I have Hashimotos and get migraines whenever I so much as have a busy day. My ferritin is 57 (13-150) could this be the cause?
Ferritin : I have Hashimotos and get migraines... - Thyroid UK
Ferritin
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Runner25
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SlowDragonAdministrator
Migraine is extremely common hypothyroid symptom
Previous post 3 months ago on 75mcg levothyroxine
healthunlocked.com/thyroidu....
Have you had dose increase in levothyroxine since this
Ft4 only 50% through range
Ft3 dire at 19% through range
Helpful calculator for working out percentage through range
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...
ESSENTIAL to maintain OPTIMAL vitamin levels
Thanks for the reply. I am 55 kilos and 5.3 tall. It is because my TSH is low at 1.0 that they won’t consider more Levo and T3 is completely unavailable on NHS in my area. My Specialist explained that a suppressed TSH over time can cause bone and heart problems which I obviously don’t want. In what I’m assuming is a flare up the last 1 week I have felt terrible. Anxious, tired, hopeless just the worst that I have been really. I’m considering lowering my Levo to 50 but adding in T3, but I’m really apprehensive as I’m no Dr!! Which is the best vitamin and mineral test for me to do myself just to make sure that I’m really optimal? Any opinions on me lowering the dose of Levo to add T3 would be welcome. X
Many Hashimoto’s patients will have TSH much lower than one, often below range…..TSH is irrelevant on replacement thyroid hormones
Most important results are always FT3 followed by Ft4 and symptoms
ALWAYS Test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
On only levothyroxine
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking levothyroxine
Also to test vitamin D, folate, B12 and ferritin
sps.nhs.uk/wp-content/uploa...
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
(That’s Ft3 at 58% minimum through range)
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor
please email Dionne at
tukadmin@thyroiduk.org
See reply by Diogenes in this post
healthunlocked.com/thyroidu...
the best paper on this that I have seen indicates that a TSH of 0.03-0.5 is best on therapy. Above that is insufficient and below MAY or MAY NOT indicate slight overdosing
academic.oup.com/jcem/artic...
Interestingly, patients with a serum TSH below the reference range, but not suppressed (0.04–0.4 mU/liter), had no increased risk of cardiovascular disease, dysrhythmias, or fractures. It is unfortunate that we did not have access to serum free T4 concentrations in these patients to ascertain whether they were above or within the laboratory reference range. However, our data indicate that it may be safe for patients to be on a dose of T4 that results in a low serum TSH concentration, as long as it is not suppressed at less than 0.03 mU/liter. Many patients report that they prefer such T4 doses (9, 10). Figure 2 indicates that the best outcomes appear to be associated with having a TSH within the lower end of the reference range.
Medichecks, Blue Horizon or Thriva all offer vitamin testing
Almost any dose of T3 will suppress TSH well below range so you need an endocrinologist who’s ok with that
Email Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3 if it’s needed
...NHS and Private
tukadmin@thyroiduk.org
But first step is to get vitamins optimal and trialing strictly gluten free diet….
55kilo x 1.6 = 88mcg as the likely daily dose levothyroxine you might need
88mcg is 75mcg and 100mcg on alternate days
Your Ft4 at only 50% through range suggests you have plenty of room to increase to that
Ask GP to increase levothyroxine as per national guidelines
Many people find different brands are not interchangeable
Important to always get same brand levothyroxine at each prescription
Are you already on strictly gluten free diet
If not get coeliac blood test done BEFORE considering trial on Strictly gluten free diet …….often helps or is essential
I have asked my GP and Specialist but because my TSH is 1.0 they won’t consider it. Also because in their eyes I’m within normal range in all my tests apart fromT3 slightly below at 3.1. I will try to stick to the same brands though. I haven’t felt well on this dose for 18 months so I really think it must be the lack of T3 as everyone seems to swear by it? I have gone gluten free 1 week ago now so hopefully that will help. I am also considering HRT as I had my ovaries removed 10 years ago and it has been since then that my health as deteriorated first high blood pressure, then gum problems then Hashimotos. Although I’ve read that I probably had Hashimotos for years as it can take a while to be diagnosed. Going back to the TSH is that normal for Hashimotos for the TSH to be suppressed whilst the T4 and T3 still aren’t optimal?
