I’ve just had some tests done and it’s not great. PND kicked me hard after giving birth a year ago. I’m only just returning back to “normal”.
I’m on 100mcg of levo and 10mg of escitalopram for the postpartum stuff still.
I keep gaining weight. I’ve been GF for 6 months now and yet my antibodies are still high. And why is my CRP so high?
Where would you start? I don’t even know where the PND stops and the Hashimotos symptoms start.
Congratulations on baby and sorry to hear about the PND. Nobody needs that after having a baby. Pleased you are picking up a little though.
So you have a few things to do to feel even better which is good news in many ways.
➢Firstly your TSH is too high at over 2, most people who feel well have a TSH of 1 or just under. Your FT4 is far too low at 28% of its range. So make appointment with GP who may want to run their own tests and insist on a dose increase ASAP.
Well done on being gluten free. Optionally you could try dairy free if the GF has helped.
Your vitamins are all pretty terrible I'm afraid but getting them OPTIMAL will really help you feel a bit better in yourself.
➢Ferritin - according to NICE a level of 30 or less is deficient so when you see your GP about Levo increase ask for a full iron panel & they may well want to rerun the ferritin. Hopefully they will then prescribe you some iron.
➢Folate is also deficient. Same as above, ask GP to test & prescribe folic acid.
➢B12 is too low. B12 - do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...
If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.
If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.
gb.pipingrock.com/methylcob...
cytoplan.co.uk/vitamin-b12-...
This B complex has all the right vitamins at a not unreasonable cost for 90 days supply(also contains folate). Once B12 is good you can stop the stand alone B12 and just continue with the B complex. amazon.co.uk/Liposomal-Soft...
➢Vitamin D is deficient. You may need a loading dose that SlowDragon can advise on.
Add one vitamin at a time for a few weeks to assess how it makes you feel before adding the next one in.
CRP can rise for a number of non specific reasons but I wouldn't worry about it. It may also mean your ferritin is even lower than it is showing as inflammation can give a false high reading for ferritin.
Lots for you to work on but will be well worth it.
Thank you so much, Jaydee. Yes, the PND was an unwelcome guest this time around. And it was just the tip of the iceberg. I have been on a cocktail of meds for months and now only left with 1. it was bound to affect my thyroid too.
Thanks so much for all the details. I would not think I have anaemia because during pregnancy and even before, my B12 was OK. Now I know it wasn't optimal, looking at all the links you provided, but it wasn't that low. I think it is due to my diet. I would sometimes forget to eat or just binge eat all the wrong things. Hopefully it is just diet! But I will mention it to the GP when I can get an appointment.
And thanks for the reassurance regarding CRP. I was starting to worry and googled and everything is so dramatic on google!
No doubt your vitamin deficiencies and less than optimal thyroid replacement fed into the PND. Be very clear with your GP that they need to treat your anaemia.
Are you taking your levothyroxine on empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
markvanderpump.co.uk/blog/p...
markvanderpump.co.uk/blog/p...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
which brand of levothyroxine are you taking
Do you always get same brand levothyroxine at each prescription
Hi SlowDragon! Yes, I take my levothyroxine at 5am every morning and nothing but water until 8 am when I can finally sit down and eat breakfast. I take the Merck brand, 100mcg. I buy mine in France because I have a private prescription from a private endocrinologist in France, where it is much cheaper (it helps my family lives there!). And I take my escitalopram in the evening. Nothing else anymore but once I had vitamins, I will be sure to leave 4 hours.
If I were to take it at bedtime, I would worry it would interact with my escitalopram? I can't take the escitalopram earlier as it makes me drowsy.
Take these results to your GP
Ferritin is deficient
GP needs to do full iron panel test for anaemia
Folate is deficient - GP should prescribe folic acid
Vitamin D is deficient - GP should prescribe LOADING dose vitamin D.
Vitamin levels are terrible almost certainly BECAUSE you’re not on high enough dose levothyroxine
ALWAYS test early morning and last dose levothyroxine 24 hours before test……assuming this how you did this test …..Request/insist on 25mcg dose increase in levothyroxine
Retest thyroid levels 6-8 weeks after any dose change or brand change in levothyroxine
Have you been taking any vitamin D before this test?
