New! Help with blood results!

[CFM83]

Hello! I was recently diagnosed with hypothyroidism! My first set of blood test results came back as:

Free T4 = 3 (12-22) and TSH 100 (0.27-4.2)

I was put on 50mg Levothyroxine for a week and then got told to up it to 75mg after. I’ve been on 75 for 5 weeks now and my recent blood test results came back as T4 14.6 and TSH 63.5. My normal doctor was on holiday when I did the second test and the doctor I saw instead told me to just stick at 75.

I’m knackered all the time still, my heart rate goes through the roof when I just walk for more than a few minutes somewhere, and I’m having to take daily laxatives. I also developed a very heavy dry frequent painful dry cough when I started the levo which lasted for weeks before it then turned into a less frequent cough, but when I did cough, it would feel like my airways were closing and I couldn’t breathe and was choking. It would wake me up in the middle of the night and even resulted in my work calling an ambulance one day as it was so bad I wasn’t breathing properly. After this, My GP sent me for a chest x ray (which came back clear), and gave me reflux tablets and an inhaler (both of which don’t really help)

Any help / opinions / advice would be much appreciated! I’ve read some articles on here about getting tested for T3 as well but to be honest I’m still confused by the whole thing and feel like my GP doesn’t believe just how awful I’m feeling or believe me about the choking cough .

Thanks in advance x

[MiniMum97]

Go and see another doctor. The doctor you saw was an idiot. With a TSH of 63.5 any doctor should be upping your levo to 100mcg for 4-6 weeks then retesting. There should be no question about this and I am shocked you have been told to remain on 75mcg.

[CFM83 in reply to MiniMum97]

Thank you. I have an appt tomorrow morning with the original doctor now she’s back from holiday so fingers crossed for upping the dosage! X

[SeasideSusie Remembering]

CFM83

Protocol is that after starting Levo retesting is done every 6 weeks with an increase of 25mcg until 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 lower with FT4 and FT3 in the upper part of their reference ranges if that is where you feel well.

The doctor you saw after your second test when TSH came back at 63.5 clearly doesn't know what he's doing. Make an urgent appointment tomorrow to see a different doctor and ask for your Levo to be increased by 25mcg.

[humanbean]

There is no point in testing Free T3 with a TSH of 63.5. It will be low, there is no doubt about that.

I agree with MiniMum97 - the doctor who didn't raise your dose after your latest results is utterly incompetent and shocking. You should write a letter of complaint as soon as possible, and see a different doctor to get your dose raised to 100mcg per day for about 6 weeks before getting tested again. If you have a partner or parent who could write it for you, and you then approve it and sign it, then that might be easier for you. We are all familiar with the effects of brain fog. You must be feeling dreadful.

One effect of becoming hypothyroid is a reduction in stomach acid, and as a result of that people may become very deficient in nutrients. Ask for testing of the following :

An iron panel including ferritin and iron

Vitamin D

Vitamin B12

Folate

You will probably have to supplement any low levels yourself, but we can advise on the options you have for supplementing nutrients.

[CFM83]

I think I’ve been tested for some of that already? My serum ferritin was 420.7 (13-150). The doctor didn’t mention that whatsoever though and the only reason I know it is because I can now check all my results online?

[humanbean in reply to CFM83]

With a ferritin level of 420, assuming that you haven't been supplementing iron, then your high level could be due to inflammation. But with just a ferritin level and no other info that is iron-related it would be impossible to tell for certain.

Even if your iron is not low, the other things I mentioned could still be low. Check your online records to see if you can find any other nutrient results.

[SlowDragon Administrator in reply to CFM83]

I think you better question this and ask for further investigation

High ferritin levels can be cause of hypothyroidism due to hemochromatosis

You will need referral to haematology for investigation

verywellhealth.com/hypothyr...

Rarely, certain diseases, like hemochromatosis, can deposit abnormal substances (iron, in the case of hemochromatosis) in your pituitary gland, causing central hypothyroidism, or less commonly, your thyroid gland, causing primary hypothyroidism.

ncbi.nlm.nih.gov/pubmed/182...

redriverhealthandwellness.c...

functionalhealthnews.com/20...

Have you had both TPO and TG thyroid antibodies tested for cause of being hypothyroid as due to autoimmune thyroid disease also called Hashimoto's?

Cough can be dairy intolerance with Hashimoto's

thyroidpharmacist.com/artic...

[CFM83]

Thank you, very helpful. On my results, I can see from the first set, my Anti TPO Ab was 273 (0-34). Again, despite it being really high, there was no mention of this result or Hashimotos?

[greygoose in reply to CFM83]

You do have Hashi's, with that result.

Are you still taking the reflux tablets? They could be affecting your absorption of levo.

[SlowDragon Administrator in reply to CFM83]

Also if you have had vitamin D, folate and B12 tested can you add these results and ranges too

Common for all to be low with Hashimoto's

Your antibodies are high this is Hashimoto's, (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. 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

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

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

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

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

thyroidpharmacist.com/artic...

But don't be surprised that GP never mentions gut, gluten or low vitamins. Hashimoto's is very poorly understood

Acid reflux is more likely low stomach acid, not high acid with Hashimoto's

What are the reflux tablets from GP?

They are likely for treating high stomach acid. You must not stop these suddenly. They have to be weened off slowly

Getting vitamins optimal, Thyroid dose increased and strictly gluten free diet are all likely to help

Low stomach acid Is common Hashimoto's issue

thyroidpharmacist.com/artic...

drmyhill.co.uk/wiki/hypochl...

scdlifestyle.com/2012/03/3-...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

pulsetoday.co.uk/clinical/m...

gov.uk/drug-safety-update/p...