I am new to this board. I was diagnosed two years ago now and on levothyroxine 50mg.
For the last couple of months I have had a really dry mouth at night. I have not slept that well either. Also I feel dzzy getting out the bath, no other time, I do not rush to get out.
My annual blood test was only a tsh one and the reading was 2.2. I have been taking vitamin D for six months. My dose has not been changed
I am wondering if my dosage needs amending or if I need further blood tests I have kept out the way of doctors over the past year due to the coronovirus and don’t go there in a hurry normally preferring to sort things out myself if possible
Can anyone shed any light, experience please?
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Redlorakeet
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Bloods should be retested 6-8 weeks after each dose increase
Request FULL thyroid and vitamin testing
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
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Have you had thyroid antibodies tested?
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)
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
TSH over one suggests you are likely under medicated
Just testing TSH is completely inadequate
Come back with new post once you get full results
Levothyroxine doesn’t top up failing thyroid, it replaces it. Important to be on high enough dose
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
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.
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.
It is as I thought, not good enough testing. Only tsh was done. I was originally diagnosed as hyper, then told to stop them and then hypo on levothyroxine and dose has not changed in two yrs.
Re the vitamin D I am currently taking 4000 a day. No idea what my result is but now I have all your info, thank you, I can do some research.
So you almost certainly have autoimmune thyroid disease also called Hashimoto’s
Hashimoto’s frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid
You need TSH, Ft4 and FT3 plus thyroid antibodies tested and all four vitamins too
As been left on low dose too long likely to have low vitamin levels as direct result
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
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.
Hi I have some blood test results. The worrying one is the calcium one which is abnormal. My reading is 2.15 which is below the recommended figure. Ferratin was 94 and vit D was143. The other one that was low was serum urea level at 3.4. Anyway they are concerned about the calcium one. I have another blood test tomorrow where they are testing my full thyroid stats, bone, ALP and PHO. I also have a bp and ecg lined up for next week.
As I said I am on 50 of levothyroxine and am sure the dosage is incorrect.
Any comments would be welcome ahead of extra tests that they are doing tomorrow.
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