Chest pain associated with hypothyroidism

[Lala62]

Does anyone else who has hypothyroidism suffer with a feeling of something stuck in the middle of the chest. I have this feeling during the day but it’s worse at night sometimes it feels like a heart attack. . It can sometimes spread to my right chest up to my shoulder. I also have the same feeling in my throat. This feeling is worse on some days but I don’t know why. It goes hand in hand with throat clearing and mucus in the throat.I don’t know whether I should ring GP?

[Marz]

In your last post your TSH was too high so you need a dose increase. VitD too low.

Which supplements are you taking - how much and results other than VitD which you mentioned in your last post.

[Lala62 in reply to Marz]

I take a daily vit d dose of 25 ug plus b12 and zinc. No increase in levothyroxine as my Gp said she wouldn’t increase without a blood test so I’m on 50 mcg and have been for 7 weeks and they won’t let me get a blood test so I have to wait till lockdown is over. I’ll get my iron levels done as well in that case. I’ve always had issues in and off with iron .

[Marz in reply to Lala62]

Are you able to have Private Testing through TUK ?

So that's only 1000 iu's of VitD which is a low dose - I would double it - especially with the current situation. How much B12 are you taking and which brand ?

Your GP does not seem to understand that 50mcg of Levo is only a starting dose - sigh. We see it here so often ..

[Lala62 in reply to Marz]

Yes thank you , I will increase my vitamin D and see if that helps. My B12 blood test was ok a year ago but doctor hadn’t tested it. I feel worse than I ever have after hemithyroidectomy when I thought I would be back to normal. I’m just a victim of bad timing with the pandemic which is understandable.

[Marz in reply to Lala62]

Which brand of B12 and how much ? - see my reply to you above 🤔

[SlowDragon Administrator in reply to Lala62]

Recommend you get full thyroid testing privately after 8 weeks

[SlowDragon Administrator]

Did you get 25mcg dose increase in levothyroxine

Ask GP to do full iron panel test for anaemia

Breathlessness and tight chest often low iron

[Lala62 in reply to SlowDragon]

Yes my GP increased it from 25 to 50 about 8 weeks ago. I had full iron panel done in January and the abnormal readings were:

MCV 81.5

MCH 25.2

Serum transferrin 2.35

In March my last test for T4 was 12.0

The only and last time Thyroid Perox Abs was tested , it was 1000 back in April 2019.

[SlowDragon Administrator in reply to Lala62]

Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).

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.

nhs.uk/medicines/levothyrox...

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

Your antibodies are high this confirms cause is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

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

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[Lala62 in reply to SlowDragon]

Sorry for the delay the ranges are

MCV 84.0-105.0

MCH 27.0 - 32.0

serum transferrin 2.50 -3.80

thyroid Perox abs <35

T4 10.0-20.0

[SlowDragon Administrator in reply to Lala62]

So looking at results and ranges this indicates anaemia

healthline.com/health/rbc-i...

Chest pain is frequently linked to low iron levels

What iron supplements did GP prescribe ?

Iron levels should be retested regularly when on iron supplements

High TPO antibodies confirms Hashimoto’s

Getting coeliac blood test BEFORE trying strictly gluten free diet

[Lala62 in reply to SlowDragon]

Thank you for your quick reply. GP didn’t prescribe any iron supplements or suggest I take any . GP says I’ve got hypothyroidism. I’m trying to stick to a gluten free diet at the moment also. Why do you think I need coeliac test?

[SlowDragon Administrator in reply to Lala62]

If you’re already on gluten free diet, don’t bother

In an ideal world all thyroid patients should get coeliac blood test. But it’s a very unreliable test and doesn’t pick up gluten intolerance

GP should obviously be treating anaemia

I will alert humanbean and SeasideSusie ...they are our resident iron experts

Look at improving your iron levels by Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

drhedberg.com/ferritin-hypo...

restartmed.com/hypothyroidi...

Post about iron supplements

healthunlocked.com/thyroidu...

Freeze dried liver capsules seem to be popular option

[Lala62 in reply to SlowDragon]

Thank you that’s great 😀 I need all the help I can get as my GP doesn’t seem interested.

[SeasideSusie Remembering in reply to Lala62]

Lala62

Serum transferrin 2.35 (2.50 -3.80)

What about the rest of the iron panel - serum iron, TIBC, ferritin?

MCV 81.5 (84.0-105.0)

MCH 25.2 (27.0 - 32.0)

May indicate iron deficiency (need rest of iron panel). Maybe anaemia. What about haemoglobin?

[SlowDragon Administrator in reply to Lala62]

Can you add ranges on these results please

[SlowDragon Administrator in reply to Lala62]

So thyroid levels need retesting after 6-8 weeks on 50mcg levothyroxine

Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).

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.

nhs.uk/medicines/levothyrox...

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[humanbean]

25mcg Vitamin D = 1000iU Vitamin D.

From personal experience I know that my vitamin D levels drop if I take 1000 iU per day. I need anywhere between 2000 iU and 4000 iU per day, depending on how often I go out and get some sun and what time of year it is.

The doses of vitamin D usually prescribed by doctors are designed to be just enough to avoid developing rickets.

This is true for prescribed doses of many nutrients - they are designed to be just large enough to avoid certain diseases. There has never been any rigorous scientific studies done to determine how to have optimal health with most minerals and vitamins. (Although iron has probably been studied more than most nutrients, the idea being to avoid anaemia.)

[Lala62 in reply to humanbean]

Thank you for that useful information. I know I’m not feeling well but my GP refuses to see anyone during COVID 19 unless it’s an emergency☹️

I’ll increase my vitamin d intake although I’ve been sitting in the sun each day .