Been trying to look if there is an connection with Hashimoto’s and a slightly raised Globulin result.
I always thought Hashimoto’s caused inflammation in the system.
The range was 35 and my result was 37.7
I am over weight, but I don’t drink. My liver results and kidneys are all in range. The only other is cholesterol HDL which I will work on.
Any advice?
High cholesterol linked to being hypothyroid
What are your most recent thyroid and vitamin results
Wow is it.... My diet isn’t great but it’s not terrible, I haven’t really been exercising tho I do need to start moving more.
So everything seems ok, the only red flags I got were the HDL cholesterol & slightly raised Globulin level.
My TSH is 2.5 and I am going to ask if I can take a little more Levo to see if my symptoms can fade a little.
Suffer really bad with with not being able to keep warm, constipation, aches and pains.
I am speaking to my gp Friday to ask her if I should be worried about the globulin.
It’s really stressed me out, I am a worrier..
thank you for replying.
Anxiety is common hypothyroid symptom
On levothyroxine TSH should always be under 2Ft3 at least 60% through range and and usually Ft4 will need to be near top of range in order to get high enough Ft3
How much levothyroxine are you currently taking
Essential to regularly retest vitamin D, folate, ferritin and B12
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
About 90% of primary hypothyroidism is autoimmune thyroid disease
Ask GP to test vitamin levels
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 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...
I did my first Medichecks these are my results
I know my T4 needs to be a little higher and my TSH a little lower.. I am going to ask GP if I could take 75mcg instead of 50 I have been on 50 for 4 weeks. I was put on 25mcg first but that did nothing.
Had lots of other results iron etc all in range..
What’s your Ft4 results
Did you test vitamins and antibodies
Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before
Click on the picture you will see my full panel..
Also attached are my other medichecks results.
Yes my antibodies were 1300..
I had my vitamin levels check January vit d was in range but low I do supplement them.. Everything was in range.
The only thing I do want to check is hormone levels.
So how low was vitamin D, folate, ferritin and B12
What vitamin supplements are you currently taking
When were vitamins last tested
Aiming for vitamin D at least around 80nmol and around 100nmol maybe better
Folate and ferritin at least half way through range
Active B12 at least over 70
Serum B12 at least over 500
So you have high antibodies and this confirms cause of your hypothyroidism 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
Poor gut function with Hashimoto’s 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.
Ft4 is only 38% through range Ft3 at 50% through range
Helpful calculator for working out percentage through range
Most people when adequately treated will have Ft4 at least 60-70% through range and Ft3 similar level
🤯 wow! Thank you....
I know my T4 needs to be higher within the range...
iv calculated my weight and I should be on 150mcg of levo not 50..
so I’m definitely going to push for increase.
So my vits were done
26th November 2020
Vit d was 70 range 50-200, so in range but low.
Ferritin- 30 range 12-300, so in range but low end
8th Oct
B12 - 282 range 190-800, low in range
Folate - 4.7 range 3-17
So vitamin D not too bad How much vitamin D are you currently taking
Ferritin is poor (common with Hashimoto’s)
But iron level not too bad
Are you vegetarian or vegan?
Look at increasing iron rich foods in diet to raise ferritin levels
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
List of iron rich foods
Links about iron and ferritin
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
You don’t need iron supplements
Post discussing why important to always do full iron panel test before taking iron supplements
healthunlocked.com/thyroidu...
Why low ferritin needs improving
healthunlocked.com/thyroidu...
Thyroid disease is as much about optimising vitamins as thyroid hormones
B12 and folate too low
What are you currently taking?
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.
This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
chriskresser.com/folate-vs-...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B is another option that contain folate, but is large capsule
Important...If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
Low B12 symptoms
b12deficiency.info/signs-an...
With B12 result below 500, recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
B12 sublingual lozenges
amazon.co.uk/Jarrow-Methylc...
cytoplan.co.uk/shop-by-prod...
healthunlocked.com/thyroidu...
healthline.com/nutrition/me...
Wow thank you again...
I’m currently taking a spray a b12 4 sprays a day in my mouth... Is this enough?
As for folate I’m not too sure what to take.
At the moment I supplement
Vit d
Magnesium
Omega 3,6,9
Vit c
B12 spray
Biotin
Apple cider gummies
Folate does confuse as I’m not sure what I should take
Rather than just folate it’s recommended we take a daily good quality vitamin B complex with folate in
Igennus vitamin B complex is nice small pill.
Suggest you start with one a day.
You probably don’t want biotin as well. Vitamin B complex contains biotin
In week before all blood tests, stop all biotin supplements. Personally in that week I then take a separate Folate supplement (Jarrow brand)
Once B12 result is over 500, you can slowly reduce and stop separate B12 spray. Just Vitamin B complex should be enough
Apple cider best nowhere near your teeth as is corrosive. A spoonful of ACV “with mother” in glass of water - drink with straw to keep teeth safe
healthunlocked.com/thyroidu...
