Currently on 75 mcg Levo- Wockhardt. It is the only thyroxine I can tolerate. Based on results endo has increased to 100mcg x2 weekly and keep at 75 Rest of week. I will retest in 6wks.
I have had a real set back from January and feeling more symptomatic and increased fatigue again.
I take a B complex. Omegas, Turmeric, magnesium. Going to start adding in selenium this week.
For context, diagnosed 4 years ago and have been so unwell and undermedicated. Was at 25mcg (50kg bodyweight) reacted to Teva. Taken off all meds. Restarted last April on 25mcg. Incredibly unwell for 6 months until I saw endocrinologist who Is titrating up and not ruling out T3. I have DH101 gene so not a great T4 to T3 converter. Also have cortisol disorder so my curve is back to front.
Recent thyroid scan showed small volume after thyroid swell and then shrank. Set back again in symptoms and feeling extreme fatigue since Jan. Had picked up a bit in general. Just never seem to feel well at all.
Any thoughts/reassurance welcome? Do I just need to br patient or should be asking for some T3 combo if I am a poor converter?
Thank you
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Mhaire
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Really appreciate your reply. So knowledgeable and reassuring.
I worry that I am in constant feedback loop if I am not converting and T3 is only 23% through range despite 6 months of 75 levo? Maybe the slow increase of levo will eventually bring the t3 up. Is it normal yo take this long and still feel so symptomatic?
Yes TPO <9 (ref<34) had USScan of thyroid in October which is when they noted 'small volume thyroid gland'. They didn't mention whether or not it was Hashi's. That's all they said. Should they have given me a diagnosis/ ruled it out?
Coeliac screen was neg. Had a full food allergy screen and no sensitivities noted.
Any recommendations for vitamin testing? What should I get tested and where could I get it done or know what to ask for?
A trial of strictly gluten free diet is always worth doing
Shrivelled and shrunk thyroid is ord’s thyroid (and almost certainly autoimmune)
Only 5% of autoimmune thyroid patients test positive for coeliac but a further 81% patients who try gluten free diet find noticeable or significant improvement or find it’s essential
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
Autoimmune disease and leaky gut often occur together
Both dairy and gluten are inflammatory foods
A 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 may 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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Blood test results - advice please
Blood test results and advice please 
Further blood results - advice please
Advice on blood test results please.
