I have had a hell of a time with my doctor not taking any of my symptoms seriously , I practically live locked up in my house crippled with pain and anxiety and depression.I gave up going to see my doctor over a year ago I just carried on the medication they prescribed me and just bared the pain and all my other symptoms, so I finally got a couple of tests done, emailed them to the doctor over a week ago and I've still not heard anything back .
I am hypothyroid and I was aware of the vitamin d deficiency, I couldn't get them to test anything else , I sunk into a really bad depression and I basically just gave up! They was struggling to up my levothyroxine from 100 as I had side effects .
I take 100 g levothyroxine
50mg sertraline
50mg amytripline
Ive not slept for days not understanding what's going on is just making me more anxious ( I don't drink or smoke )
Any help advice would be appreciated ,I don't want to just get by any more I want to get better and start living again
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Denise37
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You will need to add the reference ranges for the results please.
They can be confusing with Thriva but if you look at the bar graph the reference range is the green bar, including both light and dark green parts so take the numbers at either end of the green bar. For example, the reference range for FT4 is 12-22. Ignore the orange/red parts and any numbers there, we just need the green parts.
They also provide a "report" where they list all the tests with the results and reference ranges alongside each one.
What is obvious from your results without ranges is that your Ferritin is low, your TSH is high, your Free Thyroxine (FT4) is low.
Vitamin B9&B12(active)-35.5?
Folate-9.33
Please clarify this. Folate is B9 and is usually only given as "Folate". Presumably 35.5 is Active B12.
I just carried on the medication they prescribed me
What medication?
Do you have a diagnosis of a thyroid condition? Are you on any thyroid meds?
You are not taking enough levothyroxine. You are very undermedicated.
B12 is much too low. Ask doctor to check intrinsic factor antibodies and rule out pernicious anaemia.
Vitamin D is much too low, how much are you supplementing?
Folate would be better in double figures. I would aim for 20.
Ferritin is low, the general advice on here is for ferritin to be around 70.
It's not the levothyroxine causing you problems but your low vitamin levels.
It could be that as you raise thyroxine levels the symptoms from low vitamins are amplified. However, depriving your body of thyroid hormone is not going to help you. It is likely to make poor vitamin levels worse.
You really need to correct these deficiencies so pursue an appointment with your GP.
Ask to rule out pernicious anaemia, your GP should prescribe loading doses of vit D3. You can increase ferritin levels by eating iron rich foods like liver or liver pate.
When taking vitamin D3, it's important to take the cofactors magnesium and K2-MK7. Magnesium citrate or a magnesium body spray are a good start.
Make sure you stick to the same type of levothyroxine. Some people have problems with TEVA levothyroxine so best to avoid until you've sorted this out.
Ensure you take levothyroxine correctly, leaving 1 hour between food.
If you have any gut problems, you need to sort it out. Many people find going gluten free helps alleviate symptoms. Eating naturally fermented foods helps me. Some people find they need to exclude dairy products to see if it helps but then it's most important to eat other calcium rich foods.
Come back to this forum once you've spoken to your GP and tell us what he/she has done.
Hopefully when you get the deficiencies sorted out you won't need the sertraline because it can interact with thyroid hormone. It can take a year or so to restore vitamin levels so no quick fix but worth it. I don't know what the other medication is for but have you considered side effects causing symptoms? Could you discuss alternatives with GP?
I'm having alot of gut problems the last few months ,my appetite is almost zero nearly everything I eat gives me a bad stomach, my taste buds have changed dramatically I can only really eat bland foods , thank you for your advice
For someone on 100 mcg Levo there is something very wrong here and if your GP has ignored these results he should be sacked.
First of all, a couple of things in case you didn't know.
1) Sertraline has been associated with a decrease in the effect of levothyroxine.
2) Taking Levo and Amitriptyline can alter the effects of both medications. You may need a dose adjustment or more frequent monitoring by your doctor.
So your doctor should be keeping an eye on things.
* Do you take Biotin or a B Complex supplement that includes Biotin? If so, did you take it in the week before this test?
* Did you take your test early in the morning before eating or drinking anything other than water?
