Blood tests done 15th May. Drs appointment today 11.45 do sorry for short notice. Drs only did T4 and tsh as suspected so I did test at medichecks same day for full results as recommended on this website. My symptoms are tiredness throughout day. Usually ok first thing in morning. Vertigo. Feels like a head clamp on. Depression. And continuing constipation.I have been supplementing Vit D for 3 months to boost. Just feel useless and crappy most days.
Test results GP TSH 1.99 range 0.27-4.2 T4 16 range 10-21.
I know all my GP is going to say is you are in normal range. I am currently on 100mcg levo accord and have been for 3 months. I weigh 15stone 4lbs and need an increase or t3 supplement but GP may not see it that way.
Medichecks results
Tsh 2.45 range 0.27-4.2 T4 19.2 range 12-22 t3 4.3 range 3.1- 6.8 folate 7.8 range above 2.9. Ferritin 158 range 30 -400 vit B active 131 range 25 -165. Vit D 78 range 50 -200 TGA 331 TPA 345 I am Male 61 and Hasi. I need as much info for GP meeting this morning. Sorry for urgency. Just got medichecks results 10 minutes ago
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Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test?
What vitamin supplements are you currently taking?
High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s
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.
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.
Hi . Yes test was done 8.30 am on fasting test. Vit B supplement taken for 3 months. I have been gluten free for 3 months and improvement ie no cramping. Switched from Tevo to accord 4 months ago.
Just got back from GP appointment and this time listened to my ongoing symptoms. So has prescribed 25mcg increase in Levo. Hallelujah!And rang through to prescriptions to make sure it was same brand. Accord do 50mcg so she recommends I split it. At last my GP has come through and acknowledged that although my bloods are in range the symptoms I described to her are saying my metabolism isn't right. Just hope there is some improvement. Re test in 6 to 8 weeks.
Hello. Just need your advice on taking Levo. Should I try splitting dose and take morning and evening. The reason i am asking is that at moment i have taken 100mcg dose usually between 3am and 6am when on bathroom break. I wake up between 7am to 8am and feel quite well. But by midday I feel washed out and lethargic. Just wondered if dose split twice a day would help. I always take with water on empty stomach
The accepted conversion ratio when on T4 - Levothyroxine only is 1 / 3.50 - 4.50 - T3/T4 with most people preferring to come in at around 4 or under :
So to find your conversion ratio you simply divide your T3 into your T4 and I'm getting around 4.50 so you are moving out from centre and conversion not optimal for you as you still have symptoms of hypothyroidism.
Ideally T3 and T4 should be balanced in their ranges and we generally feel better when T4 is into the top quardrant of the range : your T4 is just at 70% and your T3 at around 32 % through and a dose increase ot two, in T4 could just be enough to bring your T3 up and you notice a relief of symptoms.
With these high antibodies this looks very much like Hashimoto's auto immune thyroid disease. I read of the research of Dr Izabella Wentz who has this disease herself and of the need to calm down the immune system rsponse by first healing the gut and working to exclude any foods that seem to upset you, and read of gluten, wheat, dairy and most processed foods being the main suspects to consider.
Having Hashimoto's puts another spanner in the works as you are liable to " hyper type swings " when your immune system is upset and attacks your thyroid causing erratic T3 and T4 levels. However these " swings swing back " with the thyroid further disabled and you most probably needing an increase in T4 to compensate for the disabled glands reduced function.
Should you want to read further I believe Thyroid uk the chariy who support this amazing forum can help you.
To qualify for a trial of T3 you need to be referred to an endocrinologist and this can be pot luck.
Thyroid uk hold a list of sympathetic endos and specialist both NHS and private, and if you plan to go this route best to check and see who and where your best option may be.
Thank you so much. What you have put here makes so much sense to me. Also slow dragons advice is immense. I have just replied to SD regarding my gp visit today and gp is trialling increase in Levo 25mcgs daily. GP is going to monitor symptoms if over prescribed and tweak it down if needed. I went to gp prepared with endo list from Thyroid UK in my pocket to ask to be referred but I didnt request as I will see how dose increase goes. I see the same gp everytime as she is honest with me. Told me previously that she cannot prescribe T3. If I need T3 in future I will need to find one that will prescribe it which seems to be a another hurdle to cross as they seem thin on the ground in North
I'm one of them though with Graves Disease and became very ill around 8 years after RAI thyroid ablation and having been refused both T3 and Natural Desiccated Thyroid i decided to do it for myself.
If you experience these " hyper type swings " I read people can sense them coming on, and so they simply stop taking their medication for a few days so to try and offset the severity of the symptoms experienced, rather than actively seeking help and getting a dose decrease, which is ultimately short lived as once this phase is over, if anything, you will be needing more, not less, thyroid hormone replacement.
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