Medicheck results

[Skye10]

Hi, I've had my blood test results this morning. They have all come back as Normal but I still feel awful. I'm so tired and my joints are so painful, I have barely been able to function all weekend. I really don't know what to do. I was hoping that the tests would reveal the cause of my fatigue but apparently not. The only raised results is my antibodies. I'm completely in despair today.

Any advice would be appreciated. Thanks

(hoping that the photo of the results is clear)

[SlowDragon Administrator]

Was this test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription…..which brand

What vitamin supplements are you currently taking

Vitamin levels look ok ….

Vitamin D might be better a little higher

FT4: 19.9 pmol/l (Range 12 - 22)

Ft4 is 79.00% through range

FT3: 4.7 pmol/l (Range 3.1 - 6.8)

Ft3 only 43.24% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

So like many people with Hashimoto’s you have poor conversion

Are you on strictly gluten free diet or dairy free diet?

[Skye10 in reply to SlowDragon]

Hi. I had my last dose of thyroxine over 24 hours prior to the test. I did intend fast before the test and do it early morning bit I had such difficulty getting the blood, I decided have a very light breakfast and exercise before trying again with my last attempt. I'm currently on100mcg daily. I don't always get the same brand of thyroxine. No, I don't take any supplements No, I'm not dairy or gluten free.

[SlowDragon Administrator]

Conversion often gets worse after menopause

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3 alongside levothyroxine

[e-mail]

Roughly where in U.K. are you

Prescription numbers for England…..58,000 prescriptions per year ….typically 6 prescriptions per person per year

Searchable by CCG area

openprescribing.net/analyse...

[Skye10 in reply to SlowDragon]

I'm in Warrington, Cheshire. I went through the menopause many years ago and had a hysterectomy in 2008.I was diagnosed with Hashimotos in 2016.

[SlowDragon Administrator in reply to Skye10]

So have you had coeliac blood test done

Worth trying strictly gluten free diet….before starting on T3

[Skye10 in reply to SlowDragon]

I had a coeliac test done a few years ago, which was negative.

[SlowDragon Administrator in reply to Skye10]

So you can now trial strictly gluten free diet…..you might be astonished at the difference

[Skye10 in reply to SlowDragon]

OK thank you.

[SlowDragon Administrator]

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 and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

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

nuclmed.gr/wp/wp-content/up...

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

restartmed.com/hashimotos-g...

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.

nice.org.uk/guidance/ng20/c...

Recognition of coeliac disease

1.1.1 Offer serological testing for coeliac disease to:

people with any of the following:

persistent unexplained abdominal or gastrointestinal symptoms

faltering growth

prolonged fatigue

unexpected weight loss

severe or persistent mouth ulcers

unexplained iron, vitamin B12 or folate deficiency

type 1 diabetes, at diagnosis

autoimmune thyroid disease, at diagnosis

irritable bowel syndrome (in adults)

first‑degree relatives of people with coeliac disease