Your endocrinologist is likely a diabetes specialist
Ft3 is below range
Most people when adequately treated will have Ft3 at least half way through range
Email Thyroid UK for list of recommend thyroid specialist endocrinologists who will increase levothyroxine and prescribe T3 if necessary
...NHS and Private
tukadmin@thyroiduk.org
Roughly where in U.K. are you
Many private specialist endocrinologist are currently doing consultations on zoom
HRT tends to result in needing increase in levothyroxine
I think he’s both. He just doesn’t seem to hold much belief in T3 and said the medical evidence is very weak? This goes against everything that everyone on here says though! I’ve been seeing him for a year and have lost the appeal for T3. Although he has done blood tests for everything else including all the vits, mins, cortisol, you name it, I’m no further forward and actually feel like I’m getting worse not better! I will email to get the names of other Specialists. I’m in Dorset, near Bournemouth. I think in the meantime I will increase my dose of Levo to alternating 75 /100 mcg each day. I too had read that HRT might mean an increase in Levo and asked my Specialist, but he said it wouldn’t have any affect on that, but would be very supportive of me having HRT. I’ve read a lot that it can improve thyroid health, I hope that’s the case!!
My ferritin is high in the range and I get migraines ( I think when I am constipated).
I have Hashimoto's and get frequent migraines, too, that are brought on by very slight stressors. Here are some thoughts on treatment of the migraines and the cause. Unfortunately, I do not have much to contribute in regard to Ferritin -- I have not investigated that aspect.
TREATMENT. My migraines are almost always preceded by the visual "aura" and blurriness. As soon as I sense I migraine aura coming on, I start taking additional electrolytes. The electrolytes that seem to work for me are POTASSIUM and MANGANESE. I usually take 600 mg of Potassium (12% DV) and 8 mg of Manganese (348% DV). Electrolytes are usually enough to ward off the actual migraine headache if I administer them quickly enought.
CAUSE. This might be unique to me, but I believe that consuming too much sugar is a major cause. I also think that Small Intestinal Bacterial Overgrowth (SIBO) is a major factor. Sugar consumption and SIBO are not unrelated. Too much sugar feeds the "bad" bacteria which produce waste products that enter the bloodstream and create conditions conducive to migraine.
To be honest, I am less confident in my understanding of the Cause than I am of the treatment for my particular migraines. Electrolytes almost always alleviates the migraine.
Have you had any stool tests to determine if you have some type of Bacterial or Fungal Overgrowth or parasite in your gut? That might be worthwhile. Meanwhile, I will read others comments RE: Ferritin with interest.
Thanks for that, that’s very interesting. Mine seem to be after I have exercised (which I have had to really cut back on as it makes me so exhausted now) and now even if I’ve had a very busy day at work I can get one. I never had headaches before being diagnosed with Hashimotos. It’s so debilitating. It’s also making me really stressed and unable to look forward to anything as I’m worried I’ll get a migraine and fatigue. Has the electrolyte that you use got a name?
My favorite product for years was called Electromix which was part of the Emergen-C family manufactured by Alacer which was a powder that you mix in water. Alacer was taken over by Pfizer and, of course, they discontinued the Electromix product, despite receiving tons of complaints from angered customer who relied on it.
I have had difficulty finding a replacement Electrolyte product as good as Electromix (a lot of other products contain a lot of sugar which defeats the purpose). Two products that come somewhat close are Ultima replenisher lemonade electrolyte power and Vital Proteins Hydration collagen.
vitalproteins.com/products/...
In my case, when Pfizer/Alacer discontinued Electromix, I read the main ingredients and noted that those were POTASSIUM and MANGANESE and then purchased those minerals in supplement form through a supplement manufacturer called Pure Encapsulations who have a reputation for high quality standards. So, for the past year or two when I sense a migraine coming, I take 3 capsules of 200 mg Potassium for a total of 600 mg, and I take 1 capsule of Manganese which is 8 mg.
Like you, I have become ridiculously sensitive and prone to migraines. It used to be after physical exertion. Now, I sometimes even get them if I spend 15 minutes in a very hot whirlpool/jacuzzi. I am still trying to figure out what exactly is going on, but I have learned that I can barely tolerate sugar anymore when it used to be no problem at all.
I have vertiginous migraine. It went through the visual aura stage several yrs ago. The neurologist suggested taking. Riboflavin, vitamin B2- maintenance 100mg/day ; up to 400mg in bad episodes. It works very well although takes about 3wks to get up to speed.
However during lockdown it’s been hard to get so I’v run out- picking up another make today. Headaches really bad but not my typical migraine, although sumatriptan seems to help.
Does anybody know why Solgar have not been producing it for some many months?
Bella🦉
Is there a particular brand that is better? I already take super b complex as recommended on here, but just looked and B2 is only 14 mg in there.
