For advance information, I am unmedicated and doctor is unwilling to do anything at the moment as I'm only "subclinical". Test was done just after 7am.
2nd December
TSH: 5.52 (0.3 - 4.8)
T4: 12.3 (7.7 - 20.6)
Previously:
9th September TSH: 5.07, T4: 13.4
2nd July TSH: 4.65
May TSH: 5.36, T4: 10.2
March TSH: 5.24, T4: 11.8
I have a telephone appointment with the third doctor since March on Friday next week and need some advice on how to approach it. I'm constantly tired, get more migraines and headaches, muscle and joint pain, I'm constantly cold (particularly hands and feet) and struggle to concentrate (often forgetting words as I'm speaking). Vitamin/iron levels have never been tested. Should I request these too? My TPO levels in 2019 were 506.7
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dizzyarmadillo
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Hi, i’m not an expert but if i was you i’d chance your luck and assertively ask the gp to refer you to an endocrinologist about your thyroid. Uk gps are supposed to look at your symptoms and blood tests . and use their instructions for medication as a guide , not a rule . I was left unmedicated for years and labelled borderline and subclinical but with horrible symptoms . after preserverance and explaining to the doctor just how debilitating it was , i finally got a gp who said she would refer me as she didn’t know what to do. The endo put me on levo straight away and said i should have been on it years ago . I have hashimotos . i also have to take multi vits and separate b12 , folate , vit d and magnesium etc because i get very deficient quickly if i don’t take them . Defo ask your gp for full blood tests to check for deficiencies and ask for referral to endo . xxx
Thanks WeeB, I was unsure about pushing for an endocrinologist referral, but maybe I should 🙈I think I definitely need to push my symptoms, particularly as it's starting to affect my work 🙄
If you’re worried you’re overreacting by asking for a referral , you’re not. If you daily life is affected and your work , then you need help. the nhs gps generally think they need to wait till your tsh is at 10 before medication and because most gps aren’t experts of hashimotos or hypothyroid , they err on side of caution and stick to the 10. ( however the gps guidance actually says they should treat everyone individually and take info consideration symptoms and time it has been going on) i was around 5 for 5 years, then around 9.8 for 2 years before finally getting referred and medicated . i ended up going part time at work , went off such a few times , and spent the best part of those years depressed , anxious and exhausted while trying to raise two boys . Your health is important and you deserve to speak to an expert if the gps are a bit unsure what to do . Remember in many other countries they would treat your thyroid if you had symptoms and your tsh was consistently over 3 or 4.
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
Test early morning and last dose levothyroxine 24 hours before test
Likely to need further increase in levothyroxine over coming months
Aiming for TSH around 1, most important results are always Ft3 followed by Ft4
Once you have had coeliac blood test done, assuming it’s negative it’s always worth trying strictly gluten free diet
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 test positive for coeliac, but a further 80% find strictly gluten free diet helps or is essential due to 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.
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