Central hypothyroidism

[squirl9462]

Could anyone please recommend an endo, preferably in South East England, who has knowledge of central hypothyroidism.

Any info by dm please

Thanks in advance

[SlowDragon Administrator]

Before considering seeing any thyroid specialist endocrinologist

Strongly recommend getting full thyroid and vitamin testing done again

Plus cortisol and DHEA ….looking at previous posts you had low cortisol in previous tests

What vitamin supplements are you currently taking

When were vitamin D, folate, ferritin and B12 last tested

What’s your diet like

Are you vegetarian or vegan

Have you had ultrasound scan of thyroid?

[squirl9462 in reply to SlowDragon]

Hi SlowDragon

Currently taking D3 supplements (800ui daily) last tested in May 2021, Result 67nmol/L (50 - 120).

Folate, May 2021, 2.4ng/ml (1.9 - 25)

Ferritin, May 2021, 16.4ug/L (13 - 150)

B12, getting injection every 8 weeks so testing not relevant.

Diet not great, trying to concentrate on protein but comfort eating all sorts of rubbish, mostly chocolate

Definitely not vegetarian option or vegan.

Had ultrasound of thyroid which showed a number of nodules but nothing needed to be done.

Had a synacthen test done @ the hospital some years ago but low in the range so was told all was ok.

I'll sort out new tests as recommended by you and see what they say.

Thanks again SlowDragon

[SlowDragon Administrator in reply to squirl9462]

So first step is to get all four vitamins optimal….then TSH might actually rise enough to get diagnosed

Low vitamins tend to lower TSH

Your vitamins are terrible

It’s chicken and egg

Low thyroid levels results in low vitamin levels due to LOW stomach acid

May 2021,

Vitamin D Result 67nmol/L (50 - 120).

Folate, May 2021, 2.4ng/ml (1.9 - 25)

Ferritin, May 2021, 16.4ug/L (13 - 150)

Optimal vitamin levels are

Vitamin D

at least around 80nmol and around 100nmol maybe better

800iu is far too low a dose. Likely to need at least 2000-3000iu to increase levels, possibly more

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose of at least 2000iu to keep it there.

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Folate and ferritin at least half way through range

Folate

As you have B12 injections it’s recommended also to supplement a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.This can help keep all B vitamins in balance and will help maintain B12 levels between injections too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Thorne Basic B is a recommended option that contains folate, but is large capsule. You can tip powder out if can’t swallow capsule

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Ferritin under 30 is classified as deficient

What is GP doing about low ferritin

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Why low ferritin needs improving

healthunlocked.com/thyroidu...

Iron/ferritin and restless legs

healthunlocked.com/thyroidu...

Helpful post about iron supplements and testing

healthunlocked.com/thyroidu...

Recommend reading many posts and replies by

humanbean on low iron and ferritin

[squirl9462 in reply to SlowDragon]

Thanks SlowDragon, GP is doing nothing about anything unfortunately. I'll have to push her into helping me but all she's interested in is anti-depressants. I should be able to at least get some iron tablets out of her given the NICE guidelines. I suspect I'll have to source the rest myself.

I've tried to read through the links you sent but my brain won't work so I'll take that slowly over the weekend

[SlowDragon Administrator in reply to squirl9462]

GP probably won’t prescribe vitamin D

Might prescribe folic acid, but likely better to self supplement a vitamin B complex anyway