Hypothyroidism, blood pressure & cholesterol - Thyroid UK

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Hypothyroidism, blood pressure & cholesterol

StelAnd profile image
22 Replies

Hi I have been seeing an Endo but my symptoms of high bp, anxiety raised cholesterol are rising. Here are my results:

Feb 2018 TSH 0.18. FT4 16.9pmoI/L BP168/93 thyroxine dose 75mg

Nov 2018 TSH 6.88mu/L Free T4 12.8pmoI/L TTG antibody negative with a recommendation my thyroxine dose went to 100mg

Dec 2018 TSH 3.81mU/L

FT4 13.7pmoI/L

FT3 2.72pmoI/L thyroxine dose to stay 75mg BP 173/99

I really am st my whits end, can any advise as I understand none of this 😢

22 Replies
SlowDragon profile image
SlowDragonAdministrator

February test was only FT4 and TSH

This is completely inadequate

You need Full thyroid and vitamin testing

TSH, FT4 and FT3 plus both TPO and TG Thyroid antibodies and vitamin D, folate, ferritin and B12 too

Private testing is available

Are you in the UK?

All thyroid tests should be done as early as possible in morning and fasting and no levothyroxine in the 24 hours prior to test

Is this how you do your tests?

Have you ever had both thyroid antibodies tested?

Ask GP to test vitamin levels and thyroid antibodies if not been done

Or test privately

NHS refuses to test FT3 in many cases

Can you add the ranges on these results please too

StelAnd profile image
StelAnd in reply to SlowDragon

I’m in uk & this was the results I received back from Endo appointments. I had a recommendation that it went to 100mg but never got to start that as when tested from the results (which was in my last thread) it was said to continue on 75mg

StelAnd profile image
StelAnd in reply to SlowDragon

Testing for B12 Ferratin, iron deficiency renal function all stated were normal in July 2018

SlowDragon profile image
SlowDragonAdministrator in reply to StelAnd

I am also out at moment

Will reply in detail this evening

StelAnd profile image
StelAnd in reply to SlowDragon

Thank you

Marz profile image
Marz in reply to StelAnd

Did you obtain copies of your results with ranges ? Normal is an opinion and not a result - Is your B12 500+ - VitD 100 - Folate and Ferritin mid-range ? These are the levels required for good thyroid function and for you to feel well.

How do you take your thyroid meds ? Are you on any other meds that could affect the uptake of Levo ? Gut issues ?

Were you able to follow any of the advice given to you by SlowDragon in your post of six months ago ? We seem to be covering the same ground 😊

StelAnd profile image
StelAnd in reply to Marz

Yes I did get private checks but the GP I saw basically reprimanded me for doing so as they’d just done bloods from my surgery which I posted then and the surgery were telling me they were normal. I don’t have the ranges from the copy letter the Endo sent to me & my doctor.

Marz profile image
Marz in reply to StelAnd

I cannot find your results for B12 etc in your previous thread/posts ... sorry if I have missed something 😊

What other meds/supplements are you taking ? How do you take the Levo ?

StelAnd profile image
StelAnd in reply to Marz

I had the medichecks blood test results 21 March . These are them

ENDOCRINOLOGYThyroid FunctionTHYROID STIMULATING HORMONE 0.85 mIU/L 0.27 - 4.20 FREE THYROXINE 17.8 pmol/L 12.00 - 22.00 TOTAL THYROXINE(T4) 86.6 nmol/L 59.00 - 154.00 FREE T3 *3.03 pmol/L 3.10 - 6.80 THYROGLOBULIN ANTIBODY 12.100 IU/mL 0.00 - 115.00 THYROID PEROXIDASE ANTIBODIES*47.5 IU/mL 0.00 - 34.00 Sorry I didn’t get the package for vitamins but Endo said B12 etc fine when done in Dec. I take my thyroxine as soon as I wake at 6.00am on an empty stomach and don’t have food until an hour or more later. I take Hawthorne garlic, about 4.00pm or later in the evening

Marz profile image
Marz in reply to StelAnd

As we see here almost daily fine means in range. It is where you are in range that is key - as detailed in my reply above !

StelAnd profile image
StelAnd in reply to Marz

Sorry for sounding dumb but my ranges? I don’t understand what they are. I’m sorry if I’m coming across as a dimwit

Marz profile image
Marz in reply to StelAnd

You have included the ranges after your thyroid results in the above post. It is the figures after the result. If the range for B12 is 180-900 and your result is 190 - then the Doc will say they are fine - but they are NOT. As I have explained above your result needs to be over 500 and nearer the top of the range when Hypo. It is the results and ranges of your B12 - Folate - Ferritin and VitD that are missing.

