Hi everyone, I was diagnosed with subclinical hypothyroidism in April 2017 with a tsh of 6 and t4 of 14, after 6 years of experiencing symptoms. My Dad and Sister both have Hashimotos, and an antibody test last year confirmed the same for me. I currently take 100mcg levo a day, but don't feel well. I am gaining weight, lacking energy and struggling to sleep at night despite being tired. I feel a huge amount of anxiety at night and feel like there is a heavy weight on my chest, it's hard to explain but it makes laying down unbearable for me. I also get palpitations. I did a medichecks blood test last week, testing tsh, t4 and t3 and wondered if anybody could tell me if the results look ok? I suspected a conversion issue could be what is causing my symptoms, or maybe that I am over medicated, but with these results I'm not sure. I have read on here today that taking levo at night has helped people with sleep problems, and I intend to try that from tomorrow but the weight gain and tirdness is really getting me down. Maybe it's not my thyroid and it's something else, but if anybody has any insight it would be greatly appreciated.
Medichecks results
TSH 1.3 miU/L. (0.27-4.2)
Free T3 4.71 pmol/L. (3.1-6.8)
Free Thyroxine 20.5 pmol/L. (12-22)
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HRH89
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Thank you for your reply! After doing a bit of reading this is what I suspected, but then with the results coming back in range I wasn't sure! No I didn't get nutrients tested, I did get my ferritin tested in July last year, as I thought I might be anemic, ferritin came back at 70.1. Sorry I still struggle to get my head around it all, but does vit D, b12, etc all help with conversion? My GP wont entertain the fact that my symptoms may be thyroid related and tries to fob me off with anti depressants, which I refuse as I know I'm not suffering with depression. I guess the next step is to get nutrients checked and see if anything shows up there?
Just being in-range is meaningless. It's where within the range that the results fall that counts. Your FT4 is right up the top of the range, and your FT3 is just under mid-range. That is wrong. There shouldn't be such a large gap between the two.
Vits D and B12 do help with conversion, yes. So does zinc and selenium. But, there can be many, many reasons for poor conversion, and we don't always find out where the problem lies. Nutrients are just the best place to start looking.
Doctors know nothing about symptoms. They don't learn them in med school. And, besides, he gets financial incentives for prescribing antidepressants and nothing for thyroid hormone replacement! So, it's obvious with one he's going to push on you - disgusting as that may sound.
Wow financial incentives? I wonder if that's why 3 different doctors at my practice have offered me antidepressants in the past 12 months! I'm going to do more private tests for nutrients and see what comes back from that. I guess there's going to be no simple or quick fix for this, but I'm feeling a bit more positive now I'm learning more about it all! Thank you for your replies and info.
Vitamin D, folate, ferritin and B12 levels need to be OPTIMAL for good conversion of FT4 to FT3
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood 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)
Is this how you do your tests?
Your FT3 is low
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
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
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone
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
Hi, thank you for your reply and all the info! Yes that's what I've always done when having a blood test since being diagnosed. I did have a coeliac blood test almost 2 years ago and it came back negative. Do you think it's worth doing another? I would definitely be more than happy to go gluten free and see if that helps. I am going to try my GP again tomorrow and ask for a blood test for nutrients. I am able to view my blood results online through patient access, but may need help determining whether they are optimal or not! Last year when I went to see her complaining of on going symptoms she did full blood count, electrolytes bone profile and TSH, of course they all came back normal and I was asked if I think I'm depressed. So I gave up on her at that point and upped my levo to 100mcg a day thinking that would help. I was alternating 75 and 100 before that. But I will directly ask for vit D, B12, folate and ferritin to be checked and see what she says. If it's a no I'll go through medichecks or blue horizon. Thank you for the detailed post!
Just a little update, I had blood tests at my GP surgery this morning, managed to get ferritin, folate and B12 tested amongst other things. Doctor rang me late afternoon to say ferritin is low and she's put out a prescription for ferrous sulphate. They didn't test Vitamin D unfortunately but here's the results I do have.
Ferritin 6.3 ug/L (10-204 ug/L)
Folate 4.9 ng/ml (3.1-20.5 ng/ml)
Vit B12 362 ng/L (187-883 ng/L)
So from the info I've been given from you guys on here, they are all too low, especially ferritin. 6 months ago my ferritin result from medichecks came back at 70.1, I certainly wasn't expecting it to have dropped that much in that time, does that sound concerning?
As well as the ferrous sulphate should I take a decent multivitamin to increase B12 and folate, or should I take them separately? I've seen some different thyroid support supplements but noticed some of these contain kelp/ iodine and I'm sure I've read that you should be careful with this if you have hypothyroidism?
I have said this before 100mcg is not a high dose, my Dad who is 78 and classed as elderly is on that dose. You clearly need and increase of 25mcg and and a blood test in 6 weeks to see if your levels have improved.
Thanks for your reply. You could well be right but my TSH at yesterday's bloods was 0.884 miu/L and i think my GP would be more likely to reduce my levo than increase it! She doesn't even know I'm taking 100mcg a day, still thinks I'm alternating 75 and 100. I could buy levo online myself and have done in the past, but from what I've been told on here conversion is a problem so will see if I can improve that first.
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