Medichecks doc thinks I should see my GP to get... - Thyroid UK

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Medichecks doc thinks I should see my GP to get my thyroid meds reduced. please comment on results.

Mugs19 profile image
24 Replies

medichecks 3 July NHS 17 April

CRP HS 0.87mg/l (<5)

Ferritin 54 ug/L (> 3.89) 26mcg/l (10 - 291

Folate-serum 9.94 ug/l (>3.9) 9.4 (>4)

Vit B12 124.000pmol/L 557n/l(?) (211-911)

Vit D 137mmol/L (50-175) 76.3 (50-125)

magnesium - 0.84 (0.7-1.0)

TSH 0.185 (0.27-4.2) 0.88 (0.35- 5.5)

FT3 4.5 (3.1-6.8) 4.9 (3.5-6.5)

FT421.6 (12-22) 20.4 (10-20)

TPAG 136.000 klU/L (<115)

TPO 381klU/L (<34)

I am taking 75 mcg levothyroxine and only since May 30, 5mcg Liothyronine. I decided to add the T3 because I felt so ill. I don't know if it was worth including the April NHS results as I was taking B complex vitamins till 3 days before the test. Forgot to stop them a week before, so they may not be valid. I haven't resumed B vits because I wasn't tolerating them. Tried changing brands but still reacting with pains in the side of my head and migraine type visual disturbance. Also could not tolerate iron - pains everywhere I have always had this problem: When pregnant got terrible pains in my feet which was diagnosed as gouty arthritis but years later when being treated for anaemia,( and not pregnant ) had the same problem, Plus pain in the forehead, travel sickness-like symptoms, disoriented. Thought about trying to supplement iron again because of low NHS result , after I had seen Spatone recommended on this site. I am feeling very ill despite good improvement in other vitamin levels. Exhausted, almost comatose at times, pain everywhere, unable to keep up walking or exercise regime. Feel dithery a lot of the time which tends to lessen as the day goes on as I get more drowsy have had stabbing pains in my eyes, blurred vision, tinnitus, a feeling that i am not in normal control of my body, Also I,ve been having strange sensations in my neck as if someone has their hands round it or that I am wearing a restrictive collar and sometimes the left side aches. I have plenty of hypo symptoms, such as constipation dry eyes and skin etc so I don,t want to go to GP and get my thyroid meds reduced. I have discovered that my lodine (etodolac) anti inflammatory is responsible for some of the tiredness. I have been on it 10 years for my arthritis and have always known that it causes tiredness and fuzzy head but never to the extent I have now. I have stopped it for the last 3 days and my head is clearer but far from o.k. So now struggling with arthritis pain. I have problems with interactions between drugs such as aspirin and penicillin which I can take separately but not together and wondered if I am getting a reaction between lodine and thyroid meds.

I would like advice as to whether I need to reduce dosage to maintain improved levels of supplements.

This is an awful lot for you to get to grips with, I know, which is why most doctors see me as a nightmare. I always appreciate your efforts for that reason. Best wishes to you all, Mugs19.

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Lora7again profile image
Lora7again

Medicheck clinicians are not thyroid disease experts. I would ignore what they have said because they haven't physically examined you. Every time I do a blood test with them I will get remarks which are not relevant to me like "you have normal thyroid function" I actually have very high antibodies and a multi-nodular goitre and my thyroid function is far from normal.

Looking at your results I notice you ferritin is low and that can give you symptoms.

greygoose profile image
greygoose

The reason the Medichecks doctor is saying to reduce your levo, is that your TSH is below range. That's all doctors look at, all they know about. And Medichecks' doctors are the same.

What would appear to be the problem is that you don't convert very well. Your FT4 is right at the top of the range, but the FT3 is not even mid-range, even though you're taking T3. So, what I would do is reduce the levo, and increase the T3. Your conversion might even improve a little if you reduce the levo by 25 mcg. But, I doubt it would be by enough for you to be able to stop the T3.

Your ferritin is very low in the NHS test. I would think that merits further investigation, like a full iron panel. I don't understand the Medichecks result.

Your folate could be higher.

Vit B12 124.000pmol/L 557n/l(?) (211-911)

You do realise these are two different tests, don't you, so you can't compare them. The Medichecks test is an active B12, whereas the NHS test is just a serum test. But, your B12 would appear to be ok.

No point in testing magnesium. The fact that it's high in range doesn't mean you're not deficient, because the body will take magnesium out of the cells to maintain the blood level. Most people just take magnesium without bothering to test because most of us are deficient due to depleted soils. Excess is excreted.

:)

Mugs19 profile image
Mugs19 in reply to greygoose

Thankyou . for you quick response.

greygoose profile image
greygoose in reply to Mugs19

You're welcome. :)

SlowDragon profile image
SlowDragonAdministrator

As you have Hashimoto’s are you on strictly gluten free diet diet or tried it?

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. 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

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

restartmed.com/hashimotos-g...

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.

Why gluten intolerance can upset cortisol levels

kalishinstitute.com/blog/gl...

