Thyroid UK
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From Hypothroidism to Sub clinical hypothyroidism...can it get better ?

Hi Guys, almost a month back i wrote about my diagnosis of Hypothyroidism and sought advices from amazing people out here..!!

Now after almost 1.5 months and following Dietary changes, taking multivitamins and Iron tablets and not to forget, Exercising and losing weght by 4kgs... My TSH which shot to 11 that time is now 7.5, which is now sub clinical..! (Although my symptoms have Not improved even a bit and i can feel the same tiredness, inactivity, hairloss etc etc even now)

Today, Again, i seek ur experiences and ideas to know if this sub clinical hypothyroidism can be treated well, without taking Levo or any such meds.

Please guide :)

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Hi pari099,

Usually you are given a starter dose of thyroid hormone medication (levothyroxine) on diagnosis, optimising vitamins & minerals can help hormone production, but they don't replace it.

I was stuck with symptoms for years being 'sub-clinical' having a TSH < 5.24.

How are you thinking of treating 'sub-clinical' hypothryoidism, iodine?

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Hi Spareribs,

Earlier my endo gave me Multivitamins which included Selenium, zinc ,folate etc. and Iron supplements as my ferritin had got really low (6 range 10-150) and advisedto Exercise for at least 1 hr each day.

Now after 1.5 months,he feels my weight reduction by 4 kgs has heped me reduce my TSH from 11 to 7.5 and has now given me higher dose of Iron tabs, as my ferritin did not improve much even after taking supplements, and has also given me Vitamin D and Clacium Tablets and has stopped with other multi vitamins.

I wonder how these calcium supplements will help me as my calcium was already within normal range. Also i could not find much about relation between calcium and hypothyroidism, and how could calcium supplements help treat this condition.

So, how are u going about it now? Are your symptoms still there?

What do u think, will i be able to reduce my TSH further?

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Thyroid tests - often if doctors see a raised TSH, the patient is asked to come back in a few months for a re-test - possibly just an 'odd' test or because of temporary thyroid problems like post-partum thyroiditis, or just to confirm the first test.

Multivitamins - it is rare for UK doctors to prescribe multivitamins, & you must have been low in both iron and vitamin D. so the thyroid would struggle making hormone, hence a higher TSH telling it to make more (IMHO). Folk here are often low in folate/B12 too.

Vitamin D (sunshine) - is essential in calcium absorption and doctors tend to prescribe low dose tablets containing both. Look up Parathyroids for a further calcium connection (apart from Vitamin D).

Ferritin - is stored iron, taking iron tablets with vitamin C (orange juice) helps absorption and prevents constipation - some prefer liquid iron supplements.

My story is on my profile should you wish to know, personally I think we should give more credit to minerals & vitamins as lack of them causes age-old problems, like anaemia, rickets etc.

If you correct your deficiencies and are suffering with thyroid symptoms, I see no point in trying to reduce the TSH, if it's Hashimoto's your thyroid will eventually fail. I think a state of 'sub-clinical' hypothyroid is no-mans land, I was stuck there, first not wanting to have diagnosis of a life-long condition & treatment then eventually something had to be done. Good luck. J :D

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Thanks for sharing this with me :)

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Were both tests done at the same time of day, and fasting? TSH is highest in the early morning and drop throughout the day. It also drops after eating.

Doctors in the UK might call a TSH of 7.5 'subclinical', but in actual fact, you are full-blown hypo once your TSH hits 3.

And, I doubt your multi-vits have done anything to help you. They're mostly a waste of time.

As was said repeatedly on your last post : you can only replace a hormone with a hormone. Not a vitamin and not exercise. And, as far as I'm aware, thyroids do not regenerate. :(

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Yes, both were done at almost same time in the morning and fasting ...although my T4 and T3 are within normal range..and it is also not due to hashimotos...but symptoms are still there...however my Ferrtin level is really low which is 6 (Range 10-150) for which i am supposed to take supplements.

Endo has now given me (Iron/B12/Folic acid) supplements as i told and also Vitamin D and Calcium supplements and has stopped with other multivitamins now.

Now, Even i wonder if it will do any good to me and i feel he is just going for trial and testing for 2 months and then he will Finally make me end up with Levo itself.

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We need good levels of vit D, b12, folate and ferritin in order for out bodies to convert and use thyroid hormones properly (whether our own or synthetic). Your Endo is a rarity who actually seems to understand this. As you dont have hashimoto it sounds like he is making sure your hypo is not caused by the deficiencies alone. Realistically, I think you are unlikely to drop your TSH from 11 down to a good level and clear all symptoms doing this alone and will probably still need levo but you never know and it is worth a try first.

