Itchiness

[willsie01]

I’m experiencing itchiness in my legs. Started around ankle level then day by day has extended into my thigh. Left leg first then right leg. Medication has recently changed: lansoprazole halved from 30 to 15 and Artorvastatin brand changed. Posted here on the off chance it may be connected with my hypothyroidism rather then cardiac meds.

[SlowDragon Administrator]

As lansoprazole (like all PPI) reduces vitamin level you need FULL Thyroid and vitamin testing

Do you always get same brand of levothyroxine?

Different brands are not interchangeable. Acacia powder in some brands can cause itching

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Or due to PPI

Ask GP to test vitamin levels

Ppi

pulsetoday.co.uk/clinical/m...

gov.uk/drug-safety-update/p...

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?

[willsie01 in reply to SlowDragon]

"As lansoprazole (like all PPI) reduces vitamin level you need FULL Thyroid and vitamin testing:"

I have my blood tested every 12 months for thyroid function. In Nov 2019 T4 was 16.2 pmol/L (range 9.0 - 22.7). TSH was 0.74 mu/L (range 0.55 - 4.78). That's all my GP does. In Dec 2019 my vitamin B12 was 434 ng/L (range 211 - 911). My vitamin D was within range but not optimal for someone with Hypothyroidism I'm told. Trying to find the result. I'm supplementing B12 & vitamin D, the latter with a BetterYou spray. I also use a BetterYou Iron spray, as well as taking ferrous sulphate tablets prescribed by GP, as I had a low ferritin level of 21 ug/L (range 22 -322) in Dec. This was retested in January, a month later and was up to 40 ug/L. The reason for the interest in my ferritin level is the general fatigue I'm experiencing.

"Do you always get same brand of levothyroxine?"

I've never noticed. Never knew it was relevant till recently. I will check now.

"For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested."

Presumably this is private testing? Where do I get it done?

"Also EXTREMELY important to test vitamin D, folate, ferritin and B12"

I have recently engaged with these and will continue.

"Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies"

All I know is that I am diagnosed as having an underactive thyroid and I have a couple of other health issues, BPH & UC and rebuilding after a triple bypass, which may well be part of the cause of my symptoms.

"Or due to PPI"

GP has agreed to half the dose after I raised the problem of nutrient absorption with him but says I must have it to protect stomach from aspirin.

"Ask GP to test vitamin levels"

As far as I know NHS only test vitamin B12?

"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?

Didn't know this and hope I remember for next test.

[SlowDragon Administrator in reply to willsie01]

List of different brands of levothyroxine here

thyroiduk.org/tuk/treatment...

Look at wether you have recently changed brands

Activis or Mercury Pharma probably best tolerated

Teva brand upsets many people

Regarding testing

TSH, Ft4 and ft3 should be tested together

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and 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

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

come back with new post once you get results

Ft4 is currently roughly 55% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Ideally Ft3 should be at least 50% through range

Many people on levothyroxine find Ft4 is at much higher % through range than Ft3

Improving low vitamin levels can increase conversion to Ft3 (the active hormone)