So I've recently been noticing that I feel really tired / sluggish and headachey in the morning. It seems to be relieved throughout the two hours after taking my thyroid medication.
I have made a note each morning and have ruled out going to bed late / lack of sleep / poor quality sleep / waking early. I do not eat anything after 9pm and do not drink caffeine at all, I usually go to sleep about midnight and wake naturally around 7am.
Could it be something random or related to thyroid medication? I was thinking perhaps I need to split the dose. I think I'll need a higher dose at the next review in about two months time.
I am currently on Levothyroxine 50ug in the morning, which I take about 7am two hours before breakfast.
My results as of the 19th Feb:
TSH 7.7 miu/L [0.2 - 5.5]
FT4 13.8 pmol/L [10.0 - 24.5]
Vitamin B12 752 ng/L [180.0 - 1000.0]
Folate 18.4 ug/L [> 4.0]
Ferratin 21 ug/L [10.0 - 300.0]
I've booked in a GP telephone conversation for the 1st March as I want to find out why my TPO Antibodies haven't come back and if they were actually requested; they should have been. Would it be worth mentioning the symptoms just before my my morning dose?
Any help on the Vitamin B12, Folate and Ferratin levels would be appreciated as they're marked within normal range, but I've not really read into much relating to those and Thyroid problems.
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luthien
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I'm not vegetarian or vegan, I don't eat red meat or dairy though as it flares up my endometriosis. I was just about to start my period so that may account for the low ferratin, I do sometimes get anaemic during those times.
The GP probably won't test ferritin any further or investigate as it's within range. I shall ask about an iron panel test for anaemia.
The GP has already said they won't test Vitamin D as it's not normal under the NHS. So I can't do anything about that apart from private tests, which I'll do in a few weeks.
So in summary, on my Phone conversation Monday;
Push for full iron panel tests
Ask about increasing the dose, but may be too soon.
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.
The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.
They have said "this is expected so no further action needed".
It's like 10 times higher than the top end of the range. So what does that mean? I would like something to go back with on Monday to investigate. I really do want to push for the Vitamin D and full Iron profile tests.
High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s
About 90% of primary hypothyroidism is autoimmune thyroid disease
Medics ignore the cause
But as the patient there’s much you can try to help improve symptoms
Ask for coeliac blood test
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.
As you've only been on 50mcg for 10 day's , you can expect how you feel to be changing over the next few weeks . For example ,I felt nothing much for a week , then slowly somewhat better for a couple /3 weeks , then worse again, over the initial 6 weeks on 50 mcg dose.
The body takes a long time to become hypothyroid, and takes a long time to recover as it gets used to the replacement hormone and you get up to the right dose .
There isn't a way to go faster unfortunately other than make sure you get a retest at 6 weeks after starting Levo 50mcg , when you can expect your dose to be increased, (usually by 25mcg at a time)
yes TSH . fT4 . and preferably the TPOab antibodies if they still a haven't been done? ( I can't remember) Sometimes they just do TSH , but in my opinion this is daft , and fT4 should be done at least until someone is feeling well on a stable dose.
Obviously fT3 would be brilliant too , but you've probably got no chance of that (doesn't hurt to keep asking though
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