Finally have more figures! : So further from my... - Thyroid UK

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Finally have more figures!

Sarahsmurfs profile image
12 Replies

So further from my previous post about my mum who has been increasingly unwell over the last 2 years can these figures help shed some light on the problems. She is severely constipated and has been had a couple of enema’s that have been successful!!

Figures are...

Blood pressure - 140/80

Systemic examination normal

Hba1c - 42 repeat in 3 months

Adj calcium, magnesium, protein and alk phos are all normal

9am cortisol = 429nmol/l excludes cortisol deficiency

FT4= 21.3 (normal)

FT3 = 3.3 (low) pmol

Tsh = 9.97 (high) mlu/l

Vitamin d = 29.96 Nmol/l (severe deficiency) prescribe supplements

She has been changed from 100 thyroxine per day to 100/125 alternate days and also been told to take the medication in the morning rather than at night.

Can anyone shed any light. Thanks in advance.

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Sarahsmurfs
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SlowDragon profile image
SlowDragonAdministrator

To have TSH so high shows your Mum is very hypothyroid

Just changing dose to 100/125 alternate days s extremely conservative.

She is likely to need further increases in dose.

Blood should be retested in 6-8 weeks

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Research suggests taking Levothyroxine at night can give better absorption, providing she was taking it on empty stomach (no meal for 2-3 hours before and only water for at least an hour before)

So slightly strange that she is now advised to take in morning

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

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

Many people find Levothyroxine brands are not interchangeable. Once find a brand that suits, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription. Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

What brand is she taking?

Her vitamin D is extremely low

She should be prescribed LOADING dose as matter of urgency to improve

oxfordshireccg.nhs.uk/profe...

She also needs vitamin B12, folate and ferritin tested too

Add results and ranges if you have them

Aurealis profile image
Aurealis

Are they trying to raise her T4 higher in the range in order to see if T3 increases into range? If it doesn’t she needs to take T3 (Liothyronine). Good luck

greygoose profile image
greygoose

Do you have the actual ranges for those results? Just saying high/low/normal is of no help at all. Is that FT3 below range? If so, then that's her problem - she's still very, very hypo. So, not surprising she's constipated and tired. The FT4, on the other hand, looks as if it might be up the top of the range. So, what's happening - or rather what isn't happening, is that she isn't converting her levo (T4) into T3. And, with such a huge gap between the two, just increasing her levo by 12.5 mcg is going to do absolutely nothing. She desperately needs T3. That's the only way she will ever be well.

For the constipation, I would suggest that taking magnesium and vit C would do her far more good than enemas. :)

Sarahsmurfs profile image
Sarahsmurfs in reply to greygoose

Thanks so much for all your advice - needing t3 was what we suspected. so, how do we go about getting t3?

greygoose profile image
greygoose in reply to Sarahsmurfs

That was just a supposition. I don't know for certain because you haven't put the ranges with the results.

Sarahsmurfs profile image
Sarahsmurfs in reply to greygoose

Because we don’t have them! We are struggling to get anyone in the medical

Profession to pay any attention. They obsess over her tummy pains and constipation and don’t seem to want to acknowledge the actual issue! So frustrating! Monday she was told severe bit d deficiency and still no prescription!! And now they just want to arrange a ct scan!

greygoose profile image
greygoose in reply to Sarahsmurfs

If you are in the UK, you are legally entitled to a copy of your blood test results, and that includes the ranges. So, if she just asks at reception for a print-out, they can't refuse without breaking the law.

The trouble is, they don't know the symptoms of hypo. Constipation is one of the main symptoms, but they don't recognise it as such. And, if you're constipated, you are going to get stomach pains!

What did they say about her high TSH? What was their justification for telling her to take her levo in the morning, instead of at night? It probably works better at night, anyway. But, even if she's not converting very well - which it certainly looks as if she isn't, unless the ranges are very strange - doctors wouldn't recognise that. Is she an assertive person? Or over-whelmed by it all? Do you go with her to the doctors?

Sarahsmurfs profile image
Sarahsmurfs in reply to greygoose

My parents have been going to the drs alone. I’m inclined to go with them

Next time as it feels like they just aren’t asking the right questions! Thank you for all your advice. I’ll jeep on at them and hopefully I can get full blood results to show on here and get some answers from someone somewhere medically! Thanks again

greygoose profile image
greygoose in reply to Sarahsmurfs

I think it would be a very good idea if you went with them. But, do your homework, first so that you recognise when the GP is fobbing them off. I have the impression that the older you are, the less they care, so a someone younger and stronger, who understands what the doctor is talking about - or when he's talking rubbish! - would give things a shot in the arm! :)

SlowDragon profile image
SlowDragonAdministrator

Meant to add, when taking vitamin D, magnesium is important

Would also help with constipation

Aiming to improve vitamin D to around 100nmol. (gP only interested in gett It to 50, 75 if lucky)

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 level improves, very likely your Mum will need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk

Magnesium citrate can help with constipation

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...

I did suffer from constipation as I have no gallbladder. I have now increased my Vit D which I take with K2. I also take vitamin C every day. I only take these three apart from my thyroid medication which I source myself I feel well and I am 72 years old with no thyroid. I have no other health conditions and now take T3 only but was taking NDT for nearly three years also with no problems.

Since increasing my Vit D and taking Vit c everyday I never suffer from constipation and have also been completely free of chronic sinus which I had for over 60 years.

HLAB35 profile image
HLAB35

For the constipation I'd recommend soluble Magnesium Citrate powder as the dose can be adjusted as your Mum gets used to it. You may find a brand that also has soluble vit c in it as well to help. If it's cheaper to source the powders separately it is fine to mix the two together. Much nicer to swallow for an elderly person than Magnesium tablets.

N.B. Serum Magnesium tests are unreliable and untrustworthy as the body will always try to keep Magnesium moving around the blood regardless of how depleted the tissues are. The reason for this is that Magnesium is essential for 100's of metabolic processes; we cannot afford to have it stored somewhere inaccessible as it were. (I've been reading a lot about Magnesium recently :-) )

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