Hi everyone. I had my thyroid test by my GP 5 days ago my TSH was 0.39
I just had Blue Horizon, and 5 days later it's 2.25!!!
Its going up and down like a yo yo . I had it done 6 months ago and it was 3.65
A month before that 0.18
So in 7 months it's been up and down between 0.18-3.65
Any ideas? I haven't changed my throxine dosage but I am menopausal
Any advice greatly appreciated
That’s because you have Hashimoto’s..
Do you always get same brand of levothyroxine
Which brand
Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test?
What time exactly was test done - for evaluation of cortisol result
Ft4 is only 56% through range
Ft3 only 4.5% through range
Helpful calculator for working out percentage through range
Ft4 shows room for dose increase in levothyroxine
Really awful Ft3 shows terrible conversion of Ft4 to Ft3
When were vitamin D, folate, ferritin and B12 last tested
Are you still taking omeprazole?
Any ppi will lower vitamin levels, especially B12 and magnesium
Are you currently still strictly gluten free
Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3
NHS and Private
tukadmin@thyroiduk.org
Are you taking HRT?
Thank you very much for your reply.
The 0.18 was taken in the afternoon as GP appointment, they only tested TSH so I did Blue Horizon yesterday before eating am and got results today (very quick)
Yes, I always take the same leveroxine but the 100mg and 75mg are different brands
75 is Tevn and 100 is Almus both from Boots
No, I'm not talking HRT, I am too concerned it will interact with Thyroid.
No, I'm not talking Omoprezol, I tried it but it made me worse but still have acid reflux type symptoms. Bit miserable really.
I'm not GF , I have booked to see a nutritionist who specialises in auto immune so going GF
All thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
So no wonder TSH was much lower on nhs test
researchgate.net/publicatio...
“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”
“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”
ncbi.nlm.nih.gov/pubmed/252...
TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.
Thank you.
I didn't know I was having it done, hence one in the afternoon
you have high antibodies this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
So essential to get vitamin D, folate, ferritin and B12 tested ASAP
Come back with new post once you get vitamin results
Meanwhile
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
healthcheckshop.co.uk/store...?
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.
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
Teva, Aristo and Glenmark are the only lactose free tablets
dropbox.com/s/6h3h0qi4eqwi6...
Teva poll
healthunlocked.com/thyroidu...
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Again, thank you. I'll pop to Boots tomorrow to change back to a 50/25 for the 75 dose.
I really appreciate all your help
TSH going up and down
Up and down monthly 
Fed up
TSH has shot up