Many symptoms of hypo and nutrient deficiencies cross over. By fixing nutrients you may find some symptoms improve or disappear altogether and were not actually caused by thyroid so would not be fixed by levo. People have sufferered for years thinking they needed more thyroid hormone despite good levels, when actually the symptoms were caused by other deficiencies, you have to fux both systems to feel well.

Thyroid disorders frequently cause gut issues which prevent us absorbing nutrients properly, hence the deficiencies which becomes a vicious circle. Vit D is key to our bodies utilizing calcium so he has probably added it to offset the calcium that was not absorbed whilst you were deficient.

When taking vit d you need to take its co-factors too, the body needs magnesium to manufacture and use vit d. You also need to take K2, this helps to ensure that the calcium is directed to bones and teeth rather than arteries and soft tissues where it can cause problems. If you search for SeasideSusie and read her replies, she gives excellent explanations and nutrient advice, she certainly helped me get well.

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Hey, Phoenix, Thanks for the information :) Yes will just search about Seaside Susie . Thank you :)

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I really think it would be helpful if you gave us your other results. The TSH on its own doesn't mean much. What were your exact numbers and ranges for FT4 and FT3 and antibodies? Just being 'in-range' is not the same as 'optimal'. And, it's pretty much impossible to prove you don't have Hashi's, because antibodies fluctuate all the time - plus, some people never even develop high antibodies, but still have Hashi's.

It's good that your doctor has stopped the multi-vits - waste of money - and started you on iron, B12, - folate would be better than folic acid - and vit D, but why the calcium? Did you test low for calcium? Calcium supplements are a bad thing to take.

If you really want our help in getting well, I suggest you post your nutrient test levels, with ranges, and tell us exactly what and how much of each, you're taking. Because doctors often get that wrong.

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Hey,

These are my exact Results :

FT3 3.08 pg/ml (2.1-4.4)

FT4 1.02 ng/dl (0.8-2.7)

TSH 7.56 uiu/ml (0.4-4.2)

Anti TPO- 6.1 iu/ml (<34)

Serum Clacium- 8.97 mg/dl (8.4-10.4)

Ferritin- 8.4 ng/ml (10-120)

ESR - 8

Now he has added both Vitamin D and Calcium tabs along with Iron supplements and has asked to exercise for 2 months and visit him with just TSH test .

What do u say..

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I say that just TSH results aren't very helpful. Your FT4 is very low. Your FT3 is just under mid-range, but it's only that high because the high TSH is pushing conversion. But, it's not sustainable. It will go down as your FT4 goes down, because your thyroid is not responding well to the TSH.

Your calcium is not low enough to warrant taking calcium supplements. Just taking vit d will raise your absorption of calcium from food - if you take enough of it, but you don't say how much you're taking. You also need to take vit K2 - MK7 to make sure extra calcium goes into your teeth and bones, and doesn't build up in the soft tissues. Just taking calcium supplements like that could lead to a heart attack or kidney stones.

Be careful with the exercise, it could make you worse. You really should be taking levo.

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Oh ok..i'll take care of the points u have mentioned ...thanks :)

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You're welcome. :)

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TSH of 7.5 is not sub clinical, if you have symptoms you need treatment

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies, FT3 and FT4 plus vitamins

Private tests are available

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. This gives highest TSH and most consistent results. (Patient to patient tip, GP will be unaware)

If 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

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hey... my T3, T4 are within normal range as of now...and Anti TPO showed it was not due to hashimoto's...although symptoms are still there..is there any scope that TSH can further go down?

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Have you had TG antibodies tested as well as TPO? You can have high TG and low TPO.

What are the actual results and ranges for FT3 and FT4. If both near bottom of range that's very different from near top of range

What are actual results and ranges for folate, ferritin, B12 and vitamin D?

Have you considered trying strictly gluten free diet?

Or testing for DIO2 gene variation?

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

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Hi, i did not get TG anti bodies tested....completely gluten free diet is almost impossible for me...but will surely try to reduce its intake as much as possible. These are my exact Results :

FT3 3.08 pg/ml (2.1-4.4)

FT4 1.02 ng/dl (0.8-2.7)

TSH 7.56 uiu/ml (0.4-4.2)

Anti TPO- 6.1 iu/ml (<34)

Serum Clacium- 8.97 mg/dl (8.4-10.4)

Ferritin- 8.4 ng/ml (10-120)

ESR - 8

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Ferritin is absolutely dire. Should be at least half way in range

Vitamin D should be around 100nmol

B12 towards top of range and folate not near bottom of range either

Persistent low vitamins with supplements suggests coeliac disease or gluten intolerance

gluten.org/resources/health...

