Everything was ticking along nicely. On 75mcg levo and taking various supplements according to my last blood test requirements and advice on this forum.
Just recovering from a long bout of sciatica in my leg, so don't know if that has brought me down, but not feeling so good lately. Last blood test was December last year so requested one from the doctor. Didn't know what to request so just put full thyroid test. Results were:-
serum TSH 1.07 miu/L 0.55-4.78
serum free T4 14.5 pmol/L 10-20
serum free T3 3.2pmo/L 3.5-6.5 abnormal
I don't think they have ever test T3 before. TSH was up from 0.58 and T4 about the same. What if anything do you think they will do about the T3? Or rather what should they do?? I haven't contacted the Dr yet and thought I would get a bit of advice from you experts first! Thanks in advance.
Jankei
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jankei
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Bloods should be retested 6-8 weeks after 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).
Also request vitamin D, folate, ferritin and B12 are tested if not been done for awhile
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
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
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.
Thanks for your prompt reply. I am currently mulling over what you say. I am currently taking vit D3 4,000 iu, vitB12 methylcobalamin 1,000 and magnesium citrate. I took a vit b complex for several months, but it was all getting a bit expensive. My vit D test in December had gone from 61 to 95. Worried about the pernicious anaemia so will ask Dr when I see him/her for test. A lot to think about and so difficult to get across to doctors if they disagree.
Trouble with testing for PA is once we start supplementing any B vitamins testing is more difficult. It takes 4-6 months of not supplementing to get back to pre-supplement levels (not advisable)
You could ask advice on PAS healthunlocked
But it's more likely low B12 and low folate are due to being seriously under treated for Hashimoto's
There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,
Patients with AITD have a high prevalence of B12 deficiency and particularly of pernicious anemia. The evaluation of B12 deficiency can be simplified by measuring fasting serum gastrin and, if elevated, referring the patient for gastroscopy.
Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.
Based on what you just said, maybe if I can get an increase in levo and try that for a while and then get another blood test with vits levels etc. Thanks
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