Newbie here - diagnosed last week with Hypothyroidism. I have so many questions - I'm sure some of them are very foolish, but I'd appreciate some kind and simple answers!
I have my blood results, but don't understand the 'Se Thyroid peroxidase Ab Conc' part:
Se Thyroid peroxidase Ab Conc (whatever this means) 302 (<100.00)
Questions:
1. What does that last bit on the blood tests mean?
2. Is it important to know the T3 level? What's the difference between T3 and T4?
Also: I've just picked up my levothyroxin (50mg). It's called Tevo and surprisingly (but thankfully) doesn't contain lactose. They've made me a blood appointment and gp appointment for a month, to check my vitamin D and I guess some bit B levels and check the prescription levels.
I have more questions:
3. The prescription says to take in the morning, at least 30 minutes before eating.. Does that have to be morning? It seems easier to take before bed if I'm not supposed to eat for a while after. Is there a reason it's morning?
4. What's the relation of Vit D/Bs with hypothyroidism? If I were to be found deficient, could that be the cause? Or does it just make things worse?
5. It's possible that I have Hashimoto's, according to the GP, but they don't seem to be testing for it. When I asked, I was told that Hashimoto's causes Hypothyroidism so whether I have it or not, the treatment would be the same, therefore it's not vital to test for...? This seems strange to me, but I understand the thinking. Can someone explain a) how they would test for it and b) what difference it makes knowing whether you have it or not?
6. This is probably a 'how long is a piece of string' type question, but if I started taking the medication tomorrow, is it a case of weeks or months until I feel better? My symptoms feel like they've been getting worse over the past 2 weeks, since my bloods.
7. I am breast-feeding. Will this be affected by the medication? Also, what's the deal with it and birth control tablets?
I'm sure I'll have more questions as this goes on, but for now I think that might be it!
Thanks in advance - I'm still finding this all very overwhelming!
1. What does that last bit on the blood tests mean?
Se Thyroid peroxidase Ab Conc (whatever this means) 302 (<100.00)
This means that your raised antibodies confirm autoimmune thyroid disease aka Hashimoto's which is where the antibodies attack the thyroid and gradually destroy it.
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.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. It's good that you are having some vitamins and minerals tested, ideally you need
Vit D
B12
Folate
Ferritin
Come back with your results (include ranges) and members will comment.
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2. Is it important to know the T3 level? What's the difference between T3 and T4?
Yes it is important to know the FT3 level. T4 is a storage hormone, some of which converts to T3 which is the active hormone every cell in our bodies need. So we really need to make sure that we convert T4 to T3 well enough. However, as you have only just started on Levo, you have a long way to go and need to get TSH down to about 1 before you can see how well you convert.
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Also: I've just picked up my levothyroxin (50mg). It's called Tevo and surprisingly (but thankfully) doesn't contain lactose.
You may do very well on Levo, but bear in mind that many members have had bad reactions to it and have needed to change to a different brand. If you get side effects then you could ask for a different brand but I don't think any of the other tablets are lactose free.
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3. The prescription says to take in the morning, at least 30 minutes before eating.. Does that have to be morning? It seems easier to take before bed if I'm not supposed to eat for a while after. Is there a reason it's morning?
The general rule is to take Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, hot chocolate, etc, as they can affect absorption of the Levo. You can take it when it suits you, if bedtime is best then that's fine but if your evening meal is your main meal of the day then leave 3 hours after eating before taking your Levo. If you find that bedtime dosing doesn't suit for one reason or another then try morning dosing. I take mine in the early hours of the morning when I visit the bathroom, that way it's well away from any food, medication or supplements.
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4. What's the relation of Vit D/Bs with hypothyroidism? If I were to be found deficient, could that be the cause? Or does it just make things worse?
Nutrient levels need to be optimal for thyroid hormone to work properly.
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5. It's possible that I have Hashimoto's, according to the GP, but they don't seem to be testing for it. When I asked, I was told that Hashimoto's causes Hypothyroidism so whether I have it or not, the treatment would be the same, therefore it's not vital to test for...? This seems strange to me, but I understand the thinking. Can someone explain a) how they would test for it and b) what difference it makes knowing whether you have it or not?
Yes, you do have Hashi's as confirmed by your raised antiobodies and mentioned above in answer to question 1. Doctors tend to call it Autoimmune Thyroiditis or Autoimmune Thyroid Disease. The treatment is the same because it's not Hashi's that's treated, it's the resulting hypothyroidism. It is important to know if you have Hashi's because then you can do something to help yourself, ie try to reduce the antibodies as mentioned above. Most doctors don't think antibodies are important, and don't always think a gluten free diet is helpful, but many Hashi's patients would argue otherwise.
