So, the endo is happy with my T3 and T4. Mid to upper range. However I still suffer from bloating, hair loss and fairly rapid pulse (90 bpm) . I take 50mcg levo and 1 grain Thai NDT.
I had my iron checked in June 19. GP told me that my levels were ‘normal’.
I’ve recently had the Mirena coil removed and have the most horrendously heavy period to the point where I can’t go to work. 8 days of full on bleeding.
GP has prescribed Tranexamic Acid tablets which are starting to work, and I’ve just had another blood test.
My haemoglobin is 105. The GP told me that once the bleeding has stopped, my level will go back to ‘normal’ and stated that it’s only slightly lower than my results in June 19 which were 110.
I have anaemic symptoms. Whooshing in ears, tight chest, etc. And the NICE guidelines below suggest that I’m anaemic??
NICE defines anaemia as a haemoglobin (Hb) level of: 2,3. <130 g/l in men. <120 g/l in women who are not pregnant. <110 g/l in pregnant women.9 Aug 2018
Where do I go from here???? Could it be that it’s not my thyroid causing my symptoms but anaemia?
I have an iron rich diet and am now taking 200 Ferrous Sulphate daily (a maintenance dose).
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Boon79
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Do you have any actual results and numbers and ranges to share with us, as without some facts to base suggestions on, everything is simply supposition.
A month ago you wrote that you had dropped the NDT and were taking just T4 :
Did this switch back to just T4 cause you more hypo symptoms and why you switched back again to a combination of T3 and T4 ?
Do you have your Ferritin results? Low Ferritin can cause hair loss and it needs to be over 80 for hair growth. I know this because I have suffered from 2 lots of extreme hair loss. My hair has now been growing back for over a year so it can recover once your levels are stabilized. Also when your thyroid levels are changing or moving that can cause hair to fall out.
Heavy periods are classic sign of being hypothyroid and will lead to low iron and ferritin
ask for full iron panel testing for Anaemia including ferritin
You need the actual results and ranges
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
I always had really heavy periods, getting heavier the further I got to diagnosis for Hashi's.
I ended up with septic shock after surgery last year, though, and my haemoglobin dropped to only 80 (minimum was 120 for a woman) after an internal bleed from the infection. It took a long time to get to my current energy levels, which are still poor, and my being persistently hypo is the major factor.
Suggest you get FULL thyroid and vitamin testing done
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
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)
If/when also on T3, or NDT make sure to take last third or quarter of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
As you have Hashimoto’s are you on strictly gluten free diet?
Often improves gut issues including bloating
Hashimoto's 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.
I’ve already done a test for celiac which was negative. I’ve gone lactose free for the past few weeks which seems to be helping.
I’m due to have full iron blood tests in 2 weeks. Thankfully I have a diet rich in iron. (Unprocessed meats, spinach, Savoy cabbage, pate etc). plus taking 200mg ferrous sulphate daily.
I also take Vit D spray and magnesium in the evening 4 hours before thyroid meds.
I switched from only levo after 2 weeks because the bloating was insane! I need some T3 from NDT.
Spinach etc can actually bind iron and make it unavailable because of the oxalic acid and polyphenols they contain. Apparently Popeye ate spinach for its vit A content, not iron.
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