Looking at previous posts, couldn’t see any recent results for vitamin D, folate, ferritin and B12
What vitamin supplements are you currently taking
Please add latest vitamin results
How do you feel?
Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Ft4 is only 42% through range
Ft3 is 56% through range
Which brand of levothyroxine are you currently taking
Yes you have room for dose increase in levothyroxine, but GP or endocrinologist may only look at low TSH and be reluctant or might want to reduce dose.
How much do you weigh in kilo
Guidelines on dose levothyroxine by weight is approx 1.6mcg levothyroxine per kilo per day (can be helpful to persuade for next increase) Common to need higher than this
I can try and get these tested again. What affects would high or low amount of these vitamins have on the T4 treatment?
I actually don't really feel any better than before starting 100mg Levo. Still very tired and sluggish with low energy.
Yes the test was done in the morning before food or drink and had not had levo for 24hrs
The brand is Aristo and I weigh 76kg so in theory should have about 120mg of Levo.
Yes i did think the fact that TSH is very low (below range) - and T4 is just within range might make it difficult to get dose increase. But I do still feel just as bad and T4 is only just in range.
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium,, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex
Hi - actually I have just looked at some food intolerance blood tests i had done - and I am intolerant of milk, cheese and egg whites. Also it says I am allergic to milk and soy. Not sure if this means I am lactose intolerant though? It also says I am intolerant of wheat, rye, oats, soy and maize.
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.
And gluten free diet as well - no wheat, barley or rye
Oats or maize ….you might be able to trial adding back in eventually
Both lactose intolerance and gluten intolerance are extremely common with autoimmune thyroid disease
So as your lactose intolerant, you need Aristo or Teva brand levothyroxine
Or via endocrinologist you could trial liquid levothyroxine (it’s relatively expensive so not usually initiated via GP)
Have you had coeliac blood test
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances.
Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
Before considering trial on gluten free diet ideally get coeliac blood test done FIRST just to rule it out
If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)
If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Hi - I used globaltestinglab.com. and went for 'Choice 70'. There are also much cheaper hair sample tests available which cost as little as £15 but I'm not sure how accurate they are.
Hi - I am still waiting for the results of the mri scan and have not had the thyroid scan. I have been given testosterone gel and it has increased testosterone to just within range. Really not sure what to do next as I presumed the Levothyroxine would make me start to feel better but i feel pretty bad still. It looks like my pituitary is producing hardly any TSH now and the T4 is all coming from the Levo. Does it matter if the TSH is reduced to zero which could happen if I raise to 125mg? thanks
Hi - so if my TSH goes even lower that would be ok as long as the T4 is ok? Would low TSH in itself lead to symptoms of tiredness and aches and pains?Also I thought the body transformed T4 into T3 so why do people take additional t3 and not just more T4?
Common on levothyroxine to have sluggish or poorly responsive TSH, especially with Hashimoto’s and/or low adrenal levels
The Hypothalamic, pituitary and adrenal axis is disrupted
Many thyroid patients have poor conversion of Ft4 to Ft3…..low vitamins, poor gut function, gluten and/or dairy intolerance, Dio2 gene variation etc etc
Naturally a correctly working thyroid would make 80% Ft4 and 20% Ft3 and it goes direct into blood stream.
Conversion is possibly reduced with low TSH…..but it’s chicken and egg….if you take low dose levothyroxine to increase TSH, thyroid hormones are inadequate. If you take high enough dose levothyroxine, TSH is reduced
Taking tablets that are absorbed in gut, in a single large daily dose is not comparable to your thyroid making thyroid hormones
Many people simply can’t manage on just levothyroxine (Ft4)
Aiming for Ft4 and Ft3 at least 50-60% through range. Often need Ft4 higher at 80-90% through range to get Ft3 even at 50% through range
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Update to Previous Thread with Results
Tsh rising not sure what to do unmedicated
Not sure what to do next?
Advice with my blood results, and what to do next
New Results: Please Help Interpret!
