Hi I have Hashimoto’s, Sjogren’s Syndrome, am border line Lupus, with heart and neuropathic problema also. Yay, go me !
I cannot lose weight. I suffer from fluid retention (about 30 years) which is sometimes under control but not often. I eat, according to my husband, like a bird. I’m allergic to gluten and dairy so no cream cakes, donuts or chips for me and I rarely use gluten/ dairy free substitutes and very rarely eat sweets. I cook all fresh food ie no pre-prepared foods. I am on a ton of medication including weekly injections of methotrexate and 6 monthly Rituximab infusions. I also take alternate days 50/75 mg of Levo at around 6-30am with a large glass of water before eating/drinking anything else at around 10.30am
These are my last Thyroid results which of course our ‘normal’ ie within range. but I know they cannot be optimal. The labs were taken on an empty stomach without any meds having been taken at 10-45am.
Any advice on how to improve things would be great.
THANK YOU 🙏
FT3 3.43 (1.40-4.40)
TOTAL T3 0.97 (0.80-1.90)
FT4 0.97 (0.70-2.00)
TOTAL T4 7.69 (4.70-12.40
TSH 0.187 (0.17-4.50)
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sjogrens101
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Essential to regularly test vitamin D, folate, Ferritin and B12
Have these been tested? Add results and ranges if you have them
If not, request GP does so
You are on very low dose Levothyroxine. FT4 is low
See GP to discuss dose increase. Initially perhaps just to 75mcg daily
Bloods should be retested 6-8 weeks after each dose increase
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
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
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
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. Teva is the only brand that makes 75mcg tablet.
Thank you so much for taking the time to reply. I was B12 and Vit D deficient but after monthly B12 and weekly liquid Vit D supplementation for 3 years, both are now at the top end of the range. Folate is low due to Methotrexate and I take 10mg per week to try to help this. Ferretin is being checked with my monthly bloods tomorrow.
I get my Levo in Spain as I am here often, the brand here is Eutirox and it does contain a very small amount of lactose !! I shall check out the Tevo brand you suggest.
It seems I’m allergic to the protein casein. I can eat a little butter and even have a little lactose free milk in tea, but lactose free cheese and other products cause joint swelling/pain as does all regular dairy products.
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