Hashimotos/hypothyroidism low calcium?

[Cade83]

Hi, I just did a private blood test to check calcium as I am so exhausted a lot of the time and I do get pain in my throat a lot (not swallowing) around my thyroid area. I know my friend had hyperparathyroidism and had adenomas removed. So I was expecting my calcium level to be high but it came back as 2.06 and the range is 2.2-2.6. My corrected calcium was 2.03 the range being the same. I just wondered if this can happen with hashimotos or hypothyroidism. I’m just wondering if there is a sinister cause rather than just lack of calcium in my diet. My vitamin d levels are normal. Should I get my phosphorus and PTH levels checked? Is low calcium linked to stomach bloating? I’ve tried cutting out so much foods, gluten, dairy, high saturated fat foods as I have a cholesterol level of 6.6. So I’m eating more fruit. I always feel in the back of my mind I could have a panic attack at any moment. I’m getting so fed up with my life right now as I just seem to get one problem after the other when I’m really trying to work on my health anxiety. TIA

[SlowDragon Administrator]

When were full thyroid and vitamin levels tested

Looking at previous post of your results 5 months ago you likely need thyroid retested /increase in dose

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

Low calcium strongly linked to low vitamin D

How much vitamin D are you currently taking

Are you also supplementing magnesium

Are you perhaps taking propranolol? (Lowers PTH)

[Cade83 in reply to SlowDragon]

My last thyroid test through my doctors was 22nd June and TSH was 1.5 miu/L unfortunately as you know the labs don’t test T4 or T3 unless TSH is out of range and even then they probably won’t do T3. However weirdly and I don’t know why but whenever I have blood tests I always fast and wait to take my levothyroxine after the blood test but my results through Thriva 28th May my TSH was 3.52 FT4 13.4 and FT3 4.1 so I’m confused as to how my bloods can be so different between Thriva and the gp results. My vitamin d is 71. I take 1000 iu of vitamin d a day and 200mg magnesium a day. I’m still on 75mcg levothyroxine. It’s very hard to get the same brand but I won’t touch teva. I’m not on propranolol either but I am on sertraline. I’m also using a steroid nasal spray and antihistamines for sinus issues. I did read that steroids can decrease your calcium but didn’t know whether this was just oral steroids or not.

[SlowDragon Administrator in reply to Cade83]

75mcg is only one step up from starter dose

Approx how much do you weigh in kilo

Guidelines are 1.6mcg levothyroxine per kilo of your weight

High cholesterol is strongly linked to being under medicated thyroid wise

Steroids tend to lower TSH

Most important results are ALWAYS Ft3, followed by Ft4

Aiming for ft3 at least 50-60% through range

[Cade83 in reply to SlowDragon]

I’m around 75kg so that would mean I should be on around 120mcg that’s quite a lot. I know I tried 100mcg before and was fine for the first 2-4 weeks but then felt like my mind was racing and I was all over the place. I was going to try 87.5mcg but never did after my TSH was only 1.3 or something back in January and thought I’d go too low. I know my TSH went too low on 100mcg.

I’d be happy going up to 2000iu of vitamin d. I take my vitamins at night with my sertraline and take levothyroxine in the morning on it’s own.

My Thriva test was done earlier than my gp one was but surely you would expect TSH to be higher the later it’s done?

[SlowDragon Administrator in reply to Cade83]

No TSH is highest early morning before 9am

TSH has Significant diurnal variation

Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

The longer we are on levothyroxine the more likely to need next dose increase

Once we are on levothyroxine the feedback mechanism is broken, so majority of thyroid patients eventually need full replacement dose

Suggest you request 25mcg increase…..but perhaps only add 12.5mcg initially …..retest 6-10 weeks after each dose change or brand change in levothyroxine

[SlowDragon Administrator in reply to Cade83]

1000iu vitamin D is unlikely high enough dose

Test vitamin D twice year when supplementing,

Aiming for vitamin D at least around 80nmol and around 100nmol maybe better

Magnesium supplements and vitamin D tablets must be minimum 4 hours away from levothyroxine

[SlowDragon Administrator in reply to Cade83]

Was Thriva test early in morning…..earlier than NHS test

Thriva test shows both Ft4 and Ft3 too low

Ft4 only 14% through range

Ft3 only 27% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Request/firmly insist on 25mcg dose increase in levothyroxine

If they refuse you will need to see recommended endocrinologist. Email Thyroid U.K. for list of recommended thyroid specialist endocrinologists

Retest in 8-10 weeks after each dose increase

Always get same brand levothyroxine at each prescription

[greygoose]

I’ve tried cutting out so much foods, gluten, dairy, high saturated fat foods as I have a cholesterol level of 6.6.

High levels of cholesterol are nothing to do with fat of any kind. They are two entirely different substances and fat does not magically turn into cholesterol when you eat it.

Cholesterol is made in the liver, and the liver does its best to keep levels consistant: the more you cholesterol you consume in food, the less it makes. The less you consume, the more it makes.

High levels of cholesterol are a symptom, not a disease. And, the usual culprit is low T3. If you don't have enough T3 in your system, the body cannot process and eliminate cholesterol correctly, and it tends to build up in the blood. Raise the FT3 level, and the cholesterol levels will fall.

[Cade83 in reply to greygoose]

I am worried about my LFT’s within 3 months my serum alkaline phosphatase went from 79 to 115 normal range being 30-130 and also my serum ALT level went from 32 to 55 range being 1-55.

How come they always say to cut out saturated fats when dealing with high cholesterol it doesn’t make sense. There’s so many things I don’t eat that I love. Like cheese, eggs, full fat yogurt etc. Can you raise FT3 without using medication?

[SlowDragon Administrator in reply to Cade83]

High cholesterol levels will drop as levothyroxine dose is increased

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.

Most people on just levothyroxine need Ft4 at least 70-80% through range to get high enough Ft3 at 50-60% through range

[greygoose in reply to Cade83]

More ignorance, that's all. They do not study nutrition. I'm the opposite to you, My cholesterol is too low - although no doctors would ever admit it - once it was below range! And the heart doctor thought it was great! But, thing is, I eat a lot of cheese, eggs, cream, butter, and my cholesterol doesn't rise one bit. But, you're far more likely to have a heart attack with low cholesterol than you are with high.

By 'medication', I presume you mean thyroid hormone replacement. Doubtful. You at least need levo and hope you are able to convert it to sufficient T3. But, you won't know how well you convert without having your FT4 and FT3 tested at the same time.

[Cade83 in reply to greygoose]

Wow never knew you could have low cholesterol. Surely with low cholesterol you won’t get a build up in your arteries and not get all clogged?

I will see about going up to 87.5 to start with but I think TEVA is the only brand that do the 12.5mcg tablets.

[greygoose in reply to Cade83]

Cholesterol doesn't clog arteries, anyway. It acts as natures sticking plaster. When arteries are damaged by inflammation, the cholesterol comes along and covers it up as it heals. The cholesterol is then absorbed into the wall of the artery in a natural way, because that is what cell walls are made of: cholesterol. It's the inflammation that causes heart attacks, not the cholesterol. So, if you have low cholesterol, you cannot achieve that healing process.

What is your FT4 level? Because could be you don't need to mess around with fiddling little dose increases of 12.5 mcg, and can just make a normal increase of 25 mcg. 87.5 is a tiny dose, anyway. You're probably under-medicated.