Hi there - I have Hashimoto's but my thyroid is still working so I know very little about thyroid medication as yet. I'm hoping to get some advice for my Mother In Law as I'm concerned that her doctor doesn't know what he's doing. Her history is relatively healthy apart from two surgeries for polyps and high blood pressure. She had a recent blood test and the doctor told her she was hypothyroid and put her on Levothyroxine (25 or 50 - I'm not quite sure which) and changed her blood pressure medication. Well, she felt terrible - and I encouraged her to go back to her doctor and she is now off the Levothyroxine and has gone back to her original blood pressure medication. We're all a bit confused and I think she needs another blood test with a new doctor as her only tests to date (reference ranges are in brackets) are as follows:
Would really appreciate any advice as she is feeling more tired than usual these days and is being dragged to China for a guided tour by her 84 year old husband! I want her to be as well as she can otherwise the holiday could end up a disaster. I'm thinking she should be taking a sub lingual B12 supplement as a minimum and should have all of the thyroid tests? Was it reasonable to prescribe thyroid medication on the basis of her TSH level alone? And then take her off it because it made her unwell? Or am I just being overly skeptical?!? Would really appreciate your views and help.
Thanking you in advance, Holly
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HashiHolly
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The brand of Levo may not have suited her. If it was Teva then many members have had lots of adverse effects from it. Other brands have affected some members too. It would have been more sensible to trial another brand than take her off Levo altogether.
B12 - check for signs of B12 deficiency here b12deficiency.info/signs-an... and if she has any then further testing for B12 deficiency/pernicious anaemia is called for.
I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:
"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."
And an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
It is good you are enquiring for your mother-in-law but my first comment is that if you have thyroid antibodies - a diagnose of Hashimotos regardless of your blood tests you should have been given levothyroxine at a 50mcg per day to begin with. Hashi's is the commonest form of hypothyroidism and going gluten-free can help reduce the antibodies which attack the thyroid gland and they wax and wane until hypo. Treatment should begin if antibodies are present even if TSH hasn't risen enough.
Email Dionne at Thyroiduk.org and ask for a copy of Dr Toft's Pulse Online article, wherein he states if antibodies are present we should get a prescription. Dr Toft is the Physician to the Queen when she's in Scotland. Dionne's email below:-
tukadmin@thyroiduk.org
Your mother-in-law's TSH is high at 7.77 is high but if you are in the UK they don't usually diagnose until it reaches 10. So the doctor sounds good.
People can be very, very unwell by the time it reaches 10. In other countries we are prescribed if TSH goes above 3.
We have two labs that will do home pin-prick tests. The blood draw should be at the earliest, fasting (she can drink water) and your mother-in-law should be well-hydrated a couple of days before blood draw and get a Full Thyroid Function Test. She needs:
TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.
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