Just received my results which I had done privately.
Ferritin 267ug/L ( range 13-150)
CRP HS 2.66 mg/L (<5 )
Vit B12 121 pm01/L ( 37.5-187.5)
Vit D 61 pm01.L ( 37.5-187.5)
TSH 0.2m1u/L ( 0.27-4.2)
Free T3 4.37pm01/L (3.1-6.8 )
Free Thyroxine 16.1pmo1/L ( 12-22 )
Thyroglobulin Antibodies 13.4 Kiu/L (0-115 )
Thyroid Peroxidase Antibodies 9.94 Kiu/L ( 0-34 )
I have been advised that I have iron overload. I did have my thyroid checked by gp approx 3 mths ago and ferritin levels were normal. Also advised to go down to 50 mcg levothroxine due to tsh level being so low, but I had low tsh when I was taking 50mcg. I would be grateful if anyone could explain results. Thanks
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Josiah150767
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Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
Extremely unlikely GP will do anything other than insist dose is reduced
Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists
You are almost certainly going to need to see a specialist
tukadmin@thyroiduk.org
Probably looking at some degree of central hypothyroidism, pretty common with autoimmune thyroid disease, but rarely diagnosed
TSH is especially unreliable with autoimmune disease
guidelines on dose levothyroxine by weight
Even if we don’t start on full replacement dose, most people need to increase levothyroxine 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.
Who said you have iron overload? Doesn’t look like it.
Don’t reduce your Levo dosage. If anything, according to your FT3 results you’re a bit undermedicated (TSH is not a reliable gauge once you start thyroid hormone replacement).
Once you Improve level, very likely you will need to be on higher maintenance dose than 1000iu to keep it there. 2000-3000iu as maintenance dose not uncommon
Test twice yearly via vitamindtest.org.uk
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7
It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average
Calculator for working out dose you may need to bring to 40ng/ml = 100nmol
I’m not sure if my antibodies have been high or were tested, and I have never had a scan. I’m have an app with a new rheumatologist in the next few days and was going to discuss this and I will mention about Vit D. I feel overwhelmed with it all at the moment as not feeling too well due to allergic reaction to hydroxychloriquine, but on a positive note I have made a start to sorting out my thyroid thanks to all the advice on this forum as I feel drs don’t take me seriously.
You don't say how you feel ... I'm guessing not great.
As SlowDragon says. your free T4 and free T3 are too low - most of us like these in the top third of range - and these are MUCH more important results than TSH, as the "frees" are you actual thyroid hormones, rather than just a message from the pituitary. I agree with her that an extra 25 mcg sounds sensible.
Your vit D is low - particularly after the excellent summer we've had - so you may want to boost that x
I don’t feel well at the moment, more due to my lupus. I had a bad flare and my hydroxychloriquine was put up to 400mg. I had an allergic reaction, had to go to hospital.i was put on high dose of Vit D by rheumatologist, 4yrs ago and now take 1000 a day which is prescribed. But before this all happened, I knew something wasn’t right with my thyroid.
Hope you can get a dose increase - ie your doc isn't over-obsessed with TSH. It may help to refer to how low in range your frees are ... but it's rubbish that it can take so long to get the right meds and feel well. But SlowDragon has given you lots of excellent advice
Obviously a very high percentage of Hashimoto’s patients find strictly gluten free diet helps or is essential
Currently research is looking at all autoimmune disease possibly being linked to leaky gut
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.
Yes I’m on an autoimmune paleo diet. It has helped quite significantly. I came off it to eat gluten to be tested for coeliac as my daughter is and started to feel unwell. I blame it starting my flare up. My test came back negative, but I’d only been gluten for about 3 wks.
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