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6. This is probably a 'how long is a piece of string' type question, but if I started taking the medication tomorrow, is it a case of weeks or months until I feel better? My symptoms feel like they've been getting worse over the past 2 weeks, since my bloods.
It can take months to start feeling properly well. Levo takes up to 6 weeks for you to feel the full benefit of your dose, whether that is starting it or a dose change.
You should have a follow up test in 6-8 weeks and an increase of 25mcg, then regular 6 weekly tests, followed by a 25mcg increase, 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.
Be aware that with Hashi's, the antibodies fluctuate and can cause fluctuations of symptoms and test results. It's a bit more complicated than non-Hashi's hypothyroidism.
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7. I am breast-feeding. Will this be affected by the medication? Also, what's the deal with it and birth control tablets?
I can't answer that question. If no-one else comes along with an answer, repost in a new thread, including breast feeding/birth control tablets in your thread title to attract the attention of those who know.
Welcome to our forum and am sorry you are hypothyroid and that you are also coping with a little baby and some women do become hypothyroid after pregnancy. I'll answer a couple and others will also respond.
Your TSH is still very high and the aim is to bring it down to 1 or lower. Most doctors think that when it reaches the top of the range (in your range that's about 4). You take levothyroxine with one full glass of water as it could stick in throat and wait an hour before eating.
You can take levothyroxine at bedtime, as long as you've last eaten about 3 hours previously (if you've had protein as it takes longer to digest). If you are having a blood test next a.m. which should be at the earliest possible miss bedtime dose and take after blood test and night dose as usual. This keeps your TSH at its highest as most doctors only take account of the TSH and nothing else.
T4 is an inactive hormone and is also called levothyroxine. Levothyroxine converts to T3 and T3 is the Active Thyroid Hormone required in our millions of T3 receptor cells.
Hypothyroidism or Hashimotos are autoimmune diseases and both are treated the same, except that hashimoto's is caused by antibodies which attack the thyroid gland until the person is hypothyroid. To reduce the antibodies going gluten-free is helpful. The antibodies wax and wane, sometime we may feel hyper (but not hyperthyroidism) and at other times hypo. The proper name for hashi's is Autoimmune Thyroid Disease.
Hi tsmicker, welcome to the forum. You've come to just the right place to ask questions!
Se Thyroid peroxidase Ab Conc (whatever this means) 302 (<100.00)
1) Serum Thyroid peroxidase antibodies concentrate. If antibodies are high, it means you have autoimmune thyroiditis - aka Hashi's. Yours are pretty low, so look negative. However, the NHS mistakenly only tests one set of antibodies, there are also the Thyroglobulin antibodies which can also indicate Hashi's if high.
2) With a TSH of over 39, we know absolutely that your FT3 is going to be low, so no point in testing it at this point. However, when the TSH comes down to about 1, then it's important to know for two reasons. a) to see if it's high enough to make you well, obviously, because it's low T3 that causes symptoms. And b) to see how well you convert from T4, the storage hormone, to T3, the active hormone. The difference between them, if you want to get technical, is that T4 has 4 atoms of iodine, and one is removed to make T3. I won't get any more technical than that!
3) They always say to take in the morning - probably out of habit. But, to be honest, it doesn't really matter what time you take it, as long as your stomach is empty and you don't eat until at least one hour afterwards. So, no reason why you shouldn't take it at night, two hours after eating.
4) Both, really. Your body needs optimal nutrients - not just B and D - to be able to use thyroid hormone correctly, be it thyroid hormone replacement, or thyroid hormone made in your thyroid - everybody needs optimal nutrients. Certain nutrients, like selenium, are necessary for good conversion of T4 to T3. And, if they are low - which they often are when we're hypo - it will certainly make things worse!
5) a) Well, they have partially tested for it, as mentioned above. But, you won't get the other antibody test on the NHS, you'd have to do it privately. b) If you know you have Hashi's, although it won't change the treatment you get from your doctors, there are things you can do for yourself. Taking selenium is one of them, which can lower antibodies. Another is adopting a 100% gluten-free diet, which could also lower antibodies, and just generally make you feel better, because a lot of Hashi's people are sensitive to gluten. You should also keep your TSH suppressed, in order to smooth out the Hashi's swings, but doctors fly into a blue funk when they see a suppressed TSH, so that's difficult.
6) Yes, definitely a piece of string question, because we're all different, and all react differently, but it will be moths rather than weeks, and you could feel worse before you feel better, I'm afraid.
7) Sorry, I can't answer your last question. But do feel free to ask as many questions as you like because there will always be someone here that can answer them.
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