White bumps on waterline of eye

[Tasia]

Hi Guys. I’m on 50mg thyroxine and have mild dry eyes. Recently been getting these small white bumps on waterline of eye they do go away but wondering what they are. I’ve read it could be clogged glands in eye. Just wondering if anyone else gets this too? Many thanks for any replies

[SlowDragon Administrator]

Looking at previous posts you have been left on just 50mcg levothyroxine for years

50mcg levothyroxine is only a starter dose

Do you have any actual recent blood test results?

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)

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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

Ask GP to test vitamin levels

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)

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

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

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

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

[Tasia in reply to SlowDragon]

Hello there many thanks for the reply.

Funny enough I’ve just had blood tests done as I was feeling very fluey every morning when I woke up. I had vitamins b12 etc done too and everything was fine apart from very low vit D and my thyroxine needed to be lowered to 50 I was on 75mg. However since being on smaller dose I do actually feel much better I’m not getting that awful hangover feeling first thing on waking up. I need to have more blood tests done again next month to see if I’m getting on ok being on 50mg and I will ask for a copy of it. Many thanks for your reply it was very kind and helpful.

[SlowDragon Administrator in reply to Tasia]

Can you add the actual results and ranges on test results

Did you have Ft3 and Ft4 tested?

50mcg is only a starter dose

Bloods should be retested 6-8 weeks after any dose (or brand) change of levothyroxine

Make sure to get tested as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Do you always get same brand of levothyroxine?

[Tasia in reply to SlowDragon]

I didn’t ask for my last blood test results as my surgery was closed due to Covid and my doctor rang me to tell me the results over phone

[SlowDragon Administrator in reply to Tasia]

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

Frequently only TSH is tested...completely inadequate

[Tasia in reply to SlowDragon]

Will do thank you again for help x

[SlowDragon Administrator in reply to Tasia]

How low was vitamin D?

What has GP prescribed?

Deficient is under 25nmol and requires loading dose

Loading dose vitamin D is 300,000iu over 6-8 weeks, so that’s typically 5000iu per day for 8 weeks or 7000iu per day for 6 weeks. Important to get levels retested at end of prescription

ouh.nhs.uk/osteoporosis/use...

Vitamin D

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

Or advise on self supplementing if over 50nmol, but under 75nmol

mm.wirral.nhs.uk/document_u...

But improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Do you have Hashimoto’s?

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamins

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

What were actual folate and B12 results and ranges?

Low vitamin D and low B vitamins may be linked as explained here

drgominak.com/sleep/vitamin...

In YouTube video when Dr Gominak talks about vitamin D levels ...vitamin D at 40ng/ml (USA units) is equal to 100nmol (UK units)

youtu.be/74F22bjBmqE(Not working as expected?)

[Tasia in reply to SlowDragon]

Sometimes the name on front of box changes on the thyroxine. I don’t know about FT3 as I just had a thyroid function test done and it said thyroxine was too high so that’s why my doctor lowered it.. My vit D was bought from a Health shop my doctor told me to buy it myself. I feel well in myself just wondering about the waterline bump but I’ve taken some hydrosan drops for dry eyes. I never take my thyroxine on morning of blood test and usually have early test. When I get my bloods done again I’ll put results up here for you to see. Many thanks again to you for all your help you’re very kind x

[SlowDragon Administrator in reply to Tasia]

So how low was your vitamin D?

If under 50nmol GP should prescribe 1600iu per day for 6 months

If under 25nmol should prescribe 300,000iu over 6-8 weeks and most importantly retest vitamin D at end of the course

[Tasia in reply to SlowDragon]

I’ve no idea she just said Vitamin D was very low and to buy tablets from chemist. I’ve been told this before few years back and did the same thing it seems to be quite a common with many of us. I will retest my vitamin D too when I go for blood tests. I’ll get everything printed out. Many thanks again x

[SlowDragon Administrator in reply to Tasia]

Low vitamins are linked to being under medicated...so definitely recommend you get hold of your actual blood test results

[Tasia in reply to SlowDragon]

I will do thank you

[AlisonL]

Hi, I get these sometimes. They are very irritating. My optician advised holding a clean, warm flannel on my eyelids regularly to alleviate it. It does seem to help. Just make sure it's very clean and not too hot.

[Tasia in reply to AlisonL]

Thank you so much Alison I will try this. They are annoying things to have as I can feel the one I have now rubbing against my eye slightly. I definitely will try this though so thank you so much x

[Fruitandnutcase in reply to Tasia]

As well as the warm face flannel, get yourself some good preservative free eye drops and put them in regularly throughout the day. You could try something ‘gunky’ Like VitaPos for night time too.

[Tasia in reply to Fruitandnutcase]

Hi there I tried the warm cloth on my eye last night and this morning and can honestly say the bump has really got much tinier I can’t feel it at all rubbing on my eye now so thanks so much I’ll carry on doing the warm flannel throughout the day too. I do use hydrosan on my eyes I find them very good eye drops. I have very mild dry eyes thankfully. Thanks for your advice x