Mugs19 profile image
Mugs19 in reply to SlowDragon

Thankyou for your reply. I need to reconsider my diet. I went gluten free many years ago and was thought to have a leaky gut and candida. I took acidopholus for years. Eventually after losing weight and reversing my diabetes, I gradually reintroduced a lot of things but avoided bread which I knew didn't do me much good (and apples). I have again been eliminating most gluten free foods but to keep my sugar levels stable I eat a snack 3 hourly between meals and am used to eating a ryvita with hummous, not knowing that rye contains gluten, because it is one of the few crispbreads that didn't have yeast extract in it. It is also difficult to avoid all gluten if eating out at family occasions. I was tested for coeliac disease in my fifties but was already eliminating gluten so it was negative. The other concern I have is that I react badly to most medicines. I get side effects to everything I take. I am getting concerned that this is what is happening with my thyroid medication. I have felt worse and worse and worse ever since I started on it. Thankyou for the link. I will read all of it more carefully later. Best wishes for youself,

Mugs

SlowDragon profile image
SlowDragonAdministrator in reply to Mugs19

Ft3 is still pretty low

You may need to reduce levothyroxine by 25mcg and increase T3 by 5mcg (as second dose later in day)

Retest in 6-8 weeks

Make sure to get blood test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before and last 5mcg dose T3 8-12 hours before test

Stop taking any supplements that contain biotin a week before ANY Blood tests

MMaud profile image
MMaud in reply to SlowDragon

Apologies for butting in Mugs19 , but I hope you don't mind me asking about the Coeliac Test.

SlowDragon is there any particular test you suggest for Coeliac? There are so many online.

Thanks in anticipation.

SlowDragon profile image
SlowDragonAdministrator in reply to MMaud

Mine was done twice by NHS ....both negative

Endoscopy showed severe gluten intolerance....as if coeliac

They are all only test for coeliac, not gluten intolerance

SlowDragon profile image
SlowDragonAdministrator in reply to MMaud

This one seems cheapest

amazon.co.uk/SELFCheck-Coel...

You need to be eating high levels of gluten for 6 weeks before testing

At least twice a day

MMaud profile image
MMaud in reply to SlowDragon

Thank you SlowDragon.

I have been tested for Coeliac, via the Endo.

I have eaten a low carb diet for almost 7 years, so 150gr+ of carbs a day wasn't going to be happening. The Endo agreed it would be bonkers to up it, just a for a test, in a falsely carbed up state.

I'm considering asking for an Endoscopy as I definitely have gluten issues, but also I do have other bowel challenges.

At £20, I might want to give a test another go, before mounting my case with the medics. I guess the fact this is a binary, Positive/Negative result is less helpful to me than an antibody count.

There's always food (yes, I know) for thought.

SlowDragon profile image
SlowDragonAdministrator in reply to MMaud

I had private endoscopy....NHS wait would have been months/years ...if ever

I was seriously incapacitated, unable to walk Gastroenterologist did it same week

SlowDragon profile image
SlowDragonAdministrator in reply to MMaud

No gluten test is a definite yes or no

Even my DNA test (done on NhS) only said probably not coeliac

The only way to know for sure is to try it ..... absolutely strictly gluten free

Separate toaster, cutting board, butter etc

MMaud profile image
MMaud in reply to SlowDragon

Apologies for the delay replying. My binary statement relates to the test you linked to. It appears to return a result by which the appearance of a line means positive and absence therefore negative.

Of course, one could take a view on feint, "maybe a line there" results, but that's exceptionally inexact.

I am already strictly GF, and have been for almost 2 years now.

SlowDragon profile image
SlowDragonAdministrator in reply to MMaud

There’s zero point doing a coeliac test if haven’t been eating gluten for minimum of 6 weeks before test ....and eaten gluten at least two or three times a day

SlowDragon profile image
SlowDragonAdministrator in reply to MMaud

I never had any obvious gut symptoms...now the tiniest speck of gluten will cause terrible joint pain

Larger amount of gluten (eg small mouthful ) very unwell for 7-10 days ....sudden feelings of being blue/depression too as recover

Triciatextiles profile image
Triciatextiles

That’s interesting. I have just had a thyroid test with medichecks and my results were similar to yours. The medic also suggested reduce levo. I ignored his comments but its worrying that even their medics don’t understand hypothyroidism and blood test results.

SlowDragon profile image
SlowDragonAdministrator in reply to Triciatextiles

You can tick box. “No doctors comments”

They are only standard Doctors who write these comments. Eg ...typical comment......if TSH is low you must be over medicated...even if Ft3 below range

MichelleHarris profile image
MichelleHarris

Cant we educate the Medichecks doctors. Dont ThyroidUK have any weight with them as they get a lot of business from us x

Lora7again profile image
Lora7again in reply to MichelleHarris

I think they will be sticking to NHS guidelines unfortunately which means going by the TSH.

NWA6 profile image
NWA6

😩 WTF!! You’re FT3 is only 37% through range but your FT4 is 96% through range so you’re not a great convertor. Reign in the Levo and increase the T3 and forget anything the Medichecks whore says 😬😂

Mugs19 profile image
Mugs19 in reply to NWA6

Thank you. Yes I know I don’t convert well. I am heterozygous. I have increased my liothyronine by 5 mcg and reducedlevo by 25mcg. The problem is I will run out of T3 med and don’t know how to get another prescription as my regular Endo has no outpatient clinics because he has been put on ward duty for covid19 patients. I am on a waiting list for an appointment with him when he restarts outpatient clinic which will only start again in August (unless it doesn’t if infections spike again.) pointless going to my gps as they are clueless on this and can’t prescribe or test t3. Difficult to get to see them anyway.

NWA6 profile image
NWA6 in reply to Mugs19

Have you emailed the Endos Secretary? He won’t be completely unavailable. I probably wouldn’t reduce the Levo too quickly if it’s going to be difficult to get more T3 atm. Perhaps every other day drop the 25.

Ask your GP to get involved in contact?

Mugs19 profile image
Mugs19 in reply to NWA6

Thank you so much for the speedy reply. I value the help I get from you all greatly. Yes I am going to have to do something. Just figuring out how to do it at the moment . the trouble is his secretary is now working for the designated member of the Endo team, ,covering all thyroid cases because he is the thyroid specialist. He is the man who told me that t3 can give you a heart attack. She has to run everything past him. I told him in April I felt like I was dying and his response was to say I didn’t need further treatment as my test results were all normal. Giving it time to see if altering dosage improves things.

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