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hey..just read about gluten intolerance/coeliac...i think ur right...i can relate to most of the symptoms of coeliac!! Now, another lifelong issue is going to take toll on me ...as if this hypothyroidism was not enough :( ..will immediately get tested for coeliac...

Anyway.. I can't thank u enough for letting me know about it!! Thanks a lot :)

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According to many naturopaths/functional doctors, there are a lot of things we can do to improve thyroid issues, whether taking conventional medication or not. I've also read some studies which suggest the thyroid can regenerate itself to some degree and under some conditions. Common suggestions from alternative therapists are targeted at those with hashis, e.g. gluten free diet, dairy free, grain free but might also help those without it. There are so many conflicting opinions and no-one has all the answers or knows what specifically is going on on your body. There are definitely success stories out there of diet and lifestyle management so if you're not sure what you want to do yet, It might be worth doing your own research.

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Okay, thanks Maxisoul :)

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Any TSH over about 3 is actually hypo. And 7.5 isn't sub clinical unless you have no symptoms what so ever, regardless of what the GP says. TSH fluctuates up to 75% over the course of a day and also probably has a seasonal rhythm, so you can only compare tests done under the exact same circumstances. How have your free T4 and free T3 improved? It's unlikely that after a high TSH over the top of the range that you can "cure" your hypo without replacement hormones. If it is autoimmune and you catch it when TSH is around 3-4, you might be able to prevent further damage to the thyroid, but otherwise, as your symptoms show you need replacement hormones.

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These are my exact Results :

FT3 3.08 pg/ml (2.1-4.4)

FT4 1.02 ng/dl (0.8-2.7)

TSH 7.56 uiu/ml (0.4-4.2)

Anti TPO- 6.1 iu/ml (<34)

Serum Clacium- 8.97 mg/dl (8.4-10.4)

Ferritin- 8.4 ng/ml (10-120)

ESR - 8

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Well that ferritin won't be helping. I hope you have a referral to gastroenterology to find out whether there is internal bleeding to account for iron loss. Have you had TG antibodies tested? It could be that it is caused purely by nutritional deficiencies but I'd want to know WHY those deficiencies occurred: coeliac, chrohns, some other gut problem, or what?

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I have'nt got TG antibodies tested...i think ur right..i searched abt coeliac and can relate to most of the symptoms :( will get tested for the same immediately...

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Could your symptoms be due to low ferritin? They are similar to hypo symptoms (tiredness/hairless etc)?

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Yes...might be possible as my ferritin s extremely low...8 (10-150)

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So what is your GP doing about that? You should probably be getting an iron infusion followed by iron tablets - at least it should have been followed by a full iron panel.

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He has just given me Capsules containing Elemental Iron and Folic Acid as active ingredients. Apart from this, Calcium and vitamin d tablets...that's it...and has asked to visit him after 2 months..

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How much elemental iron per day and how much vit D. You don't need calcium with those results. I'd still ask for a gastro referral unless you are vegan and it is obviously dietary. Is your B12 over 500? If both folate and B12 are low, you should be being tested for pernicious anaemia. I'm not sure that GP is following guidelines.

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The Iron tablet consists of :

Folic Acid - Vitamin B9 - 550 MCG

Elemental Iron - 100 MG

Vitamin D Consists of Cholecalciferol - 60000 IU once per week

couldn't find the composition of calcium tablet.

i am vegan and i also suspect i could have gluten intolerance (as suggested by people here) but one symptom of weight loss in case of gluten intolerance doesnt apply to me..as i am gaining weight.

GP just asked me to get Ferritin and calcium tested... didn't ask for B12 and folate..

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I'm not sure that you can absorb other nutrients well in the presence of iron, so you may not be getting the folate you need, but it is a decent dose. Is that 2 or 3 x a day (won't be enough if only 1 - you'd usually get 3 x ferrous fumarate 210 a day which is 3 x 66 elemental iron)? You need to take iron 4 hours away from thyroid hormones and take it with vitamin C for absorption.

Vit D is a reasonable dose for loading, so that's good for a few months, but then you'll need a retest. Don't forget the magnesium and K2 that others have mentioned.

If you are vegan it is actually rare to be deficient in folate (cos of all the veg!) but common to be deficient in B12, so I'd want to know why the folate supplement.

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