Solgar is by far the best but has been impossible to buy for almost a yr- I was told it was to revamp the label!
So I’ve been using Health-aid from my pharmacy 100mg and now Holland and Barrett also 100mg - neither make 200 or 400 mg. Of those I think Holland&Barrett is marginally better, & comes in 100 tablets bottles so marginally cheaper. although not much in it, so get which ever is easiest for you.
It’s not available on script even tho the neurology hospital has been pushing for it.
I’ve been taking initially 200mg split for 3 days then 200 + 100mg. That has made a big difference to my head.
The dose is still not balanced and urine very yellow where body processing but not absorbing properly. My neuro said, “keep between 200-300 until absorbing better then return to your 100mg maintenance.”
The difference it makes to my head is like light to darkness. I don’t feel so irritable which is usually the first sign that something isn’t balanced.
Hope that helps. Don’t waste money on complexes unless there is something else in it you need.
B6, pyrodoxine 50mg can be obtained on prescription for depression and over sensitive breasts (PCOS).
Bella🦉q
Also how do you know if you’re absorbing?
I wrote you. A long reply but I think it’s now lost. I’ll try a short version.
I was seen in a joint clinic with my neuro and the consultant who runs the specialist migraine clinic.
I’v had migraine many yrs, long before thyroid problems, and over those yrs they have changed character from scintillating to vertiginous migraine involving the vagus nerve.
It was suggested by the migraine specialist I try riboflavin. I was told B2 is not stored in the body so I would need a maintenance dose of 100mg but could go up to 400mg when migraines bad.
I suspect it’s like Vit C what can’t be used is excreted in urine. So I don’t think you can over dose but check with your pharmacy.
I find that when I’m taking too much for my body to absorb the urine is bright yellow as I reach a level the colour fades and my head is much clearer and less painful.
I’m probably deficient because I cannot oxidise sulphur, no enzyme for it in my body. So I can’t eat dark green veg eg kale. I eat eggs and they help the head.
There is a booklet Re different types of migraine and treatments. I was given it by the hospital but may have been produced by one of the migraine charities.
Bella
Thank you for the info, that’s really helpful. In contrast to you I never had even headaches really until my thyroid started messing up….. It’s so hard to know what is causing them, or what will help as my Specialist and GP are very vague and full of could be. They even said that headaches aren’t a common side effect of Hypo, but seems they are! I have gone gluten free now and am still trying to get my thyroid to a functional level, but I think I’ll definitely try B2 too. It’s all such a minefield isn’t it!
Yes it is. Try to tune into how your body feels. I now only have to smell something my body doesn’t like & become dizzy or headache begins.
So I now smell everything- reminds me of my cat, so I figure if it’s good enough for her then maybe good enough for me. 😸😸
I notice you have partly given up running, have you considered swimming- when we can? i swim with a disabled swimming club- there maybe one near you.
I swam even when CFS was bad I still got in a pool to float. I was fortunate we had a small pool at Uni , cold but useable. I’ve taken part in the British long distance swim which includes disabled and won gold.
So that may help to kick start your metabolism when you feel well enough to try.
I also use osteopathy, mainly for my lungs and spine, but my osteopath is also a cranial osteopath and that helps the head.
I also see a craniosacral therapist who is very good at clearing my head and settling my body.
Ideas to research in your area.
Have a good wk.
Bella🦉
I am re thinking my fitness regime which used to consist of running, running and running, but as heartbreaking as it is because I’ve loved it for 25 years, I know I’ve got to rethink things. I’m still hoping to run just 3 miles twice a week, but have added in cold water swimming (I live 5 miles from the coast so am lucky), some paddle boarding in the summer and I need to find a beginner yoga class too. I’ve been procrastinating for years about yoga and also lifting weights, but as of yet have only dabbled! We’ll done on your achievements, that’s amazing!!!
My lifelong migraines disappeared when I went gluten free and though it may not work for everyone there's no harm in trying.
Same here, once I stay Gluten free, Migraines are few. Plus taking Potassium 2gram helps mitigate its progression when it attacks.
Depends really what symptoms you have there are so many, it took only 3 days for my stomach muscle spasms to disappear and my aching arms improved every day, I was feeling much much better before the month ended thats why I continued as it had only meant to be a short trial. Ive been gf for almost 10 years now wouldn't dream of ever touching gluten again. You have to be really strict for it to work, best of luck.
Forgot to say that I used to have 2 or 3, 3 day migraines a month and suddenly realised that I hadn't had any for over a month, the best thing that happened to me in 50 years.
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