Obviously I can’t up my levothyroxine to bring up my Free T4 but it never really seems to change. Because it was done by GP T3 was never checked. Does anyone know if your CRP can be raised due to both you autoantibodies being positive as my CRP came back as 55 Range being 1-5. I have had issues with my sinuses on and off for about 8 weeks. Also does anyone struggle with their cholesterol even when they eat relatively clean. My serum cholesterol being 5.3 which should be below 5, ideally below 4. I honestly have to eat like a rabbit to keep it low.
Thanks in advance
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Cade83
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Even if we don’t start on full replacement dose, most people need to increase dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose
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.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.
RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct 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 first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then 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
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Obviously I can’t up my levothyroxine to bring up my Free T4 but it never really seems to change.
That's a very intriguing statement. And not at all obvious to me. Why can't you increase your levo? If ever I saw a result that needed levo increasing, it's that one! Or do you mean your doctor won't increase it?
Also does anyone struggle with their cholesterol even when they eat relatively clean. My serum cholesterol being 5.3 which should be below 5, ideally below 4. I honestly have to eat like a rabbit to keep it low.
Oh dear. Your doctor been telling you scare stories?
Cholesterol has little to do with what you eat. It is made in the liver (because the body needs it!) and the more you eat, the less your liver makes. The less you eat, the more your liver makes. The body tries to keep a steady level of cholesterol to meet its needs. The cholesterol is then transported round the body in protein carriers (that's what they actually test, the carrier, not the cholesterol) to where it's needed. The brain needs large amounts of cholesterol, but every cell also needs it because cell walls are made of cholesterol. Without it, you'd fall to bits!
However, when the T3 is low, the body cannot process cholesterol correctly, and it tends to build up in the blood. BUT - and it's a huge but - who really says that cholesterol should be below 5? Since Big Pharma invented statins, the goal posts have been steadily moved so that doctors have an excuse to put more and more people on statins. For no good reason. High cholesterol is not a disease, it's a symptom that something is going wrong with the body somewhere - very often hypothyroidism.
In any case, high levels of cholesterol are not a problem in and of themselves. Cholesterol won't do you any harm. It does not cause heart attacks or strokes. Quite the opposite. In fact, people with higher cholesterol levels tend to live longer. What's more important is eating a varied, nutrient-rich diet to keep you healthy. So, forget cholesterol, eat well, and concentrate on raising your FT3 - which is obviously low - and the cholesterol will take care of itself.
That’s really interesting that cholesterol has little to do with what we eat. Unfortunately both my parents struggle with cholesterol. Although my mum too has under active thyroid. I need to get my T3 checked really as I don’t know what that is. I know from previous results I’m sure my T3 was ok. Looking at results from Aug 2019 it was 4.56 with range being 3.1-6.8.
Looking at results from Aug 2019 it was 4.56 with range being 3.1-6.8.
That's too low. It's not even mid-range. But, FT3 needs to be looked at in conjunction with FT4 - both tested at the same time - to see if you have a conversion problem or if you're just under-medicated.
Besides, that was nearly a year ago. A lot can happen in a year. And, your high cholesterol is saying that your FT3 is low.
Unfortunately both my parents struggle with cholesterol.
It's not a struggle. It's not important - excepting that it probably means your mum's T3 was too low - possibly your dad's, too. But, cholesterol is not going to do you any harm. Your whole body is made of cholesterol.
What is far more dangerous that high cholesterol is low cholesterol. Because sex hormones are made of cholesterol, and if they're low, you're not going to be well. Low cholesterol will cause heart attacks.
I’ll have to get T4 and T3 done privately again see where their at. I may even get my mum to do hers privately because they only ever check her TSH I think. I’m on HRT for testosterone as I’m trans so that gets checked every six months or so. Although I’ve never had my Estrogen checked since having a total hysterectomy.
As your cholesterol is a good level, you probably won't have any problem making sex hormones at the moment, but it's something to bear in mind if ever statins are suggested! That is something you really don't want to take.
That really is interesting because last bloods showed cholesterol over 5 and dr wanted to put me on stains which I refused he said I'm a candidate for stroke/,heart attack within 10 yrs I did say that underactive can cause thst and I need to get my t3&4 on the right dose. Yes dr's do scare monger. Last bloods by trivia also said crp raised so infection somewhere but as dr's seem to prefer working from home it's not like I can just make appt to see someone.
Sorry to jump in here on Cade83's post, it was just very interesting.x
Doubtful your doctor would look for an infection, anyway. They just seem to do the bare minimum, these days. It's not unusual to have raised CRP when hypo.
I’m currently in 75mcgs and I just assumed that because my TSH is 1.21 that if I increased to 100mcgs that it would be too much and it would lower my TSH too much?
I’m not on a gluten or lactose free diet. Partly because I don’t really know what has gluten in apart from bread and partly because it’s expensive buying gluten free stuff. I did used to get lactose free milk so maybe I need to try that again. I’m sure I’ve had a celiac test and it was negative. I am taking vitamin D supplements but obviously need to increase to a bigger dose as I’m only taking 1000IU. I do take magnesium 200mg vitamin C 1000mg and vitamin B complex.
The TSH is not the important number. Once it gets down to 1, testing it doesn't give you much information. It certainly shouldn't be used to dose by. The most important number is the FT3, because T3 is the active hormone.
Going gluten-free is more about cooking from scratch and avoiding processed foods. If you cook from scratch, you know what goes into it. Not only is gluten-free processed food expensive, but it's full of other additives that aren't good for you, either. Processed food almost always contains soy derivatives, artificial sweeteners and processed seed oils, all of which are bad for hypos.
My cholesterol was rising year on year and my GP kept nagging me to take statins. I did a private blood test December last year and discovered to my horror that my FT3 was only 5% within the range.
A 25mcg increase in levo increased this to mid range and brought my cholesterol down from 6.3 to 5.4.
Three months later and another increase of 25 mcg levo and my FT3 is happily near the top of the range and my cholesterol has reduced to 4.9.
Living proof that undermedicated hypothyroidism causes cholesterol to rise.
Doctors are indeed overly paranoid about the dangers of "so-called" high cholesterol!
My TSH always looked suppressed because I take Metformin which acts along the hypothalamus/pituitary axis and makes it look artificially low. It's irrelevant, but it was 0.01 before and after dose increases.
I believe I ended up with type 2 diabetes due to long term insulin resistance caused by being under medicated for a long time. It was a bitter pill to swallow when I was diagnosed because my diet and lifestyle really didn't fit the "usual" profile for potential diabetes.
I am lucky in that just one GP out of the 4 at the practice realise that for me the TSH doesn't matter. I have had blazing arguments with the others when they have tried to REDUCE my meds when my Ft3 was at rock bottom.....they only look at TSH. Scandalous.
Ah ok fair enough. Yeah it infuriates me that they don’t look at the whole picture and only look at TSH and say that’s in range so your ok 🤨
I didn’t realise being under medicated could put you at risk of type 2 diabetes. It’s great when you find a GP that listens and actually works with you.
It's terrifying that there is so much ignorance amongst the medics. It shouldn't be up to the patient to have to instruct their GP about how to treat them.
If I hadn't known better, I would have just accepted what I was told by the 3 useless Gps at the practice and allowed them to reduce my already, woefully inadequate T4.
Hypothyroidism....oh yeah, it's a whole can of worms !!!!!!!!
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Iron panel results and trouble raising T4 medication?
Low TSH with normal T3, T4. 
Suppressed TSH AND LOW T4
Low T3 Low T4 and very Low TSH