Thank you... I will get some of that ordered..
Then retest my b12 and folate in a few weeks.
Thank you for all your help xx
No point testing until 6-8 weeks after increase in levothyroxine to 75mcg
Which brand of levothyroxine are you currently taking
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
But for some people (usually if lactose intolerant, Teva is by far the best option)
Are you currently taking Teva?
Teva, Aristo and Glenmark are the only lactose free tablets
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but beware 25mcg Northstar is Teva
List of different brands available in U.K.
thyroiduk.org/medications-f...
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
This is what I take at the moment
This is Accord - boxed as Almus by Boots Northstar 50mcg and 100mcg are Accord too - boxed by Lloyds
Accord also available as its own box from other pharmacies
Many members who're hypothyroid complain of unexplained weight gain but it is due to being hypothyroid (which means slow) and everything in our body slows down until we're on a sufficient dose of levothyroxine (or options).
The same applies to a higher cholesterol level which should also reduce. I think many doctors believe a high cholesterol means we are eating the wrong food but it is due to our whole metabolism slowing down
Our dose of levo should be slowly increased until we are symptom-free and feel well again. Unfortunately few doctors seem to be unaware of this fact.
This is the method to get the best results of our tests:-
Always make the earliest possible appointment - even if made weeks ahead. The TSH is highest early a.m. and drops throughout the day, so an early a.m. blood draw gives us the best results.
It is a fasting test (you can drink water) and allow a gap of 24 hours between your last dose of levo and the test and take it afterwards.
Ask for B12, Vit D, iron, ferritin and folate to be tested.
Always get a print-out of your results for your own records and post if you have a query.
Thank you!
I always get my results sent to me, everything else is ok at the moment a part from Globulin & HDL.
But will work on that I am going ask GP to raise to 75mcg Levo to see if that helps and just suggest this for 4 weeks.
My GP is really hard work and doesn’t really understand Thyroid or Hashimoto’s.
The other thing I am going to ask for is my hormones to be checked as I’m not sure if that can linked to raised Globulin to.
You are so right cholesterol, my diet isn’t horrendous, admittedly could be better and because of how poorly iv felt iv not really exercised. But will make an effort to move more.
Thank you so much for replying.
As our dose of thyroid hormones are increased cholesterol should lower.
Many doctors seem happy to prescribe statins but I wouldn't recommend it.
No I don’t want statins,
It is only my HDL that is out not my LDL or Total.. They are in range.
I would never have linked hashi/UAT with cholesterol, so thank you.
I will speak to gp on Friday and ask for a small raise in Levo and see if that helps.
Thank you
GP unlikely aware either
nhs.uk/conditions/statins/c...
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
I will mention this to my gp on Friday.
I’m hoping they will put up my Levo and this will adjust..
Thank you so much!
Need to get to the bottom of the raised globulin
High globulin most likely due to you having autoimmune thyroid disease
Thank you so much for your replies today. MReally helped, me I really appreciate it.
I think it is shocking that GPs knowledge about clinical symptoms of a patient who is hypo is now so awful that they are unable to restore their thyroid patients' health. They all used to do so and that was before Big Pharma introduced blood tests to confirm or not that a person was hypo.
Few doctors take any notice of suggestions that we, the patient, have heard or have suggested
I’m praying she listens tomorrow..
Iv been nice and played the long game..
but I’m going to ask her to up my Levo and order me some hormone tests.
See how that goes x
A majority of patients 'Do It Themselves' with the assistance of members on this forum who seem to be more knowledgeable than their GPs. (I know that for a fact). However, it will be nice for you to have a positive outcome from your GP.
I had to fight for months to have Levo, so I’m not holding my breath.
If I don’t get the answers I want I will write to the practice manager or change gps
You can tell your GP you are a member of Healthunlocked ThyroidUK who are assisting you to recover your health.
Maybe it will help if all GPs look on the site to know exactly how little their knowledge may be, in order to learn how best they can help restore the health of their hypo patients.
Hopefully she/he will increase your dose until TSH is 1 or lower with both 'frees' (rarely tested) in the upper part of the ranges.
Thank you so so much... I will drop that in with the phone call today..
I will let you know how I get on today..
thank you
50mcg is only a STARTER dose levothyroxine
How long have you been left on just 50mcg
Bloods should be retested 6-8 weeks after EACH dose increase
Levothyroxine doesn’t top up failing thyroid, it completely replaces it
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
bestpractice.bmj.com/topics...
Which brand of levothyroxine are you currently taking
Many people find different brands are not interchangeable
Hashimoto’s 
Antibodies and Hashimoto’s
Hashimoto’s - Overactive and Underactive Thyroid 
Irritability with Hashimoto’s 
