Further to my earlier post, full ( controlled ) test results enclosed for your advice/comments. Other relevant conditions to consider, Eosinophilic Asthma, Psoriasis and Vitiligo.
CRP HS 0.7 RANGE 0-5
FERRITIN 257 RANGE 30-400
FOLATE 13.7 RANGE <2.9
VITAMIN B12 51 RANGE 25.1-165
VITAMIN D 76 RANGE 50-200
TSH 0.87 RANGE 0.27-4.2
FREE T3 3.8 RANGE 3.1-6.8
FREE THYROXINE 17.8 RANGE 12-22
THYROGLOBULIN ANTI 150 RANGE 0-115
THYROID PEROXIDASE 184 RANGE 0-34
MANY THANKS
Looking at previous post
You’re on 100mcg levothyroxine
Which brand of levothyroxine
Do you always get same brand at each prescription
What vitamin supplements are you currently taking
Did you know that high thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies
TSH 0.87 RANGE 0.27-4.2
FREE T3 3.8 RANGE 3.1-6.8
FREE THYROXINE 17.8 RANGE 12-22
Ft4 is only 58% through range
Ft3 a very low 19% through range
Helpful calculator for working out percentage through range
Vitamin D, folate and B12 are all too low
Aiming for vitamin D at least around 100nmol
Active B12 at least over 70
Getting all four vitamins optimal may help improve conversion rate
If not already on strictly gluten free diet
Have you had coeliac blood test done yet
If not get this done
Very high percentage of Hashimoto’s patients benefit from strictly gluten free diet
How much do you weigh in kilo approx
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...
Guidelines are just that ....guidelines.
Some people need more …..some less
healthunlocked.com/thyroidu...
No supplements other than a protein drink each day as I have lost a lost of muscle in the last few years and suffered from fatigue. I was just over 12 stone and now im just under 11 stone/69.5kilo. I had a telephone appointment with GP and mentioned this and as I had improved somewhat whilst on the protein drink asked if i might not be getting sufficient nutrients from my food, she said mu celiac results were ok, i've just had a look on patient access and the only test I can see are IgA
4.72 g/l
0.80 - 4.00
Abnormal
21 Oct 2020
guidelines on dose levothyroxine by weight
Your current weight 69.5 x 1.6 =. 112mcg per day
You likely have room to increase levothyroxine to 112.5mcg every day
(100mcg and 125mcg on alternate days)
Ft4 is currently only 58% through range
Only 5% of Hashimoto’s patients are coeliac A further 80% find strictly gluten free diet helps or is essential
The only way to know if gluten free diet will help you is to try it
Many protein drinks have soya in …..not recommended for anyone taking levothyroxine
Check out the ingredients
No Soya, stopped that some time ago. I will get retested for coeliac and add the vitamins see if any improvement. Could you PM me the names of a good Endo in the PR2 area ?
Coeliac test
lloydspharmacy.com/products...
Email Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private
tukadmin@thyroiduk.org
Thank you.
Very informative, thanks for that. I’m in the process of getting a coeliac screen I did see an immunologist who confirmed I didn’t have any intolerances but didn’t actually remark on what he had tested me against. Does your private endo send you for the test via your GP ? I did go private originally, just before COVID kicked in but he was somewhat out of my area and all the test he did where also at his hospital which was a pain traveling there and I do not have any of the results on patient access which further complicates matters.
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