Been a watcher for but could do with some thoughts & guidance please.
Diagnosed Hashimotos about 2.5 yes ago now, at that time EXTREME hypo symptoms and TSH/ T4 & T3 all wildly out of reference ranges. I was originally under a great endo who left and then her replacement discharged me back to GP as I was technically ‘in range’ even though still significantly symptomatic.
Since then my symptoms have been erratic and my levels have been up and down. My medication dose has continued to be tweaked by 25mcgs each time (again either up & down) but causing really dramatic changes in my levels.
I have started having palpitations, dizziness, trembling & pains so ended up in ED last night and asked them to check thyroid too.
TSH <0.05
T4 23.7
It has never been like this before!
Can you give any thoughts or advice why I am jumping from one extreme to another??
So many thanks for all your work here
😊
Written by
Stella80
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It would be good to see the ranges so we can see if you're in or over. Also worth getting T3 tested as that's the active hormone and will give you a fuller picture. You might be over medicated but you might not - you need the full picture by getting bloods done privately.
First step is to get FULL thyroid and vitamin testing done
Also coeliac blood test
For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
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
Thanks for your reply. I am already diagnosed with coeliac disease (this was about 5/6 months after my HT diagnosis) so follow a strict gluten free diet and have done for 2 years.
I have not had a full vitamin testing done in a while, but I did have to take folic acid & ferrous sulfate following a check about a year or so ago, which on the following check was stable again.
I do take a vit d and B12 supplement daily, what role might vitamin deficiencies have in the extremes of my thyroid function?
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
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.
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
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.
Come back with new post once you get full thyroid and vitamin testing results
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