Fist timer - Some pointers please (Hashimoto's) - Thyroid UK

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Fist timer - Some pointers please (Hashimoto's)

Cola4444 profile image
16 Replies

Hi all,

- 54 year old male

- UK CItizen - but thankfully caught up in the lockdown in Thailand right now & diagnosed here. I've been ill for at least a year in UK & GP's & A&E of no help during a flare up over Xmas in the UK. Said nothing was wrong with me... probably Stress, onset Arthritis, Fibromyalgia or Prostatitis.

- Laser BPH Prostate reduction surgery 28/10/19

(inflamed prostate & multiple UTI & Kidney infections)

- DIAGNOSED HASHIMOTO's - 15/04/20

(I think this may of been coming on over last few years...very dry eyes, blood sugar levels up, cholesterol up, sweating lots, low libido, poor memory / concentration... and a joke with my friends that I would spend 1-2 days in bed recovering after just a few beers out. My hangovers increasingly got worse over the past 5 years).

- Started Levo 25 mcg 04/06/20

- Main Symptoms:

a) Bad headaches & shooting pains in the head

b) Mild to strong Joint and muscle pain - both hips and the right knee since 4 weeks ago.

c) Brain fog - memory & words

d) Insomnia - sleep 2-3 hours then awake

e) Low energy & mood

f) Sweating a lot (daily 30-35 degrees here right now)

g) Blurry vision and sometimes dry eyes (eyes were very dry prior to now... going back 6 month to two years ago).

h) Potential kidney issue ? - foamy pee in the mornings.

BLOODS:

1) TSH 5.55 4/6/20 (0.35 - 4.94)

- Was 3.56 12/5/20 & 2.72 15/4/20 & 5.46 19/2/20

2) FT4 1.16 4/6/20 (0.70 - 1.48)

- Was 0.93 12/5 & 0.81 15/4

3) FT3 3.08 4/6/20 (2.3 - 4.2)

- Was 2.53 12/5/20

4) TPO Antibodies 662 4/6/20 (0.0 - 5.61)

-Was 734 15/4/20

5) TgAb 4/6/20 29.62 (0.0 - 4.11)

6) Iodine (Urine) 613 21/5/20 (90-230) VERY HIGH

7) Calcium 10.20 26/5/20 (8.4-10.20) TOP OF RANGE

8) Uric Acid 7.20 26/5/20 (3.5-7.20) TOP OF RANGE

9) Vit. D 44.47 4/6/20 (30-100 sufficient) LOW

- Was 35.00 17/2/30

10) Iron Serum 107 22/6/20 (65-175) LOW ?

- Was 119 17/2/20

11) Ferritin 58.1 22/6/20 (15-200) LOW ?

- Was 95.4 One Month earlier 21/5/20

- Why losing Ferritin & Iron ??

12) Folate 4.90 21/5/20 (3.10 - 20.50) VERY LOW

13) Vit. B12 656 21/5/20 (188-887) OK

14) DHEA-S 112.60 21/5/20 (136 - 447) VERY LOW

15) LH 3.33 15/5/20 (0.57 - 12.07) LOW

16) Testosterone 3.49 15/5/20 (2.41 - 8.27) LOW

- Was 4.49 a few weeks earlier 21/4/20

17) GH (Growth) 0.27 26/5/20 (0.4 - 10.0) VERY LOW

Note: 14-17 - could this be a Pituitary problem - especially with the headaches & shooting head pains ?

ACTION To Date (Diagnosed 15/4/20):

a) Gluten, Dairy & Soy Free from 17/4/20

b) Fortnightly Testosterone from 21/5/30

c) 25 mcg Levo (half tablet) from 4/6/20

- Thai DR wants to keep me on this for first 6 weeks then up to 50 mcg for another 6 weeks i believe.

SUPPLEMENTS:

a) Ferritin 5mg once daily - last few days (since 24/6)

b) Iron Ferrous Gluconate 27mg (since 24/6)

- Note: Ferritin Bloods nearly halved 21/5 to 22/6

c) Vit. D3 2,000 iu per day (from 17/4)

d) Vitamin B12 5000 mcg x3 per week (from 15/4)

- Just ordered a good B-Complex with B12 methylcobalamin

e) Selenium 200 mcg one per day (from 26/4)

f) Zinc Citrate 15mg one per day (from 26/4)

g) Magnesium Glycinate 200mg twice per day

(from 23/5)

h) Methly Folate 400 mcg one per day (from 23/5)

i) Vitamin K2 Mk7 100mcg one per day (from 10/6)

(I'm guessing my high Calcium might be going into my muscles / tendons... hence bad hip, knee and thigh pains. Harder to walk far over past few weeks).

j) 30 billion probiotic just finished (one month)

... just started Probiotic Acidophilus 3 billion Live - first thing each morning with Coconut Kefir Yoghurt

Currently looking at: DHEA, L-Tyrosine, Acetyl-L-Carnitine, Panax Ginseng, Gingko Biloba, Tribulus,

and Ashwagandha (potentially upset hormone levels ?)

