Hypothyroid hashimotos

[Jomenan]

Hi I'm looking for a bit of advice please. I was diagnosed with interactive thyroid about 4 years ago after being told for most of my adult life that I was borderline! My TSH level taking 125mcg of throxine sits at about 0.4. About 4 months ago I saw my gp as I had started feeling tired, forgetful, putting weight on and gen achy. The gp re did my TSH. ESR, FBC and Vit D . The TSH had gone down to 0.3 and she told me at lower my thyroxine to 100mcg for 6 weeks. She also said that my ESR was raised (a prb I've had for years) and I needed vit D tabs. I stayed feeling awful but did it for 6 weeks then got RE tested and my ESR had gone up to 4.9. I saw another gp who put my dose back up to 125mcg and tested my TPO which was 157. He also told me that I have hashimotos. After another 6 weeks of still not feeling great and putting on loads of weight I have been RE tested and my TSH is back to 0.4. I'm starting to feel like I'm nuts as my bloods look like I should be feeling fine but I'm really not!!!!!

[SlowDragon Administrator]

As you have Hashimoto's then low vitamin levels are extremely common

How low was vitamin D? What dose are you on?

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. Dairy is second most common.

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

Ideally ask GP for coeliac blood test first and folate, B12 and ferritin too

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take early morning on waking, but it may be more convenient and possibly more effective taken at bedtime

verywell.com/should-i-take-...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased and many people find Teva brand causes symptoms.

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

[e-mail]

[Jomenan in reply to SlowDragon]

Thank you for your reply I will get looking at some of the links. Once I was told I had hashimotos I had a little look and have been dairy and gluten free for a whole week so fingers crossed it helps 😀 RE my VIt D it was 5nmol/L and I've been given tabs 20,000 units once a month for 6 months. My ferritin was 62, My folate 7.2 and B12 was 327 (taken in march).

Xx

[SlowDragon Administrator in reply to Jomenan]

So your vitamin D was really severely deficient. Are you sure you are only taking 20,000iu tablet once a month? That's only 666iu per day.

Guidelines say you need 300,000iu over 6-8 week, which is over 5000iu per day.

oxfordshireccg.nhs.uk/profe...

Many Hashimoto's patients need high dose vitamin D. 5000iu a day is not uncommon when increasing levels

Aiming to improve to around 100nmol. Vitamin D mouth spray by Better You is good as avoids poor gut function.

It's trial and error what dose each person needs.

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Retesting twice yearly via vitamindtest.org.uk

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

betterbones.com/bone-nutrit...




articles.mercola.com/sites/...

healthy-holistic-living.com...




articles.mercola.com/sites/...


betterbones.com/bone-nutrit...

easy-immune-health.com/magn...

Folate and B12 are on low side. Do you have any low B12 symptoms?

If so adding a good quality vitamin B complex, one with folate in may be of benefit. Eg Igennus Super B complex or Jarrow B right

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[Jomenan in reply to SlowDragon]

Thank you to much again for info. My vit D isn't as low as I thought sorry I have looked at result again and I had put the value of my D2, my combined result was 35.

[SlowDragon Administrator in reply to Jomenan]

So if your vitamin D was 35 you need 1600iu daily for six months