk/our-tests/act...

This suggests you need further testing and possibly GP will agree to B12 injections. Folate is also low and works with B12

You might ask advice on PAS healthunlocked

healthunlocked.com/pasoc

thyroiduk.org.uk/tuk/testin...

Your ferritin is also low - ask GP to run full iron panel to test for Anaemia

Vitamin D is good. Do you supplement?

Strictly gluten free diet may help improve brain fog too

[Holza in reply to SlowDragon]

Hi thank you so much for your quick reply I have been taking Levo for about 15 years I'm on 100mcg so wondering do I need t3 added or who the best person is to see to help me? I don't supplement my vitamin d. You think I need more vitamin b12 and iron even though they have said they are normal? Thank you so much for your help I have felt so alone about my illness for a long time x

[SlowDragon Administrator in reply to Holza]

Oh as you are on Levothyroxine you are under medicated and need dose increase

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

So ask GP for 25mcg dose increase in Levo and retesting in 6-8 weeks

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

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]

Also request list of recommended thyroid specialists, in case GP reluctant to increase dose

Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3

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

Yes many of us on Levothyroxine need B12 and folate at very good levels to help replacement thyroid hormones work

Ferritin likely to need to be half way in range too

detailed supplements advice on vitamins

healthunlocked.com/thyroidu...

[Holza in reply to SlowDragon]

You have been very helpful slow dragon thank you so much 😊 i am getting an appointment with dr toft hopefully he can help to. I will have a good look at all the info you sent me thanks again x

[SeasideSusie Remembering]

Holza

As you are pregnant, your TSH is too high. Please make a new thread (mention pregnancy and TSH in title) so that those who know more about TSH levels in pregnancy can give advice. I believe TSH should be below 2.5, any higher and there is risk of miscarriage, whatever information you are given about this you must discuss with your GP so as not to risk your baby.

Do you have any symptoms of B12 deficiency b12deficiency.info/signs-an... If so you can ask on the Pernicious Anaemia Society forum for advice, although SlowDragon has already mentioned further testing as suggested in the link she gave about Active B12 and levels below 70.

Folate needs to be at least half way through range, and a good B Complex can help raise that, eg Thorne Basic B.

You really must get your ferritin up to at least 70, preferably half way through range, and because you are pregnant you wont be able to eat liver which helps raise ferritin. Include lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in... but you may need iron supplements from your GP. If given iron tablets, take each one with 1000mg VIt C to aid absorption and help prevent constipation and take 4 hours away from thyroid meds and 2 hours away from other meds and supplements as iron affects absorption.

You will have to check that any supplements you take are safe to be taking whilst pregnant, it is not my area of expertise.