Help! Stuck what to do…

[Ajva]

New labs. No biotin before and meds 12 hours before.

I feel awful with body aches, hair loss and extreme fatigue, dizziness.

I am on 1 grain armour (please note I can not tolerate synthetics). I would prefer to be on separate meds but I have allergic reactions to all synthetics.

I also have POTs (postural orthostatic tachycardia syndrome). The thyroid medication is causing me even more heart issues with fast pulse (prob the t3). But I am obviously under medicated.

My Dr is being cautious about increasing dose due to heart. But I feel so awful….

Any help!

[SlowDragon Administrator]

Extremely high thyroid antibodies

Have you had coeliac blood test

Are you on strictly gluten free or dairy free diet

What vitamin supplements are you currently taking

What are vitamin D, folate, ferritin and B12 results

Fast pulse can be due to being under medicated

[Ajva in reply to SlowDragon]

I am strictly gluten free with minimal dairy. My antibodies are down quite a bit from my last couple of bloods. I have below my vitamin levels.

Pink

[SlowDragon Administrator in reply to Ajva]

So your vitamin levels need significant improvement

What vitamin supplements are you currently taking

Ferritin is deficient

Are you vegetarian or vegan

GP should have done full iron panel test for anaemia….have they?

GP has presumably prescribed ferrous fumerate….how many per day

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 and retest 3-4 times a year if supplementing

Medichecks iron panel test

medichecks.com/products/iro...

Low Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to Ajva]

Vitamin D

How much vitamin D are you currently taking

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol. Some CCG areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

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

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose 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. One spray = 1000iu

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...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Great article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[SlowDragon Administrator in reply to Ajva]

Low folate

supplementing 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

Difference between folate and folic acid

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (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...

[SlowDragon Administrator]

Previous post healthunlocked.com/thyroidu...

So on strictly gluten free diet

No vitamin results yet?

Perhaps try adding 12.5mcg levothyroxine alongside NDT

Obviously not Teva as you reacted to that

Perhaps Wockhardt or if after trailing…and that’s no good….request trial on LIQUID Levothyroxine

Many members on here who couldn’t tolerate any levothyroxine tablets have found liquid levothyroxine much better

Usually as split dose…… waking and mid-late afternoon

gov.uk/drug-safety-update/l...

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.

[Ajva in reply to SlowDragon]

Thank you for all the information. I have not been prescribed anymore iron tablets. I did have them but again could not tolerate the side effects. I do have something called MCAS so I am extremely sensitive to medication and fillers. This is the issue I am finding which is causing me to not tolerate many medications very well.

I have nhs bloods done that I will get the results from next week. They will probably want me to try 75mg of levo. I also got them to test iron so will see what that comes back as.

I eat meat I have an extremely high iron intake my body does not seem to be absorbing vitamins or iron well at the moment. I do have gut issues so likely the cause.

In regards to medication I am now on 1 1/4 grains of armour. Should I switch to a 75mg levo and see how I go or stick with the armour?

[SlowDragon Administrator in reply to Ajva]

When hypothyroid we frequently develop low stomach acid, this leads to poor nutrient absorption and low vitamin levels as direct result

MCAS and autoimmune thyroid disease appear to frequently be linked

integrative-medicine.ca/his...

[SlowDragon Administrator in reply to Ajva]

Quite a number of members take NDT and add Levothyroxine alongside if they can’t tolerate increasing NDT

Presumably you split NDT into 2 smaller doses

You could try 3 smaller doses through the day

I couldn’t get on with NDT, I found it was too much T3 . I vastly prefer the flexibility of levothyroxine plus 3 small doses of T3 spread through the day.

Vitamins need to be optimal

[Ajva in reply to SlowDragon]

Yes I am finding my t3 is getting high. I would much prefer to be on synthetics separate t3 and t4 it is just tolerating them seems to be more of an issue. I can tolerate armour better but does make my heart race due to the t3. As you can see I am only on 1 1/4 grain so no where near what I need to be on. I’m going to see how I go the next few months.

If it doesn’t work, I am going to have to go back on levo and play around with doses I guess. It is either that or be undermedicated with armour

[Imaaan]

Hi,

I deal with tachycardia/palpitations so I understand the struggles of trying to increase a dosage. My holter monitor showed 123 beats in the middle of night and its probably due to my sleep apnea. I'm still on my journey but I have found some success in dividing my doses in the morning and then at night 10pm. I always make sure to have my supper and night supplements by 6:10pm so they are around 4 hours away.

If you're struggling with increasing the ndt maybe you could benefit from adding 12.5 mcg of t4. I'm on 45mg of Erfa and 25 mcg of Synthroid currently myself. I take 30mg plus 12.5 am and 15mg plus 12.5 pm

You mentioned that you eat meat regularly and I'm wondering does that include liver as well? Liver is a God send for me to increase my levels. Whenever my ferratin levels drop below 60% I feel extremely awful and my TSH, free t3 and t4 get effected. On your range, the midway point is 80 something.

[Ajva in reply to Imaaan]

I am glad I am not the only one. My heart rate standing nowadays (just standing) is 150+ and I am medicated on heart drugs to slow it down. The more I increase thyroid meds the worse my heart is getting. I was ok on 1/4 and 1/2 grain. I am really struggling with medication and doses at the moment to what my body can actually tolerate.

Where do you manage to source synthroid from? I am thinking that doing a mix of levo and NDT might be the only option.

I take 1/2 grain at 2pm after food, 2nd dose at 9/10pm before bed away from food. Because I have heart drugs in the morning when waking I can’t take thyroid meds then.

I eat alot of meat, greens liver etc but my iron levels seem to be dropping not improving

[Imaaan in reply to Ajva]

Just a heads up, if the meds you speak of is a beta blocker then it can lower your magnesium levels.

I take 1/2 grain at 2pm after food, 2nd dose at 9/10pm before bed away from food.

^^^^ When do you have your lunch? The reason I ask is that I once tried reducing my 1 hour wait after meds to 30 min before breakfast and my TSH skyrocketed.

As for Synthroid, I get it prescribed by my family physician along with my Erfa. If youre located in the UK it's not available according to the admins on here. Another tip is , if you cant take the additional t3 in your ndt you can take t4 at 12.5 mcg every other day or every day

[SlowDragon Administrator in reply to Imaaan]

You can’t take different dose T3 on different days. Any medications that contain T3 must be same dose everyday

You can take different dose levothyroxine on different days as it’s a storage hormone

[Imaaan in reply to SlowDragon]

I meant to write t4. I've edited. Thnxs for catching that

[SlowDragon Administrator in reply to Ajva]

What heart medication?

Is this propranolol?

[Ajva in reply to SlowDragon]

No I am on Ivabradine.

[Jenny583]

Have you considered Thyrogold Ajva? it's bovine and apparently free of nasty excipiants.