I see you have requested info on an Endo in Manchester in another thread. Am not sure what you are hoping to gain - you have been given so much information over several threads - and the conclusion of many here is that you are under medicated and have a below range T3. So what an Endo can tell you that is more helpful I fear is very little. Also they rarely consider the T3 result - in spite of it being the most important result. They certainly do not look at vitamins and minerals - very rare indeed.

thyroiduk.org

Please read the above link and all the information within to help you understand the Thyroid and its workings ... Keep reading and reading ... we have all had to learn in order to find wellness :-)

greygoose profile image
greygoose

I think you need a new endo! Any doctor that leaves a patient on 75 mcg levo with a TSH of over three, is not fit to practice! You are still hypo, and that's why your symptoms are increasing.

StelAnd profile image
StelAnd in reply to greygoose

Apart from changing Endo (how do I approach that?) what do you suggest I do? Thank you for your reply, I really don’t understand any of it.

greygoose profile image
greygoose in reply to StelAnd

I can't tell you how to change your endo, I don't live in the UK. But, you so obviously need an increase in dose. Sorry, don't have time to go into any detail right now. Got to go out.

fibrolinda profile image
fibrolinda

The aim of a treated hypo patiant is Tsh of 1 or under and free t3 and 4 in the top 3rd of range. My brain is fried so trying to come p with the info is beyond me but your free t3 is Below range and the reason you are so ill. You are going to have to fight your corner, how good is your GP? You can explain to him/her that you are being kept ill by incorrect treatment and request referral to Endo who is Thyroid specialist, not diabetic specialist. If you look to the right or find PINNED POSTS and there is one 'A suggested gift to doctor diagnosing hypothyroidism or treatment and have a read. Also look at parent site Thyroid Uk and read and learn thyroiduk.org/index.html There are articles on treating with guidelines on levels etc, maybe post asking for link to Dr Toft article r any other relevant info. Oh I am so sorry, my brain is so fogged I cannot pull anything out but please learn. You are under medicated and being kept ill by …… no polite words to describe your Endo.

StelAnd profile image
StelAnd in reply to fibrolinda

Thank you for your reply fibrolinda

StelAnd profile image
StelAnd

Thank you so much for your reply. Call me dumb but I do not understand what it means by my ranges?

SlowDragon profile image
SlowDragonAdministrator

Firstly as others have said, on Levothyroxine our TSH should be between 0.4 -1.5 maximum. Not somewhere within range

Each test has a range that normal results fall within

Eg TSH 1.2 (range 0.4 -4.8)

In this case of TSH, the range is used to diagnose patients who need Levothyroxin. But once we are on Levothyroxine this "normal" range is too wide. Most thyroid patients need TSH low in range, often under 1. Sometimes under 0.4

New NHS England Liothyronine guidelines November 2018 clearly state on pages 8 & 12 that TSH should be between 0.4-1.5 when treated with just Levothyroxine

sps.nhs.uk/wp-content/uploa...

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


On Levothyroxine, because the TSH becomes unreliable, the most important tests are FT3 and FT4.

Most endocrinologists are Diabetes specialists. You need to see one who specialises in Thyroid

Email Dionne at Thyroid Uk for list of recommended thyroid specialists on Monday

please email Dionne at

tukadmin@thyroiduk.org

Always get actual results and ranges on all your blood tests. A result without the lab ranges is pretty meaningless. You are legally entitled to printed copies of your blood test results and ranges

This is especially important on vitamin test results and FT4 and FT3, ranges can vary widely from lab to lab

Vitamins need to be at good levels to help thyroid hormones work well. So somewhere near bottom of range may not be good enough

Ask your GP to test vitamins for you, plus request coeliac blood test as you have autoimmune thyroid disease (diagnosed by above range TPO antibodies)

Or get Thyroid and ultra vitamin test via Medichecks

SlowDragon profile image
SlowDragonAdministrator

First step is to get FULL testing including vitamins, via GP or privately for any not done

Getting vitamins optimal essential. Most/many with Hashimoto's need to supplement regularly to maintain good levels of some or all of these.

Dose increase in Levothyroxine via GP

Trying strictly gluten free diet (after coeliac blood test just to rule that out )

Come back with new post once you have results and ranges

Meanwhile see if there's a recommended NHS endo near you (likely a long wait and you need to persuade GP to refer you)

Or Private option, no wait and don't need GP permission, but may still need letter of referral (which they can't refuse on a private consultation)

Always get full testing BEFORE seeing a private consultant. Otherwise appointment is waste of time and tests via Medichecks, Blue Horizon etc are usually cheaper options on testing than via private consultant

StelAnd profile image
StelAnd

Thank you so much again slow dragon

StelAnd profile image
StelAnd

Many thanks

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