Your results, if unaffected by the Sertraline and Amitriptyline or Biotin or coffee (TSH is affected by coffee), show gross undermedication. The aim of a treated Hypo patient on Levo, generally, is for TSH to be 1 or below iwth FT4 and FT3 to be in the upper part of their reference ranges.
* Were you informed by Thriva why your Transferrin Saturation and TIBC were not tested?
Your Serum Iron level is on the low side at 13.6 (5.8-34.5), this is only 27/18% through range and it's recommended that it should be 55-70% through range, the higher end for males.
Your Ferritin is low at 23.4 (13-150) which is just 7.59% through range and it's recommended to be half way through range.
You could have iron deficiency but you'd need the other two tests carried out to be sure.
* Have you ever had thyroid antibodies tested to know if you have autoimmune thyroid disease, aka Hashimoto's?
Your Active B12 of 35.5 is absolutely dire, it's below range. Your Total B12 level of 150 is just as bad and barely over the deficiency level. lt's very likely you have B12 deficiency which may be caused by Pernicious Anaemia. Your GP should test you but first check for signs of B12 deficiency here:
If you do have any signs/symptoms then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
Your folate is barely in range at 9.33 (8.83-60.8) and it's recommended to be at least half way through range. You can eat folate rich foods to help improve your level and after you have had further B12/PA testing then you can supplement but not before as taking folace or folic acid will mask signs of B12 deficiency.
Vit D of 19.8nmol/L is Vit D deficiency and your GP should follow the NICE Clinical Knowledge Summary and prescribe loading doses:
"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 25 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.
* Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
Once the loading doses have been completed it's essential to retest your level, your GP may not do this and in that case you must do it yourself as your follow on dose depends on the new level.
The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L.
Once you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Supplementation will very likely be for life as you have Vit D deficiency. Your GP will stop prescribing once your level reaches either 50 or 75, so you will then have to buy your own D3 supplement.
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3 as recommended by the Vit D Council.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
It's absolutely essential that you address these vitamin deficiencies.
I wouldn't be suprised to know that you have Hashimoto's as it can cause gut/absorption problems which lead to nutrient deficiencies. If not already tested then you should have thyroid antibodies - Thyroid Peroxidase (TPO) and Thyroglobulin antibodies (Tg) tested.
You also need to speak to a doctor about your thyroid results.
Thanks wow you've gave me more in a few short minutes , than my doctor has in years , I think it's time to take charge of my own health, I've recently bought magnesium , the doctor took the vitamin d medication of my prescription after a few months so I will sort that aswell and chase the doctor up tomorrow and re-order the other tests you suggested . They said they couldn't complete certain tests because my blood vessels popped and I have alot of the b12 symptoms I have had for a long time especially the neurological ones
You blood are well out of normal. The reson for that is you TSH is very very low. You have hardly no free thyroxin you your body. You need to see a dr and get your thyroxin medication upped . then you will see your other bloods come down, good luck.
On the contrary, for most hypothyroid people they feel best when their TSH is roughly 1 or under, and in this case the TSH is actually very high at 22.8.
The Free T4 should be, for many people (although it does depend on what form thyroid hormones are taken), round about 60% of the way through the range or higher - wherever the OP feels best. But in this case the OP has a Free T4 level way below range.
But the really vital one for feeling healthy is Free T3 which hasn't been tested. Free T3 is the active thyroid hormone and for most of us needs to be 50% of the way through the range or higher.
For all these tests people have their own "sweet-spot" that makes them feel well. But most doctors think "anywhere in range" is fine for any test they do.
I would encourage you to check out Dr Myhill’s website. Also maybe consider a paleo ketogenic diet. It helped my gut issues and mood greatly plus energy levels significantly rose due to stabilisation of blood sugars. Good luck!
Expect you have Hashimoto’s ....obviously need to test Thyroid antibodies if not been done
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
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.
Thyroid disease is as much a disease of poor gut function as it is thyroid
Essential to supplement to bring all four vitamins to OPTIMAL levels
Your vitamin D and B12 are absolutely dire. Folate and ferritin very poor
Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists....your GP clearly well out of their depth
TSH and FT4 labs alone shout "undermedicated" as do your symptoms! But there is more....
