Conversion problems

[Lynny66]

My mum recently under went private blood tests because her T4 & TSH were both high and have been difficult to control over the past year with GP moving her dosage about which hasn't helped. The problems seems to have started since taking a statin but maybe coincidental. Mum was taking the statin at the same time as the thyroxine with her breakfast! No one told her any different. She has changed this to taking thyroxine an hour before breakfast and the statin at night. She feels a bit better for doing this after 6 weeks although levels are still high - TSH has come down a bit. Her reverse T3 is high.

The consultant told us the blood test showed that her magnesium and selenium are low so is going to provide supplements also a probiotic. She also did a stool test which showed a parasite in her gut -. he is going to prescribe antibiotics for that. Her antibodies were fine.

He mentioned doing a 'genetic' test that wouldn't be covered by the insurance and would cost £250 that would give us an answer sooner. Can anyone explain what this test is and what it does? We opted to try the supplements, and antibiotic and see what happens in 8 weeks to her levels and how she feels and then to do the stool test and bloods again. He told her to eat more healthy fats too. She had cut down on fats because was told her cholesterol was high when they gave her the statin. The cholesterol is an ok reading now. Consultant increased her Thyroxine dose back to what it was when she was settled for the last 30 years! 75mg. If this doesn't work he suggested then paying for the genetic test.

I could kick myself now for not asking for the genetic test to be explained.

Thanks for any advice.

[SlowDragon Administrator]

High cholesterol is linked to being under treated and hypothyroid

Statin may not be necessary once she is correctly treated

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

50mcg Levothyroxine is only a starter dose. Most patients eventually need somewhere between 100mcg and 200mcg

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 is in top third of range and FT3 at least half way in range

Low vitamin levels are EXTREMELY common when under treated

Bloods should be retested 6-8 weeks after each dose increase (or change in brand of Levothyroxine)

For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised or if under medicated

Has she had BOTH TPO and TG thyroid antibodies tested?

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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)

Always take Levo on empty stomach and then nothing apart from water for at least an hour after.

Many take Levothyroxine early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

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 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

NHS guidelines on Levothyroxine including what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

NICE guidelines

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

[Marz]

There are several Genetic Testing companies - some better than others I have read You could try googling and read the comments to see which would be best. Telephoning the consultant could be the other option - or his secretary !

Statins do not benefit women or anyone come to that. Is her VitD low ? The main benefit of a statin is anti-inflammatory - so VitD would also do the same

[humanbean]

Some info on statins that is worth reading - I particularly like no 17 :

spacedoc.com/articles/50-fa...

[greygoose in reply to humanbean]

That is brilliant! It's all there. I shall use that in future, rather than trying to remember it all to type it out myself!

[humanbean in reply to greygoose]

Yes, I like the link for exactly the same reasons. It saves me the effort of trying to explain my thoughts on statins. And I'd struggle to explain my thoughts anyway.

[greygoose in reply to humanbean]

There are so many points to remember. It's all rather complex. But, the bottom line is always: don't take statins.