I am taking 200 mcg Levothyroxine - up from 25 mcg over 3 years. I am very overweight, fatigued, aching joints, irritable and depressed - amongst other things! I am seeing my GP tomorrow with these results and I am unsure how to approach the session with him - 10 minutes!. This is my first posting but I have been a member for over 2 years. Any advice and comment would really help. God bless you.
Written by
Galfetti
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If you have been a member for two years you will know that your high antibodies confirm you have Hashimoto's also also known by medics here in UK more commonly as autoimmune thyroid disease.
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's
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)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood
your B12 is very low. You need to show results to GP and ask for further testing for Pernicious Anaemia before starting either on B12 injections, or if GP won't agree, daily sublingual B12 lozenges. Plus a good quality vitamin B complex with folate in rather than folic acid.
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
Vitamin D is also low, but not low enough for GP to need to treat. Self supplementing with a vitamin D mouth spray and aiming to improve to around 100nmol
Retesting twice yearly via vitamindtest.org.uk £29 postal kit from NHS, if not doing full testing
Read up about importance of magnesium and vitamin K2 Mk7 when supplementing vitamin D
Selenium supplements can help improve conversion of FT4 to FT3 as well
Ferritin is often high with Hashimoto's, but your GP may investigate further
Your conversion of FT4 to FT3 is poor, but improving vitamin levels should help.
Only make one change or add one supplement at a time.
Thank you so much for your quick reply. it seems I have much to discuss wth my GP tomorrow - 10 minutes! Can you tell me what level B12 should be - in nmol/L? And what level FT4 conversion to FT3 should - in pmol/L? Thank you so much for your helpful comments.
Your GP may try to reduce your Levothyroxine dose due to above range FT4. If they do it's best you strongly object to that, and point out your FT3 is already too low
Improving low vitamins should help improve conversion and then FT4 result will reduce and hopefully FT3 increase
Blue Horizon B12 is standard B12 (not active B12) result should be over 500. GP may not agree to testing as its in range, though it's very low.
With Hashimoto's we need B12 at top of range. If GP is unwilling then you can just supplement daily. But ideally would run tests for Pernicious Anaemia first before doing so
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