Would like to explore LDN when I get back home to the UK (to bring down my high TPO antibodies).

Thank you all very much. This has turned my life upside down. I was running 7k miles 3 times per week one year ago. The headaches, brain fog and joint / muscle pains are reducing my Quality of Life dramatically. I'm getting to grips with No Gluten/dairy/soy and its definitely helped with less stomach bloating (inflammation).

I've already applied a lot of the above supplements from reading the posts on this site.

I'm keen to get my FT3 & FT4 up and sort out the key bloods to see if this reduces the Headaches & Joint / Muscle pains... and potential kidney function issue.

Thank you !!

Martin

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Cola4444 profile image
Cola4444
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16 Replies
Lora7again profile image
Lora7again

Hopefully someone will be along to advise you shortly but I just have to ask why you are not taking Thyroid S if you are in Thailand?

Cola4444 profile image
Cola4444 in reply to Lora7again

Wow first time I heard of Thyroid S... I just googled it.

I'm on Levothyroxine / Euthyrox 50mcg (taking half to start... but obviously too low).

I will ask my GP here in Thailand about Thyroid S, this Thursday.

Thank you !

Lora7again profile image
Lora7again in reply to Cola4444

I personally think Thyroid S is much better than Levothyroxine and a lot of people here in the UK cannot get it at the moment because of the coronavirus.

Cola4444 profile image
Cola4444 in reply to Lora7again

Thanks tor the info Lora.

I will followup on this.

Nanaedake profile image
Nanaedake

Your TSH is only slightly elevated and although FT3 and FT4 are low, they are still in range. The cause of symptoms could be thyroid related or something else.

What did the Dr say about unusually high calcium levels despite low vitamin D levels? If it were me, I would want to have tests for parathyroid hormone and retest calcium a few times to find out what's going on. Read up on parathyroid function, it's not something regular GPs are trained to assess so if there's an ongoing problem with calcium you will need a referral to a specialist and there are not many of them either. It might be that when vitamin D levels are optimised calcium will fall back to a normal level and stay there but you need to monitor it.

To find out if kidney function is compromised you need eGFR and Creatine blood tests along with urine tests, repeated on a few occasions. Stay well hydrated leading up to any tests.

Not sur you need to take large doses of B12 as you are nearly at reasonable level. Seems like the B complex is the better idea and it's your folate that is low so that will help. As you are taking methyl folate, 3 or 4 months high dose will bring you into range and the B complex should maintain your levels.

Your iron serum is not low so you probably shouldn't take iron supplements but would be better to increase iron rich foods in your diet instead. I'm not a doctor so these are things you should discuss with your doctor Before supplementing.

You really shouldn't be thinking about taking ashwaganda or other herbal remedies because you'll be adding in so many factors you won't know what is giving you side effects. Also, I believe Ashwaganda is not recommended for Hashimotos thyroiditis but others might tell me I'm wrong.

fuchsia-pink profile image
fuchsia-pink in reply to Nanaedake

Your TSH is only slightly elevated - why do you say that?

At 5.55 it's comfortably above the top of the range and more than 15 times higher than the bottom of the range. I appreciate that Martin is only on a very low dose of levo, and has only just started taking it, but agree with greygoose that the dose seems very low. Based on 1.6 mcg per kg of weight, it would no doubt be very much higher.

I would suggest he needs a dose increase, and re-test after 6 - 8 weeks to see how much TSH has come down, free T4 and T3 have come up, and when nutrients have had a chance to do their thing, and how much better he feels.

Cola4444 profile image
Cola4444 in reply to fuchsia-pink

Thanks for this. I'm 90-92kgs so 25 mcg is a pretty low dose.

I will ask my GP this Thursday here in Thailand for an increase up to 50 mcg now (after 4 weeks)... as opposed to waiting to the 6 week point, which i believe is my GP's plan.

Yes, I'm hoping when my Low Folate, Vitamin D & Ferritin get up the range and take effect... that they will help me to feel better.

Thank you !

greygoose profile image
greygoose

17) GH (Growth) 0.27 26/5/20 (0.4 - 10.0) VERY LOW

Note: 14-17 - could this be a Pituitary problem - especially with the headaches & shooting head pains ?

It is possible to have low HGH (Human Growth Hormone) without having a pituitary problem. Lots of hypos do have low HGH, but as it's rarely tested, we don't know exactly how many. Production of HGH depends on FT3 levels - and conversion of T4 to T3 depends on HGH levels, so it's a bit of a vicious circle.

However, from what I gather from your labs - and sorry, but they are rather difficult to read the way you've posted them - you've never had a TSH higher than:

TSH 5.55 4/6/20 (0.35 - 4.94)

FT4 1.16 4/6/20 (0.70 - 1.48) 46.94%

FT3 3.08 4/6/20 (2.3 - 4.2) 37.78%

(we need to see the three readings together, without having to scroll up and down.)

And you started 25 mcg levo based on those results? Pity such a low dose for a man of your age. At least 50 mcg would have been better.

