Undermedicated? Advice please for coeliac sufferer and thyroid patient

[Polo58]

Symptoms - easily upset, lack of confidence, intolerance to stress, feeling cold, sweating, depression, anxiety, headaches, confusion, constipation, heavy periods, dry skin, aching in joints, dry eyes, pale skin, cracks in corners of mouth, weight gain

I take 50mcg levothyroxine, diagnosed 2012 with hypothyroid reduced from 150mcg in November because I had adverse effects from the Levothyroxine which GP thinks has worsened my coeliac disease and my thyroid levels have not really improved much on any dose

Thankyou

TSH 5.2 (0.2 - 4.2)

Free T4 14.8 (12 - 22)

Free T3 3.6 (3.1 - 6.8)

Thyroid peroxidase antibody 495 (<34)

Thyroglobulin antibody 358.3 (<115)

Ferritin 56 (30 - 400)

Folate 2.36 (2.50 - 19.50)

Vitamin D 59.3 (50 - 75 suboptimal)

Vitamin B12 301 (190 - 900)

[SeasideSusie Remembering]

Polo

We need to see your test results to know if you are undermedicated. Can you please post them, with their reference ranges. To get a full picture ideally we need to see

TSH

FT4

FT3

Thyroid antibodies

Vit D

B12

Folate

Ferritin

It may explain some of your symptoms when we see all the results.

Did you have adverse effects from Levo before November.? Did you have a different brand of Levo then or have you always been on the same brand?

[Polo58 in reply to SeasideSusie]

Thankyou I had adverse effects since being changed to Teva. I was on different brands before that - Actavis, Wockhardt and Mercury. I will post results now

[SeasideSusie Remembering in reply to Polo58]

Polo

Many members have had awful side effects from Teva. Ask for a brand you were previously feeling OK on. If your normal pharmacy can't get that brand then ask for your prescription back and ring round other pharmacies until you find one that can. It's best to stick to the same brand.

Also, do a yellow card report for the Teva

yellowcard.mhra.gov.uk

[Polo58 in reply to SeasideSusie]

I am lactose intolerant and my endocrinologist is aware of this but when on Mercury and Wockhardt and Actavis before my thyroid levels did not improve very much and he has made a note of this but he wants me back on the lactose containing tablets anyway

I don't want to go without

[SeasideSusie Remembering in reply to Polo58]

Polo

Teva is the only lactose free Levo tablet in the UK.

There is liquid Levo and their are European lactose free Levo tablets. The European tablets are Aliud Pharma and Henning and would have to be by special order. You would have to discuss these with your endo or GP.

thyroiduk.org/tuk/treatment...

[Polo58 in reply to SeasideSusie]

I take 3000iu oral spray for Vit D by Better You, it contains K2-MK7 and have been taking it since Sep 2017

I take 5mg folic acid once a day since 2016

I have B12 injections, have taken my second one

I have iron deficiency diagnosed 2016

[Polo58 in reply to SeasideSusie]

Results added

[SeasideSusie Remembering]

Polo

Yes, you are under medicated so you need a Levo you can tolerate and not give you side effects, at a dose to bring your TSH down to around 1 or below with FT4 and FT3 in the upper part of their reference ranges if that is where you feel well.

Your high antibodies confirm autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. As the antibodies fluctuate, so can test results and symptoms. Most doctors dismiss antibodies as being of no importance so you need to help yourself where Hashi's is concerned. Adopting a strict gluten free diet and supplementing with selenium l-selenomethionine 200mcg daily can help reduce antibodies, as can keeping TSH suppressed.

chriskresser.com/the-gluten...

hypothyroidmom.com/hashimot...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

Hashi's can cause gut/absorption problems and very often low nutrient levels are the result.

Your Ferritin is too low, it needs to be at least 70 for thyroid hormone to work. Eating liver regularly can help raise Ferritin, maximum 200g per week.

Folate is below range, what has your GP said?

Vit D Council recommends a level of 100-150nmol/L so you could supplement with 4000iu-5000iu D3 daily for 3 months then retest. Once you have reached the recommended level you'll need to find your maintenance dose which may be 2000iu daily, maybe more or less, maybe more in winter than summer, it's trial and error.

You'll also need to supplement with D3's important cofactors magnesium and Vit K2-mk7.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds. Magnesium is calming so best taken in the evening, four hours away from thyroid meds.

As you have Hashi's then an oral spray is recommended for best absorption, eg BetterYou - they do a combined D3/K2-mk7.

B12 is on the low side. Do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an...

If you do have any then ask your GP for investigation into B12 deficiency/pernicious anaemia. Otherwise you could supplement with sublingual methylcobalamin lozenges 1000mcg daily along with a good B Complex eg Thorne Basic B or Igennus Super B.

[Polo58 in reply to SeasideSusie]

Thankyou I take 3000iu vitamin D by Better You, it is oral spray and contains K2-MK7. GP wants to discuss folate level with me at follow up