Chronic Shingles & Hashi/Hypo

[badgenes]

Anyone else get Shingles everytime their TSH rises due to Hashi’s & it’s time for an increase in Levo.mg’s? This has been my pattern for a year now. First round was face/neck second was armpits. Both times bilateral. Shingles vaccine has not been an option for me because I can’t go long enough in between outbreaks to get it. I’ve gone from 50 to 75 to 88mg of Levo in less than a year & was diagnosed right under 2 yrs. ago. 550 TPO, 2 right lobe nodules <1cm. Watch & wait category on those but all my lymph node, pain & debilitation issues also on right side of body from head to toe🙄 Any advice, tips or even others similar complaints/vents greatly appreciated🥴

[SlowDragon Administrator]

When was dose increased to 88mcg

Bloods should be retested 6-8 weeks after each dose increase

Which brand of levothyroxine are you currently taking

Do you always get same brand

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 at least annually

When were vitamin levels last tested

What vitamin supplements are you currently taking

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

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/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[SlowDragon Administrator]

Being hypothyroid apparently makes you more susceptible to Shingles

sciencedirect.com/science/a...

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

guidelines on dose levothyroxine by weight

Even if we frequently 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 eventually 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.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

[MichelleHarris]

I cant imagine how awful that must be. I had Shingles twice and very ill in lots of ways before they reluctantly diagnosed me with a TSH of over 19. Its so hard to fight for proper treatment when youre ill but you are on a great site for support now x