Thyroiditis symptoms

[pelakey1]

Hi.. I'm Pete.. had hypo for many years and diagnosed with thyroiditis earlier this year with some nodules, dizziness and a swallowing problem.. all great fun!! If anyone can shed any 'confirmed' diagnosis on these symptoms.. that would be appreciated!

[Lizzo30]

Hi here is an article suggesting that low testosterone in men may be linked to hypothyroidism

thyroidpharmacist.com/artic...

[pelakey1 in reply to Lizzo30]

Thankyou for the response, I'll consider its content

[SlowDragon Administrator]

Welcome to the forum

How much levothyroxine are you currently taking

Do you always get same brand

What vitamin supplements are you currently taking

First thing is, do you have any actual blood test results? if not will need to get hold of copies.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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 and thyroid antibodies

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

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)

Is this how you do your tests?

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/

Also vitamin D available as separate test via MMH

Or alternative Vitamin D NHS postal kit

vitamindtest.org.uk

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

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...

Email Thyroid UK for list of recommend thyroid specialist endocrinologists.........NHS and Private

[e-mail]

The aim of levothyroxine is to increase dose upwards until Ft4 is in top third of range and Ft3 at least half way through range (regardless of how low TSH is)

Very important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works

[pelakey1 in reply to SlowDragon]

Hi and thanks for reply.. levothyroxine 100mg per day tested recently and normal range, taking iron supps and was taking iodine (now ditched) as well as calcium. I have blood test results, they are all fine. Test so far, full blood count, renal function, magnesium, liver function, renal function including chloride, renal function general, liver function profile, TSH, free thyroxine (free t4), and nucleated red blood cells. I was not advised to NOT take levo 24 hrs prior to test. I have not yet been diagnosed with Hashimotos but I definitely have thyroiditis of some kind. I want to get all the necessary tests done (especially if there is no danger to doing so). Aside from the above tests I have mentioned in my 'my care' profile, no other tests have been done. Many thanks for your input on this, it is becoming clear to me that not everything is being done to aid my condition but after neurological tests and scans I have now been referred to an endocrinologist so any advice or tests to request from them would be very very useful. Thanks

[SlowDragon Administrator in reply to pelakey1]

Please add actual results and ranges

We need OPTIMAL results.....not just somewhere within range

Ft3 minimum of 60% through range, all four vitamins at OPTIMAL levels

As male important to check testosterone levels too

[pelakey1 in reply to SlowDragon]

hi, i've never had an ft3 test to my knowledge, or the vitamin tests you mentioned, I have included my full tests in my last response but can certainly get the ranges for you of the tests I have had. I don't think i've had a testosterone test either.

[pelakey1 in reply to SlowDragon]

TSH is 0.35 mU/L free t4 is 20.2 pmol/L - as far as I can see no thyroid antibody tests or vitamin level tests have been done, atleast there is no mention of the words antibody, thyroid or vitamin in any of my tests, or any of the other words you mention in original email.

[SlowDragon Administrator in reply to pelakey1]

Suggest you consider getting FULL thyroid and vitamin testing done privately (GP highly unlikely to agree to full testing)

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

What vitamin supplements are you currently taking

Remember to stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results

Private test do early Monday or Tuesday morning and then post back via tracked 24 hour postal service

Come back with new post once you get results

optimal vitamin levels are

Vitamin D at least around 80nmol and around 100nmol maybe better

Folate and ferritin at least half way through range

Serum B12 at least over 500

Active B12 at least over 70

Extremely common to have low vitamin levels the longer we are on just levothyroxine, especially if under medicated

Low vitamin levels results in poor conversion of Ft4 to Ft3.

[pelakey1 in reply to SlowDragon]

Thanks, i appreciate it

[pelakey1 in reply to SlowDragon]

Will blue horizon Thyroid Premium Gold cover all needed tests please?

[SlowDragon Administrator in reply to pelakey1]

Links in my first reply

Medichecks usually cheapest

Currently has 25% off at £59.25

medichecks.com/products/adv...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

[pelakey1 in reply to SlowDragon]

thanks

[SlowDragon Administrator in reply to pelakey1]

100mcg isn’t high dose

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, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

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.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

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.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

[pelakey1 in reply to SlowDragon]

I have been on thyroxine for nigh on 20 years and its tested 6 monthly, it has been 100mg for a very long time. I am of course not sure what that means or whether my doctor is testing me correctly