I was diagnosed hypothyroid 8 years ago and I take thyroxine 100mcg and t3 6.5mcg, my TSH and Free t4 indicate euthyroidism to my Endo but I still feel under the weather. The only thing sorted since being on this combi, symptom wise, is my puffy eyes!
30-04-2020 nhs labs
TSH 1.06 mIU/L (0.2 - 4.2)
Free t4 16 pmol/l (12 - 22)
Free t3 4.2 pmol/l (3.1 - 6.8)
I have high antibodies noted on a private blood test done 6 years ago.
15-05-15 private labs antibodies
Thyroglobulin antibodies 275.3 iu/ml (0 - 115)
Thyroid peroxidase antibodies 84 iu/ml (0 - 34
Any advice please? Thank you!
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Bluelei
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Your endo might think your results are euthyroid but they are not optimal and obviously not right for you. Unfortunately most doctors just want to see results within range, they don't care where in range or whether you would feel better if your results were higher in range, experience tells us that symptoms don't matter, numbers just being in range do, where doctors are concerned.
Your FT4 is just 40% through range and your FT3 is just 29.72% through range.
Does your endo know that you take T3, I am assuming that you self source this and that you take 6.25mcg (1/4 of a 25mcg tablet).
Low T3 causes symptoms, and your FT3 is very low in range, there is ample room for you to increase your T3. I would start taking an extra 1/4 of a tablet, maybe take 1/4 in the morning and 1/4 in the afternoon. Retest in 6-8 weeks, see how you feel and where your levels lie.
Your raised antibodies confirm autoimmune thyroid disease, aka Hashimoto's, did you know this?
I self source the t3 and my Endo supports this. I am happy to increase to another quarter of t3. I am just wary of getting a fast heart rate and tremors after I do.
Letter from Endo says bloods to be reviewed in 4 months and continue current therapy.
Hashimoto's is where the thyroid is attacked and gradually destroyed.
Fluctuations in symptoms and test results are common with Hashi's.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. It's essential to test Vit D, B12, Folate and Ferritin and address any problems. You are welcome to post these results, including reference ranges (plus units of measurement for Vit D and B12), for comment and suggestions for supplementing where necessary.
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I am happy to increase to another quarter of t3. I am just wary of getting a fast heart rate and tremors after I do.
If you take 1/4 in the morning and 1/4 in the afternoon you shouldn't get a "spike" from taking the increased dose all in one go. Just monitor how you feel, the half life of T3 is 24 hours so if you had an adverse reaction leave off the next day's dose altogether then go back to 1/4 tablet. If you can cut them smaller, you could try an increase of 1/8th tablet later on. But to be honest, with such a low FT4 result you shouldn't get any problems by just adding an extra 1/4 of a tablet.
So my symptoms don’t make much sense? Bruising, dry skin, flaky nails, cold intolerance, fatigue, throat feeling tight, sudden weight gain, dizziness and headaches mainly.
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
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
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 optimal
All four are far too low and need serious improvement
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