Severe hypothyroidism and amenorrhoea

[Didcotindian]

My wife has recently been diagnosed with severe hypothyroidism. Her TSH values are above 15 and the anti-TPO levels are around 1300. She has been prescribed a dose of 100 mcg levothyroxine for two months and consult GP in two months. Her periods have stopped around 4 months back. She recently faces spotting for around two weeks. Is it good to consult a private gynecologist now or follow GP's advice?

[SlowDragon Administrator]

Welcome to the forum

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

How long has she been taking 100mcg

Which brand of levothyroxine is she currently taking

Many people find different brands are not interchangeable

For full Thyroid evaluation she will need TSH, FT4 and FT3 tested.

Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common with autoimmune thyroid disease

Ask GP to test vitamin levels at next test

B12 issues can cause spots/acne

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)

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s.

Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/signs-symptom...

[SlowDragon Administrator]

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels can 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

healthcheckshop.co.uk/store...?

Assuming test is negative your wife can immediately go on strictly gluten free diet

(If test is positive she 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.

[Didcotindian]

Thank you very much for your comments. I have got a doubt about gluten free diet. She doesn't have any food intolerence symptoms, does she still have to go gluten-free to get anti-TPO under control? Please explain.

Accord is the brand she takes. She started with 100 mcg around 6 weeks back and goes on until now. Also, plasma C reactive protein is quite high (around 15) but the GP did not make any mention about it.

[RedApple Administrator in reply to Didcotindian]

Didcotindian, 'does she still have to go gluten-free'

No, your wife does not have to go gluten free. This is merely a suggestion based on the experience of others on this forum who have found this to be very helpful in their quest to feel better.

It will take some time for things such as periods to normalise, so probably best to follow GPs advice for the time being. Once your wife has been taking a suitable dose of levothyroxine regularly for a few months and her blood levels have stabilised, that would be the time to consider a gynaecologist if things in that department are still abnormal. But GP will be able to advise your wife about this anyway.