Hi everyone, after my first post I did some private blood tests, as my doctor would not do any for a further 3 months. I am reluctant to go back to the doctor as I struggled to get an extra 25mg off her taking me to 75mg, and she said having an out of range autoimmune test is nothing. I think I need to look for another.
Iron Status
Ferritin 38.20 ug/L (Range: 13 - 150)
Vitamins
Folate - Serum X 2.9 ug/L (Range: > 3.89)
Vitamin B12 - Active 127.000 pmol/L (Range: 37.5 - 150)
Vitamin D 97.60 nmol/L
<25 Deficient
25 - <50 Insufficient
50 - 75 Adequate
>75 - 200 Optimal
(Range: 50 - 200)
Thyroid Hormones
TSH X 4.52 mU/L (Range: 0.27 - 4.2)
Free T3 3.14 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 15.800 pmol/L (Range: 12 - 22)
Autoimmunity
Thyroglobulin Antibodies X 116.000 IU/mL (Range: < 115)
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
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
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
Hi, I am on almus levothyroxine, have been tested for coeliac and it was negative, have no other issues apart from GERD, was taking a thyroid supplement but it had iodine in so stopped taking it. I have started taking selenium and vit d
So it’s always worth trying strictly gluten free diet, especially if you have Gerd
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 a further 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 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.
Yes, you are right and you should look at seeking another doctor and hopefully one with an understanding of thyroid health issues and the contributing factors to ensure you stay as well as possible.
Whilst the NHS are not able to solve an auto immune thyroid disease, evident by your over range antibodies, it will be in your best interests to read around the subject and become your own best advocate on Hashimoto's thyroid AI disease, which can express itself in transient " hyper " and " hypo " symptoms as the thyroid gland comes under attack from your immune system.
So quite what has triggered your immune system to go " on the attack ' is a whole other question and it could be that there is a genetic predisposition, all you can try and do is calm down your immune system response.
Dr Izabella Wentz has Hashimoto's and has written and researched extensively in all aspects of this disease so there's a starting point for you. You will read of the necessity to check first for certain food intolerances such as gluten, wheat dairy, and where necessary heal the gut wall to improve absorption of vitamins and minerals and thyroid hormone conversion.
T4 is a storage hormone and needs to be converted by your body into T3 the active hormone that runs the body and it is the T3 that causes all the symptoms - too low a level for you and you have symptoms of hypothyroidism just as too high a level of T3 for you and you may have " hyper " type symptoms.
Conversion of T4 into T3 can be compromised by low levels of vitamins and minerals, especially those of ferritin, folate, B12 and vitamin D , inflammation, any physiological stress ( physical or emotional ) dieting depression and ageing.
If you go into the Thyroid UK website, who are the charity who support this forum you will find further details of all things thyroid including Hashimoto's and a list of both hyper and hypo symptoms to help you understand where you are in all this, and yes, as usual, it's not that simple as some symptoms can be seen in both lists.
With Hashimoto's your immune system is triggered to attack your thyroid and when this happens you can experience erratic thyroid hormone production - causing transient hyper symptoms but when this attack, this swing, swings back your thyroid is damaged and whilst it struggles to repair itself it will likely be less productive than before, and you may well need additional T4 to help support the failing gland.
No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal levels :
I feel at my best with a ferritin at around 100 :folate at around 20 : active B2 at around 75 ++ and vitamin D at around 100 :
A high TSH is indicating your thyroid needs more medication and yo will likely feel better when the TSH drops down to around 1 or under :
We generally feel better when out T4 is in the top quadrant of the range at around 80% and currently you are at around 38% with your T3 barely in the range at not even 3% :
Hope that helps a bit - did you have an inflammation marker - generally expressed as CRP :
I'm with Graves post RAI thyroid ablation in 2005 :
Hi, because you’re already taking levo it’s completely wrong that your tsh is over range. It should be in the lower end of the range probably less than 2 or even lower. Another doctor as is recommended earlier. Jo xx
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