Hi , I was wondering if there is any link between rheumatoid arthritis and hypothyroidism.
Because of covid19 I am waiting to visit my doctor with my symptoms of a low grade throbbing and a stiffness especially in my fingers and hands. Also like buzzing feeling in my body at night. I have been taking a Vit D and k2 mouth spray as advised to help with a low calcium picked up on my last bloods. I am finding it hard to access my last blood results taken at the hospital January time. I am taking 50mcg Levothyroxine and 8..12 weekly B12 injection. It is about 5weeks since my last injection and a symptom of really sharp painful fingertip pain is happening at the moment. I’ve always put it down to B12 deficiency and in my past posts I have touched on this and always had good advice off this site and the P A site. Sorry about all this information especially during the more important Covid and lockdown. I do realize my lack of information regds bloods is leading to another question, which blood test on the medicheck site does anyone think I should be looking at to get me a more general upto date blood analysis to cover my overall blood health that would include Thyroid, B12 and a complete vitamin, nutrition and possible rheumatoid arthritis check not sure which test to go for. I realize it would only be advice but as always it would be great fully received .
Advice before on some results I printed was my levo not being high enough doseage that’s another reason for my wanting a medichecks test as I understand they give you a full review instead of dribs and drabs and doctors just saying oh your thyroids ok on 50mcg of Levothyroxine. Thanks in anticipation.
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If you have one autoimmune disease (like Hashimoto's thyroiditis) you have a greater likelihood of others eg rheumatoid arthritis, SLE, diabetes, Sjogrens, . This does not mean automatically you will get them, it is just a higher chance. RA seems to have been an unlucky hit for you.
Thankyou for replying Diogenes.... as I mentioned I did wonder if the sensations in my hands especially were possibly due to rheumatoid arthritis and not B12 deficiency, still wondering which blood tests to go for. My doctors just look blankly at me when I enquire if I havehashimoto’s or PAneamia or just B12 def. Thanks for your input and please keep safe.
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
Have you had thyroid antibodies tested?
Ask GP to test vitamin levels (and antibodies if not been tested yet)
You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
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?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to 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, or buy test online BEFORE trying strictly gluten free diet
Assuming test is negative you can immediately go on strictly gluten free diet
If coeliac test is positive you will need to remain on high gluten diet until endoscopy, with maximum 6 weeks wait, officially
Trying strictly gluten free diet for 3-6 months
If no noticeable improvement, reintroduce gluten and see if symptoms get worse
Thankyou Slowdragon, yes I am sure it was you who mentioned me being on a starter dose of Levothyroxine, I have been on this dose for around 2 years now. You have really helped and I will look in more depth the different blood tests available, you have really simplified your information to me.
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