I have lived in France for the past year and was diagnosed with Hashimotos Hypothyroidism while I've been living here. I was diagnosed in April 2018 after experiencing various symptoms for a few months prior to this. My worst symptom being joint pain, especially in my wrists and fingers.
My endocrinologist put me on levothyroxine starting low at 25mcg and increasing to 62.5 at the highest. I had to change to l-thyroxin henning due to reaction (I am lactose intolerant) at one point. About a month later I had severe illness in my stomach which either caused or was a symptom of my hypo flipping to hyper (although my thryroid remained enlarged according to ultrasound). After taking me off all medications for 3 weeks my endo did more tests and put me on 25mcg of l-thyroxin henning. My most recent test was 4 weeks after beginning on this dosage (results below). My joint pain is back and keeps me awake at night and just generally uncomfortable in the day. I am tired again but this could be from not sleeping at night rather than a symptom in its own right.
Antithyroglobulin antibodies: 417 (ref <115)
Free T3: 2.98 (ref 2.30 - 4.2)
Free T4: 1.01 (ref 1 - 1.6)
TSH Ultra-sensible: 4.91 (ref 0.27 - 4.20)
I would love if someone could please give me advice on this!
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JessD86
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You are undermedicated. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well. So your TSH is over range, your FT4 is at the very bottom of the range andyour FT3 isl ow in range. You need an increase in your dose of Levo, retest after 6 weeks, another increase, retest after 6 weeks, and continue until your levels are where they need to be for you to feel well.
Are you addressing the Hashi's with a strict gluten free diet to help reduce the antibodies? Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
As you have joint pain, this could possibly be due to low Vit D.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. So it would be worth testing the following
Thank you for replying (and to my other post also).
I was previously on the dosage increase, test after 6 weeks journey but then got a stomach infection/inflammation and at the same time my test results showed I had switched to Hyper. I was prescribed antibiotics by a hospital doctor for the intestine inflammation and it cleared up after about two weeks. My endo looked at my test results and wasn't sure about whether the stomach infection was connected to my thyroid issues or not but had me go off the meds for a couple of weeks and now I'm essentially starting again.
No one has mentioned going gluten-free to me. I have seen a gastroenterologist here who looked at my blood tests and CT scan of my stomach and he was certain my thyroid wasn't connected at all. He thinks I just had a bacteria in my stomach from something I ate (I don't agree as my husband ate the same things as I did and he wasn't sick at all).
Either way, going gluten free would be quite difficult here and I am in the middle of moving at the moment so eating out much more than cooking. I will definitely look into doing this when I get back to the UK as it will be easier for me then. Thank you for the advice.
I am hoping that when I get back to London and find a new Endo I will be tested for everything needed (and will specifically ask about the things you suggested above).
Thank you so much for taking a look at my results and for your advice!
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
As gut problems are common with Hashi's, it's worth looking into that. SlowDragon has lots of advice and you can see some information and links in her reply towards the end of this thread healthunlocked.com/thyroidu...
For full Thyroid evaluation you need TSH, FT4, 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
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, 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)
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels. Low vitamin levels affect Thyroid hormone working
Low stomach acid also can make H pylori infection more likely
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, sometimes 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 Gut connection is very poorly understood
Trying strictly gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
As SeasideSusie says, you're currently not on enough Levothyroxine
Levothyroxine should be increased in 25mcg steps, retesting 6-8 weeks after each dose increase
This continues until TSH is around one and FT4 towards top of range and FT3 at least half way in range
Once back in UK, 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 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
NICE guidelines saying how to initiate and increase. Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine
City Assays do the Vit D test for overseas clients as well. The client just had to add the appropriate postage to the envelope when sending back to the UK. I suppose because it's a dried blood spot there's nothing to spoil like with a fresh serum blood sample.
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