Energy (none)

[foxglove]

Anyone able to suggest anything that can help with non-existent energy? My thyroid checks alright and iron levels ditto, glucose a bit raised but within range

[tattybogle]

".....my thyroid checks alright.... " ?

If you mean these result from 4 months ago, they are really NOT alright.

"TSH 3.25, (0.27-4.2) T4 12.7, (12-22) T3 3.7 (3.1-6.8)

Recent test results - told all ok . Is that so do you think? ...I feel more or less well! " healthunlocked.com/thyroidu...

TSH too high for someone on Levo + Thyroid-S.

fT4 extremely low.

fT3 pretty low.

[SeasideSusie Remembering]

foxglove

My thyroid checks alright and iron levels ditto

Have your results changed from those you posted here in April?

healthunlocked.com/thyroidu...

Although you said you feel better when TSH is between 2.5 and 3.5, your FT4 and FT3 were both at the bottom of their ranges - 7% and 16% through their ranges respectively - which are far too low for anyone on thyroid hormone replacement.

What are your actual iron results? Have you had an iron panel or just ferritin test?

What about B12, folate and Vit D levels?

[SeasideSusie Remembering]

foxglove

You said at the time of your test in April you were taking 25mcg of levo and a quarter grain Thyroid-s. You are now taking half a grain of Thyroid-S only (if I've understood what you put in your PM correctly)?

As Thyroid-S contains 38mcg T4 and 9mcg T3, you've gone from

25mcg Levo plus 1/4 grain Thyroid-S = 34.5mcg T4 plus 2.25mcg T3 to

1/2 grain Thyroid-S = 18mcg T4 plus 4.5mcg T3

[serenfach]

I can only say that once you get your thyroid levels right for you, then it is like a trickle charger, the energy levels slowly come back and one day you decide to do something that you have been putting off and you surprise yourself.

For me, I actually picked up a duster and used it!

[foxglove in reply to serenfach]

Thanks for reply - well done on the duster thing I very well know the feeling on that. Last night I took an extra quarter grain thyroid-s and will continue on that for a bit. My worry is that I am booked for bloods re. annual health check (21st Sept.) and have.t told doc. I'm taking NDT!!!

But meantime -= Roll on energy return

[SlowDragon Ambassador]

It was ludicrous for GP to have left you on only 25mcg

Yes, because of your age you needed to start on 25mcg levothyroxine

But bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Dose of levothyroxine is increased slowly upwards in 25mcg steps until TSH is ALWAYS under 2

Most people when adequately treated will have TSH around or under one and Ft4 at least 60-70% through range

Typically that’s approx 1.6mcg levothyroxine per kilo of your weight

Roughly how much do you weigh in kilo

On NDT results will look different when adequately treated

TSH will be very low, almost certainly well below one

Ft3 at least 60% through range

Ft4 likely low

Day before test split NDT into 3 smaller doses and take last 1/3rd 8-12 hours before test

Always test as early as possible in morning before eating or drinking anything other than water

Vitamins likely very low when under medicated

Also low vitamin levels extremely common as we get older too

Peripheral neuropathy is frequently mix of low B12/B vitamins and low vitamin D

[SlowDragon Ambassador]

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine or NDT

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Low vitamin levels common as we get older too

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 levothyroxine 24 hours before test

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 all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

What are your most recent vitamin D, folate, ferritin and B12 results and what vitamin supplements are you currently taking

[SlowDragon Ambassador]

Do you have autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies

Assuming yes, as about 90% of primary hypothyroidism is autoimmune thyroid disease

Low vitamin levels are extremely common when hypothyroid, especially when under medicated as you currently are

Also with Hashimoto’s low vitamin levels are extremely common

Are you on strictly dairy free or gluten free diet

All Patients with autoimmune thyroid disease should have vitamin D tested annually (but NHS will only test every 2 years ….if that)

pubmed.ncbi.nlm.nih.gov/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

pubmed.ncbi.nlm.nih.gov/273...

Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.

pubmed.ncbi.nlm.nih.gov/300...

The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.

ncbi.nlm.nih.gov/pubmed/300...

ncbi.nlm.nih.gov/pmc/articl...

Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.

Same applies to low B12 - extremely common in hypothyroid patients

All patients who are hypothyroid should have B12 tested

ncbi.nlm.nih.gov/pubmed/186...

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,

.

Folate supplements can help lower homocysteine

ncbi.nlm.nih.gov/pmc/articl...

Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.

Low ferritin frequent in hypothyroidism

endocrineweb.com/profession...