So, your FT4 was 46.97% through the range at that time, and your FT3 was 37.78%, which was pretty much euthyroid. If anything, your TSH is high compared to your Free levels. So, not sure that that indicates a pituitary problem.

You say you were told there was nothing wrong with you in the UK, but did they ever test your TSH? If so, what was the highest it got?

So, I would suggest that your next step would be to investigate your adrenals... 24 hours saliva cortisol test - if possible where you are - and DHEA.

Currently looking at: DHEA, L-Tyrosine, Acetyl-L-Carnitine, Panax Ginseng, Gingko Biloba, Tribulus,

and Ashwagandha (potentially upset hormone levels ?)

You certainly wouldn't want to take DHEA without testing first.

Ginseng and Ashwagandha are adaptogens: proceed with caution. I know that adaptogens are said to balance hormones, raising low levels and decreasing high levels. In practice, it might not work out that way. Ginseng and Ashwagandha have been know to lower already low cortisol. So, testing is essential before taking any of them.

Would like to explore LDN when I get back home to the UK (to bring down my high TPO antibodies).

Whilst LDN has been known to help with autoimmune conditions, TPO antibodies are not the problem. They are not doing any harm, and even if you got rid of all of them - which is unlikely - you would still have Hashi's. That doesn't go away. And, it is perfectly possible to have Hashi's without ever having high levels of antibodies.

SlowDragon profile image
SlowDragonAdministrator

Have you been supplementing any vitamin D?

This might account for high calcium

If not, get parathyroid levels tested

Cola4444 profile image
Cola4444 in reply to SlowDragon

Yes, supplementing 5,000 IU Vit. D per day from 17/4 - 31/5.

2,000 IU per day since to date.

PTH blood test 21/5/20 was 39.6 pg/ml (15.0 - 68.5).

Will check PTH again at the end pf this Month.

Thanks !

Cola4444 profile image
Cola4444

Many thanks for some good things to followup on here.

Hopefully the Calcium levels will stabilize when my Vit. D gets up a bit more and I can ease back on supplementing Vit. D.

The DR didn't really comment on the high calcium & low vitamin D. I will followup on this and re-check calcium & PTH bloods going forward. I will get a second opinion on my Thyroid / Parathyroids and have another ultrasound and scan if possible.

eGFR and Creatinine test noted.

B complex noted instead of high strength B12.

Ashwaganda noted. I did read that it came with risks with regard to activating hormones.

Thanks for your time and input.

Greatly appreciated.

Nanaedake profile image
Nanaedake in reply to Cola4444

I didn't realise you were supplementing vit D3 so likely your calcium levels will drop back down once your vit D has increased but worth PTH retesting to be sure.

My TSH has been around 11.0 with no noticeable symptoms although of course if that had continued symptoms would likely have appeared. So, it's possible some of your symptoms are related to vit D deficiency, an infection or another factor.

It's good the doctor picked up elevated thyroid hormone and TPO antibodies as you can now monitor it and get the right treatment.

Cola4444 profile image
Cola4444

Interesting correlation between HGH and FT3 levels and T4 to T3 conversion. Yes a viscous circle. Hopefully increasing my T3 will help.

No my TSH has never been higher than 5.55

13/2: 5.1, 19/2: 5.46, 15/4, 2.7, 12/5: 3.56

4/6: 5.55

Format improvement noted for next time.

Yes 25mcg seems low and i'm 92kgs.

I will seek an increase to 50 mcg this Thursday when I see my GP.

No - the UK never checked my Thyroid at Xmas.

I must of been having a flare up with all that gluten, dairy etc I honestly thought i was dying and then my anxiety kicked in, lymph nodes swollen in my neck etc... so my GP stuck me on Tramadol which didn't help.

I will followup on the 24hour saliva cortisol test and DHEA.

Risks with adaptogens noted. Thank you.

Zero TPO antibodies and will still have Hashi's Ok got it (didn't realise that).

Thanks Greygoose

greygoose profile image
greygoose in reply to Cola4444

Only saw this by chance. If you want to reply to someone on here, you need to click on the blue 'Reply' button under their comment, or they won't be notified. :)

Interesting correlation between HGH and FT3 levels and T4 to T3 conversion. Yes a viscous circle. Hopefully increasing my T3 will help.

You might need more help than that. Did your GP not suggest HGH injections? They are expensive and awkward to manage because you have to keep the stuff refrigerated at all times, but they will do you no end of good if he can prescribe them. Not something that's possible to get hold of without a prescription, I'm afraid.

I must of been having a flare up with all that gluten, dairy etc I honestly thought i was dying and then my anxiety kicked in, lymph nodes swollen in my neck etc... so my GP stuck me on Tramadol which didn't help.

Possibly, but not realistically. There's no proof that eating gluten/dairy causes Hashi's swings. Sounds more like an infection.

Cola4444 profile image
Cola4444 in reply to greygoose

Good advice. I will followup on the HGH.

Many thanks !

greygoose profile image
greygoose in reply to Cola4444

You're welcome. :)

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