Hi, I’m seeing a TUK list endo tomorrow so have just received a new set of blood results to take with me. These seem to be better than before, but I still feel awful.
I appreciate that results, including antibody levels, fluctuate over time. But given my current results, I’m wondering what I should be hoping for from the endo? Any thoughts very welcome.
First had elevated thyroglobulin antibodies in 2013. Had clinically hypothyroid results in 1990s but GP chose not to treat.
In 2017 TSH and T4 were clinically borderline and thyroglobulin antibodies were 435 KU/L (normal: <115).
I have let this issue slide due to ongoing depression, but finally hoping to get some help.
Many thanks.
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Laura71
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Thorne Basic B recommended vitamin B complex that contains folate, but they 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
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months.
once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
Thank you so much. I’ve not had any thyroid replacement hormones. Would you think I should be prescribed it given those results?
I am not currently taking any supplements, but will follow your advice.
I can’t tolerate any iron supplements (not even haem iron). My digestion goes crazy. I assume that ferritin improvement is due to being post menopausal. I may try to get an infusion privately, but may not be possible as not so low now?
You would need FULL iron panel test before considering an infusion
Meanwhile 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
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
I’m not gluten or dairy free at present. I have gone gluten free for six+ months several times in the past, but not seem enough improvement to keep going.
The symptoms of hypothyroidism are insidious and include anxiety and depression and it looks like you could have started thyroid hormone replacement years ago.
Improving vitamins and minerals will improve overall health and well being and thyroid hormone conversion.
T4 - Levothyroxine works well for around 80% of those who take it.
However having Hashimoto's auto immune disease you may well find as the gland becomes further disabled you'll need full spectrum thyroid hormone support to include a little T3 - Liothyronine with your T4 prescription or switch to taking Natural Desiccated Thyroid which contains all the same known hormones as that of the human gland.
Levothyroxine needs to be converted by your body into T3 the active hormone that runs all your body functions, from your physical, mental, emotional, psychological and spiritual wellbeing to your inner central heating system and your metabolism.
I now aim to maintain my ferritin at around 100 : folate at around 20 : active B12 75++ ( serum B12 500++ ) and vitamin D at around 100 for optimal conversion and take Natural Desiccated Thyroid.
Many forum members refer to the research by Dr Izabella Wentz for Hashimoto's AI disease - thyroidpharmacist.com
P.S, good luck tomorrow - we are a patient to patient forum so please leave feedback on the appointment and we can be a sounding board if you wish to update us.
If you have a print out of your results from 2013/2018 showing over range Tgabs - please make this available at appointment tomorrow as your most recent result do not show over range Thyroglobulin antibodies which is not unusual as they can wax and wane.
Well, the endo I saw said that based on my having previously had raised antibodies over a number of years and being symptomatic, he would prescribe me 25mg levo to try for six weeks. If I feel a benefit he’ll write to my GP and ask for it to be continued.
I then checked my repeat px list from GP and saw that I have *50mg* levo on repeat, it’s been on there since 2017. As you said pennyannie I could have been taking it for years. I just got paralysed by indecision, thinking may be NDT would be better, etc etc. 🤷🏻♀️
By coincidence I had a meds review with my GP’s pharmacist today - he agreed I should take the levo and reauthorised it for another year. So I guess I’ll start with 25mg and nutritional supplements and see how it goes?
OK then - for optimal absorption you need to take the medication on an empty stomach with a glass of water and wait around an hour before eating or drinking anything - most people tend to take their daily dose in the morning, some at night, others if they wake up in the night for the toilet.
After 6-8 weeks you will need a follow up blood test and maybe your dose adjusted - make notes as to symptoms relieved - if any - 25mcg is a starter dose - so you will likely find you will need increments of 25mcg at each 6-8 week interval and blood test until you find the right dose for you.
When preparing for the follow up blood test - book an early as possible blood draw - fast overnight just taking in water - and take your T4 medication AFTER the blood draw leaving around a 24 hour gap in medication.
Stop any supplements containing biotin for around the week before as this can affect some laboratory assay measuring equipment, and if testing ferritin, folate, B12 and vitamin refrain from taking any of these supplements for around a week so we can see exactly what your body is holding on to.
You should be dosed and monitored on a TSH, Free T3 and Free T4 blood test result and you should be able to track your T3 and T4 levels slowly rising slowly through the range from your bench mark readings.
We generally feel at our best when our T4 is in the top quadrant of the range as this should, in theory, convert to a good level of T3 at around a 1/4 ratio T3/T4.
I also mentioned my high blood pressure (still worryingly high on max Ramipril, about to add another med) but he said although severe hypothyroidism could affect BP, my on and off borderline hypo would not be a factor.
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