Confused.

[Conygarview]

Yesterday the doctor gave me the results of my TSH. Aug 2016 2.1, Oct 2017 5.4, September 2018 4.5, Nov 18 2.4. He doesn't test for anything else. I was on 125mm. Over Christmas I had hot flushes, and panic, waves of feeling ill. Impossible to see a doctor then, so decided I was over active and dropped myself to 100, still the same so dropped to 50mm. It seem that my reaction was to dairy and now I have cut that out I am feeling better, but think I am still low, I am on 75 now. The doctor said stay on75 for 3 months. I have a blood test booked on Feb 8th at 8:30, so will fast first. I feel that I have really messed up. I need advice.

[SeasideSusie Remembering]

Conygarview

To be able to understand your results, we need the reference ranges please as they vary from lab to lab.

All those TSH results suggest you were 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.

However, TSH alone doesn't give the full picture as it's not a thyroid hormone, it's a pituitary hormone which tells the thyroid to make thyroxine if it detects there isn't enough. So you need FT4 and FT3 testing as well.

Also, have you had thyroid antibodies tested, that tells you if you have autoimmune thyroid disease which is where the thyroid is gradually destroyed and as antibodies fluctuate you can swing from hypo symptoms/results to hyper symptoms/results and back again.

Also, for thyroid hormone to work we need optimal nutrient levels. Have you had the following tested:

Vit D

B12

Folate

Ferritin

If not, ask for those too.

If you can't get these tests done, we have recommended labs which supply home fingerprick tests (or venous if preferred).

[Conygarview in reply to SeasideSusie]

The doctor read the TSH numbers to me, I have nothing else. I think I will have to do a test you recommend. On December 23 , I was in A&E on a heart monitor for 5 hours after an ECG, with high BP and racing heart. They thought that I had been glutened or my Levo dose was too high. A nurse there was dairy free and that started me thinking that was my problem too. I told the doctor and was given liquid thyroxine, dairy free. We went away for the holidays that evening. Still having symptoms, I tried lactose free for several days, no good! My daughter found your really helpful web site and I am Now dairy free. Feeling better but not good.

[SeasideSusie Remembering in reply to Conygarview]

The recommended test for a full picture of thyroid and vitamin status is

Medichecks Thyroid Check ULTRAVIT medichecks.com/thyroid-func...

or

Blue Horizon Thyroid Check PLUS ELEVEN bluehorizonmedicals.co.uk/t...

Both can be done by fingerprick or venous blood draw is extra cost.

[SlowDragon Administrator]

If you are dairy or lactose intolerant, and many people with Hashimoto's are, then you may need Lactose free Levothyroxine

Only two options available.

Teva brand of tablets. Many people don't get on well with

Or liquid Levothyroxine. Quite expensive, so GP would be reluctant to prescribe

Just testing TSH is completely inadequate

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially as you have Hashimoto's

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

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

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Come back with new post once you get results and ranges

Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise

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, 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

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...