I have just been to the doctors for a recap on my medication and bloating.
My last results are:-
TSH 6.5 (0.27-4.2)
Free T4 22.7 (12-22)
Free T3 3.0 (3.1-6.8)
Vit D 73.7
B12 299 (180-914)
Folate 4.1 (3.0-20)
Ferritin 38 (10-307)
I have positive antibodies of 118 and on 75 mg of Levo.
I went to discuss again the bloating which is affecting my life too much. I had previously been advised to go on a low FODMAP diet, try peppermint capsules as the dr thought it was IBS. After 3 weeks no improvement.
She has upped my medication to 100 and told me to take a mild laxative for the bloating such as Fibrogel. I did suggest that this could be leaky gut/SIBO, all of which were glossed over. I do not feel constipated at all, she seemed to think if you didn't pass one long stool then you were? first I have heard of this, guess she is the doctor.I also asked about taking more supplements as have previously been advised here to up my B12/folate/levels ( already take vit d supplements). I was told this was not necessary, and I felt like a know-all. SeasideSusie, I took the article suggested by yourself and highlighted question 6 (Dr T ), but I notice you say
'If your FT4 an FT3 levels are accurate then you aren't converting T4 to T3 and possibly making rT3 instead of FT3. Pumping more Levo in will make this worse.'
I told her I cannot convert T4 into T3 properly. The reply I got to this was that there is no evidence that T3 Liothyroxine? helps, and obviously she could not prescribe it. I have previously been told the same thing by an Endocrinologist.
Any thoughts again please, should I be taking the 100 umg and try the fibrogel to see if it works. I do have B12 ready to go but am still a little bit reluctant to take it.
Must add I have been gluten free since November.
Thank you once again.
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goofball
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Good lord! I am shocked to almost wordlessness. Almost. Did she say nothing about the well over-range TSH. Or the under-range FT3? How dare she call herself a doctor when she's so ignorant?
Your conversion is very bad. And the problem is not so much the rT3, as the low FT3. Yes, your rT3 will be high, but it will be the low FT3 causing any symptoms you have. And, the upshot is, you are still very hypo, despite your high FT4. And your doctor knows less than nothing.
Anyway, as for the bloating, I would suggest that, being so hypo, you have low stomach acid - and your low B12 will be making that worse. So, what you need is not a laxative, but something to raise your stomach acid. At the moment, your food is probably fermenting in your stomach causing gas. (There are several forms of constipation, but I've never heard her definition before!) I suggest that you read this article, and try the home acid test at the end:
Thank you as I thought constipation pah! Would you suggest that I keep taking 75 levo do still have a months worth left.
No she didn’t mention Ferritin. I did mention all those figures and like I say felt an idiot as she didn’t run with any of my suggestions as to the bloating which is what I am the most bothered about. Your test I will try and do thank you. Do you think I shouldn’t waste my time on the laxatives? It’s very difficult as you feel obliged to do as they suggest. Guess I’ll have to go to another doctor. What are private doctors like any better ? Do you think I should just roll with the vitamin B 12 supplements now.
She's the idiot, not you. Well, badly educated, anyway. I suppose you could say it's not her fault if she doesn't know these things, but I wonder how many sick days - or skiving-off days - she had in med school. She seems to have missed rather a lot of their already skimpy endocrine lectures.
There's no point taking a laxative if you're not constipated - they can be habit-forming. In any case, if you were constipated, I'd suggest high doses of vit C and magnesium, rather than a laxative.
If you stop taking the 75 mcg levo, your level will go down again, which won't help anything. But, if I were you, I would consider self-treating with T3 if the worst comes to the worst. Which it well might, given the current political situation. Your doctor may believe there's no proof that T3 helps, but she'd soon be screaming the odds if someone took away all her naturally produced T3.
The average private doctor is no better than the average GP - they've had the same education. In fact, most private GPs/endos are both private and NHS. The only advantage is that you might get seen sooner. But, the majority of endos are diabetes specialists, with some weird notions about thyroid. So, unless you can find one that is patient-recommended to be T3/NDT-friendly, I would save your money, if I were you. You can email Dionne at
tukadmin@thyroiduk.org
for her list of recommended doctors.
You are not obliged to do anything they suggest, or take anything they prescribe. It would be different if they actually knew what they were doing, but they don't.
Thank you . I meant still take the 75 instead of the 100 she has re prescribed. Trouble is I have the 100 on repeat as she altered it. I am just worried about taking B12 without any go ahead but think I should. If I do have low stomach acid does the article give a solution please ( sorry not had chance to read it yet) thank you 😀
Goodness. If you're waiting for a doctor to tell you to take B12 you could wait a very long time. You cannot over-dose on B12 because it's water-soluble. So, I would just go ahead, if I were you.
Should you take the 100 mcg rather than the 75? Well, looking at your FT4, it's probably not going to make much difference. I think you're already past the cut-off where you start making more rT3 than T3, so it doesn't matter either way. You might even manage to raise your FT3 a little bit. It won't be enough, of course, but give it a try. See how you feel. If you feel worse, go back to the 75 mcg.
I haven't read that article for a long time, but as I recall, it does suggest solutions at the end. If not, come back and ask the question. Lots of people here know. I don't because I've never had that problem, but it really does sound like you do.
Why are Doctors so badly educated in thyroid issues. It is so unprofessional, that’s 2 different doctors tell me rubbish about my stomach one saying IBS the other constipation an absolute joke. Even I with no medical knowledge know that I am not constipated and really was gobsmacked when she came out with her dodgy definition, she actually said that about one long poo (sorry) I don’t have any pain and go regularly. Gosh makes you wander how people with life threatening conditions actually make it through. Thank you once again x
Half the problem is, thyroid problems aren't seen as life-threatening - even though they can be if neglected.
The other half is that Big Pharma controls what doctors learn in med school - he who pays the piper, and all that. And, it's not in BP's interests for doctor to learn how to diagnose and treat thyroid correctly. They are making a small fortune making drugs to 'treat' all our symptoms as individual diseases: statins, Beta Blockers, PPIs, etc - laxatives, even. If we were treated correctly, we wouldn't 'need' all that, and PB would lose a hell of a lot of money.
And, god forbid that doctors should know about nutrition! BP would go completely out of business!
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You cannot over-dose on B12 because it's water-soluble. So, I would just go ahead, if I were you. 
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