Follow up with GP

[lnjdevereux]

Levo upped to 50mcg, I've been given propranolol and sertraline to help cope with anxiety and depression/mood swings until they can ascertain if I have pernicious anaemia. She's ordered a full blood count and other panels again. Dr has told me she doubts my symptoms are related to thyroid as my TSH is raised but t4 and t3 within range... at least she's booked in for a follow up which is far more than happened last time I was in. Here we go then.

[SeasideSusie Remembering]

Injdevereux

A TSH of 9.76 with both types of antibodies in the 500s and your GP doesn't think your symptoms are thyroid related? I think you should find a new GP.

[lnjdevereux in reply to SeasideSusie]

Hi Susie, sorry I meant the psychological ones. She doesn't think my levels are bad enough to cause anxiety and depression but rather it could be pernicious anaemia or just general mental illness. She accepts that I have thyroid related symptoms otherwise. Should have been more clear!

[greygoose in reply to lnjdevereux]

She doesn't know much about thyroid, then, does she. How high does she think the TSH should be to cause depression? 20? 45.6? 159.75? The woman is rediculous.

Do you know the level of your FT3? It's low T3 that causes symptoms, not TSH. And, just because it's in range, doesn't mean it's good. I'm betting it's right down the bottom of the range. I agree with Susie, you need a new doctor.

[lnjdevereux in reply to greygoose]

Hi Greygoose, it was 4.78 with a range of 3.1 to 6.8, is that low or middling?

[greygoose in reply to lnjdevereux]

That's just under mid-range. Most people need it up the top of the range to feel well. It's quite low enough to cause all sorts of symptoms.

[lnjdevereux in reply to greygoose]

Hmm okay, I think I've worked out it needs to be nearer 5.87 but I'm guessing the only way to do that is NDT which I doubt my dr will prescribe

[greygoose in reply to lnjdevereux]

Well, I don't know, what was your FT4 result? You're only on a starter dose, you're obviously under-medicated. It's possible that taking up your levo to 75 mcg - or even 100 - will do the trick. Not everybody needs NDT.

[lnjdevereux in reply to greygoose]

FT4 was 16 with a range of 12-22 and TT4 was 90.5 with range 59-154.

[greygoose in reply to lnjdevereux]

OK, so that's low. You will need another increase. But, at least you appear to be converting OK.

[lnjdevereux in reply to greygoose]

Reassuring that it's one less problem to worry about!

[lnjdevereux]

You are right, I feel so ill I'm close to tears and want to give up the mood swings and anxiety have got so bad now that it is affecting my daily life and the added pressure of studying for a Masters whilst working 6 days a week is really starting weigh down on me. I don't know what to do, all I feel capable of doing is curling up in a ball and hibernating.

[SeasideSusie Remembering in reply to lnjdevereux]

I don't know how you're coping with everything, especially the studying as well.

Everyone else is right. You probably don't need the sertraline, your symptoms all fit in with hypothyroidism - see the list of signs and symptoms here

thyroiduk.org/tuk/about_the...

and note those under

Mental and Emotional

Panic attacks

Memory loss & confusion

Mental sluggishness

Poor concentration

Noises and voices in head

Phobias

Loss of drive

Post Natal Depression

Nightmares

Easily upset

Wanting to be solitary

Mood swings

Depression

Nervousness/anxiety

Personality changes

Feelings of resentment

Lack of confidence

Familiar???

I would print off that list and mark all the ones relevant to you. Show your GP and say you believe if your are optimally treated for your hypothyroidism then those symptoms should disappear.

**

Now that your Levo has been increased to 50mcg, make sure you are retested in 6-8 weeks following the advice we usually give here for thyroid tests

When booking thyroid tests, always book the very first appointment of the morning, fast overnight (water allowed) and leave off Levo for 24 hours. This gives the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction. TSH is highest early morning and lowers throughout the day. It also lowers after eating. This is a patient to patient tip which we don't discuss with doctors or phlebotomists.

You will need regular retesting/increases of 25mcg every 6 weeks until your levels are where they need to be for you to feel well. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo, if that is where you feel well.

**

I see from your previous post with your Medichecks results, nobody mentioned your Hashi's. This is where the antibodies attack and gradually destroy the thyroid.

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. This has shown up in your B12 and folate results and I know that you are having B12 looked into. It might also help to address any gut issues and you could read through the information and links that SlowDragon has given in her reply towards the very bottom of this thread healthunlocked.com/thyroidu...

**

[lnjdevereux in reply to SeasideSusie]

Thank you Susie. Yes I've got an assignment due on Weds and my concentration is really poor - can't sit and focus for extended periods of time so I think the assignment is either going to be passable and late, or terrible and on time.

Would going gluten free affect TSH etc? Or is it just to reduce the antibodies on their own?

I have my lunch break from work shortly so I will spend that reading these articles in between journal articles for my assignment and hopefully that will help my concentration!

[SeasideSusie Remembering in reply to lnjdevereux]

SlowDragon is the one who knows a lot about gluten free - I'm not Hashi's (thankfully!) and I've not felt the need to try a gluten free diet.

[SlowDragon Administrator in reply to lnjdevereux]

Anxiety is extremely common when hypothyroidism is not adequately treated.

Many Medics only associate it with hyperthyroid.

Getting dose increased as advised in 25mcg steps (retesting 6-8 weeks after each dose increase) until TSH is down to around one and FT4 towards top of range and FT3 at least half way in range is essential

With Hashimoto's gluten intolerance may also be a cause of anxiety. Surprisingly going strictly gluten free can reduce anxiety levels

hypothyroidmom.com/12-shock...

I was stuck on propranolol with Hashimoto's for almost 20 years......turned out I was severely gluten intolerant (not coeliac).

Many, many Hashimoto's patients develop gluten intolerance, or they develop leaky gut and this then causes Hashimoto's and gluten intolerance

You do not need to be experiencing any gut symptoms, that's why it can be hard to diagnose

[Angel_of_the_North in reply to lnjdevereux]

Yes, don't forget the GP gets more money for diagnosing and treating mental problems and depression than for treating the thyroid, so of course she wants you to be depressed and take ADs! Follow the money.