Hi there, Ive been taking levothyroxine for hypothyroidism for 6 months now.
I previously was anaemic but that had resolved after iron supplementation also around 6 months ago. I just rang for update on levels and was told thyroid satisfactory but cholesterol high and iron and haemoglobin low.
I was told to ring the GP for an appointment tomorrow.
I know that there are specific ranges I should have and to ask for those values but can't remember what they are. I am not even sure what was tested. Could anyone point me to reference values?
thanks
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jeffbird
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You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
I really think you should ask the receptionists for a printout of results. Yes, the receptionists need permission from the doctor to do so, but at worst it will mean you have to go back the next day to pick them up. Doctors would consider a request that they print out results as a waste of their time or a waste of an appointment.
Thanks for your reply, the printoff was ready this afternoon but the receptionist wouldn’t let my husband have it 👍 GP also forgot to print off the prescription so long story short Ill get the results and tablets tomorrow
your levels need to be optimal. Demand your results in hand and post here. Optimal levels are required for thyroid, not “normal” levels. And your iron levels are not resolved if it’s still low!
to be fair to my gp if I ask they will tell me the results - I'm not upset that the receptionist doesn't have the ability to do that for me. Ive a lot of ongoing issues since having covid in 2020 and they all seem to be connected.
I had antibodies tested me when I was diagnosed in May - Im not sure that they were checked this time. When I get the results I will post on here.
If your cholesterol is high it's very doubtful that your 'thyroid function' is satisfactory. And, after six months on levo, it's doubtful your thyroid is functioning at all. High cholesterol is a hypo symptom, due to low T3. Does your doctor even test for FT3?
Are you sure that the receptionist can't print out your results for you? They usually do it. I don't suppose your doctor will. He might tell you verbally that your TSH is xyz, but probably won't give the ranges, which are essential. You need a printed copy so there's no danger of mistakes creeping in.
You need to click on reply button otherwise other poster isn’t alerted
50mcg is only the standard STARTER dose
Bloods should be retested 6-8 weeks after each dose increase
Dose levothyroxine is increased slowly upwards in 25mcg steps over 6-12 months approx….until on approx full replacement dose
Levothyroxine doesn’t “top up” failing thyroid…..because of feed back mechanism, almost everyone, will likely eventually be on what is approx full replacement dose. This is usually around 1.6mcg per kilo of your weight per day
Unless extremely petite likely to need to be on at least 100mcg levothyroxine per day
But we have to increase SLOWLY, especially if you have been left far too long on too small a dose levothyroxine
Which brand of levothyroxine are you currently taking
Many people find different brands are not interchangeable
Recommended not to change brand when increasing dose, otherwise you can’t tell if it’s brand change or dose causing any issues
Teva is the only brand that makes 75mcg tablets
If avoiding Teva …..request 50mcg and 25mcg tablets
If taking Accord (also boxed as Almus via Boots or Northstar via Lloyds) Accord brand don’t make 25mcg. Request extra 50mcg tablets and cut in half to get 25mcg dose extra per day
Cut with pill cutter or sharp craft scalpel
Use weekly pill dispenser for remaining half. Only cut as required….don’t cut several at once
Bloods should be retested 6-8 weeks after being on 75mcg everyday
Likely to have low vitamin levels as been left too long on too low a dose levothyroxine
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.
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function 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
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.
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Comprehensive list of references for needing LOW TSH on levothyroxine
I was tested for Coeliac before (negative) because of anaemia
I’m taking accord brand (first 2 months were TEVA and made me feel much worse)
Looking at those dose/weight guideline suggests 75mg would be more appropriate dose but I suppose can’t tell that until I see the actual test values at the gp tomorrow
a small proportion of patients treated with levothyroxine report symptoms, often consistent with thyroid dysfunction, when their levothyroxine tablets are changed to a different product – these cases are noted in UK professional guidelines
if a patient reports symptoms after changing their levothyroxine product, consider testing thyroid function
If a patient is persistently symptomatic after switching levothyroxine products, whether they are biochemically euthyroid or have evidence of abnormal thyroid function, consider consistently prescribing a specific levothyroxine product known to be well tolerated by the patient
I have some results but not many, spoke to a different GP to previously who was rather vague. Am going to call back to get a print off of the full set as I need to collect a prescription for iron tablets
thyroid was 13.1
iron stores were low (guessing she meant ferritin here)
cholesterol was 7.3 which is similar to previous values (I'm slightly under average weight, eat healthily and prior to all this used to run a lot and am building back up distances slowly e.g. 5k on weekend)
Hb was 112
she was clearly in a bit of a rush. said she couldn't find my coeliac screen results either so I will ask receptionist about that too. pretty disappointing call to be honest.
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
Similarly low vitamin levels linked to being hypothyroid
When a doctor or receptionist tells you that your iron is low, it is most likely they have tested only ferritin (iron stores). Your serum iron and saturation will rarely have been tested.
The most informative kind of iron testing is an iron panel. This link is for a private finger-prick iron panel.
Yes depending on the results *when I eventually get them * I might go for a medicheck as they have a partner clinic in Belfast. Thanks again. Btw prescriptions are free in NI but I will check that other post too. Thanks again for taking the time to reply
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* I might go for a medicheck as they have a partner clinic in Belfast. Thanks again. Btw prescriptions are free in NI but I will check that other post too. Thanks again for taking the time to reply
Thyroid results satisfactory
Paper about the relationship of iron deficiency and thyroid function
Low Ferritin and raised Iron 
Low ferritin, high iron
Iron and Thyroid results 