My GP prescribed Sertraline years ago for FM pain....I now think it added to my already poor absorption of thyroxine. I slowly titrated the dose down and stopped it....I am fine without it!
You have already been given excellent advice from very well informed members so I suggest you now take that on board,, answer any questions members have asked and follow the advice offered.
Medics are poorly educated in matters thyroid....you will get better advice from experienced forum members than from most medics. I can vouch for that.
Your GP needs to take your health seriously it's shocking that he leaves you with such a poor Q of L. Be brave, take control!!
Be aware it is not a quick fix ( as headache/ paracetamol) so you need to be patient.
You will get better with the correct medication so try to think positive.....and read and learn as much as you can about your condition.
Nothing to add but just wanted to say poor you! With those results you must be feeling horrendous. But fingers crossed armed with all the help from this forum you will soon be on your way to feeling much much better.
Thank you all, you have all been a massive help , I should of got myself together sooner, it's time to educate myself and take responsibility for my own health, it's difficult when I struggle to get a sentence together these days but I'll find a way to get through to my doctor or to just find a new one
Your GGT is above range and I have had that a couple of times and it is to do with your thyroid not functioning properly. Mine has been in the hundreds but is now ok because my thyroid levels are right for me.
Adding to all the other great advice given here, i would say you need some kind of iron supplementation...(stored iron is way too low). my own ferritin had been under 30 at every draw... it took a long time to get a doctor to actually listen...(many hypothyroid symptoms are same as anaemic symptoms). i had so many symptoms it was ridiculous, I'd never felt worse... ffwd 6 wks and i feel much much better than i did. Still got a long way to go with all other health issues but the iron has helped massively (i have some brain power back, and a bit of my spark) good luck
Whatever you do, do NOT let them give you statin drugs to treat the high cholesterol numbers. Your cholesterol is high because you have hypothyroidism that is (criminally, if you ask me) under-medicated. Once you have the thyroid problems straightened out, your cholesterol numbers will magically go down.
Also, instead of correcting the medical problem, your doctor decided it must all be in your head and prescribed TWO types of antidepressants. I'll bet you don't need any at all. You just need to be made well.
He prescribed amitriptyline (.ive just realised i spelt it wrong above in my original post ) for nerve pain and because I have awful insomnia , they helped to make me sleep for the 1st few months but not anymore , it's over a week since I sent the doctor my results and he's still not got back to me , I called Friday and they told me call back Wednesday, hopefully the doctor will of reviewed them by then 🤷♀️ my dad takes statins, he's awful with them , they cause him really bad stomach problems, and to be honest my stomach problems are bad enough now so i don't intend to take statins, thanks for the advice
Just had my long awaited phone consultation with my doctor , she's upping my levothyroxine to 150 , and prescribing me my vitamin D , she said she didn't see a problem with any of my other blood test results , even when.i informed her of some of the debilitating side effective been having , i asked what she thought of my b12 , and ferritin and folate ,she said everything was in range,I'm gathering my information and issuing a complaint ,whilst looking for another doctor 🤦♀️🤷♀️ you couldn't make this stuff up.
It’s absolutely atrocious. Just read through this post end to end as am trying to help my mum (also a Denise funnily enough) with her doctor. She has a low b12 result and low fT3 but her doctors just say the results are okay. I wrote them a letter and explained they should treat by symptoms and that they should consider the fT3 and not the TSH but her TSH Is below 0.27 which is just under range and they want to reduce her thyroxine even though her fT3 is low in range. It’s frustrating. Other than paying for her to go private I don’t really know what else to do! It’s crazy!
I'm sorry your mums having these problems, it's so easy for doctors to dismiss us it's not their life that's impacted by their bad health , I can guarantee you the people on here have more help and advice than any doctor , it seems doctors have little to no clue about indepth thyroid issues , im sure someone on here will be able to help and advise you ...
Absolutely. I’ve learned so much from all these great people and this forum. We all need to learn so we can be our own best advocates. Thanks for your message
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