GP should prescribe LOADING dose
That’s 300,000iu in total over 6-8 weeks
That’s 5000iu per day for 8 weeks
Or
7000iu per day for 6 weeks
NHS Guidelines on dose vitamin D required
ouh.nhs.uk/osteoporosis/use...
GP will often only prescribe to bring vitamin D levels to 50nmol.
Some areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Test twice yearly via NHS private testing service when supplementing
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.
There’s a version made that also contains vitamin K2 Mk7.
One spray = 1000iu
amazon.co.uk/BetterYou-Dlux...
It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average
Vitamin D and thyroid disease
grassrootshealth.net/blog/t...
Vitamin D may prevent Autoimmune disease
newscientist.com/article/23...
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
Oh wow thanks so much for that. I also read that a lack of vitamin D can make one very sweaty around the head which is exactly what I have been experiencing. My psychiatrist attributed it to the SSRI and gave me something else to help and it did nothing. I think I know why now!
Did your doctors do any similar tests before telling you it was PND? Cos… looking at these… I’m not sure that could ever have been a definitive diagnosis. Iron deficiency anaemia, folate anaemia AND Vit D deficiency? You must feel pretty awful xx
Couldn’t agree more and am now wondering if my own PND 16 years ago was actually something similar.
Small point though that anaemia status is not known as the only thing that appears to have been tested here is Ferritin - anaemia is specifically low Haemoglobin.
HungryHungryHypo as folk have said you need your iron levels checked for anaemia, and tbh need iron tablets either way because of your low Ferritin, and you also need the other vits and a small dose increase of Levo. Wishing you all the best as I was in your shoes once.
I am sorry you ha dot go through that too. It has been the hardest time in my life so far and I really struggled bonding with my youngest for so long. I still carry so much guilt from it.
I'm so so sorry to hear that - please be kind to yourself as none of it was your fault or within your control
Unfortunately, it was definitely PND. I only mentioned the PND because it was an easy shortcut but I also had PTSD from the awful birth and then OCD and good old maternal psychosis. It was not a fun time. But now that I am better, I still feel so sluggish and I definitely don't think it is the PND.
When my eldest was born, I was also given antidepressants for mild PND and it turned out I had developed hashimotos.
If you lots a lot of blood at birth you need assessment for Sheehan syndrome
Gosh, horrendous. They never seem to mention this stuff in the baby books, do they? Glad you’re lots better—hopefully we can help you get a bit nearer to feeling much better. x
You have a BIG list of things to attend to here. Try not to be overwhelmed and plug away. It’s terrible a GP would leave you in this state. However it happens.
Yes it is a bit daunting! But hopefully, nothing that can't be reversed.
Oh wow, thank you so much everyone. I went away for a few days and what a lovely surprise it was to see such informative and compassionate posts. I am going to reply individually but before I do, I must say it feels good to be believed and understood. The postpartum period was really hard for me this time around and I thought my declining (already depleted) energy was all in my head. Being validated is powerful, so thank you.
Absolutely not in your head!
'not' in your head ..
it took 5 yrs for anyone to suspect my thyroid when i had problems after a baby.
first i lost a bunch of weight despite eating loads (i didn't need to loose any) , which was put down to 'breastfeeding and having to walk up a big hill every day' ,.....then i went a bit nutty/ withdrawn / over emotional for a couple of months, which was put down to "don't worry , lots of women go a bit 'weird' for a few months after a baby ".... then i got slower and colder and very very tired, with legs like lead .. which was put down to "PND" and counselling was suggested (i didn't go ~ i knew it was physical, not mental) ..... and then i continued to get more knackered for 4 yrs, and that was put down to "depression/Seasonal Affective Disorder" but i knew i wasn't depressed .
When they did (finally) think to test my thyroid ~ bingo , autoimmune hypo diagnosis with TPOab in the thousands) + levo prescribed.
i thought it was just me being a useless human or all in my head...... but it was clearly autoimmune hypo all along , with a brief spell of 'hyper' at the beginning (very common in autoimmune hypo) , all kicked off by the pregnancy .
Since your TSH is 2.75 it's possible your levo dose could do with increasing ... your GP may say "your TSH is in range, so it's fine" .. if so, show GP these ref's when asking for 25mcg increase .. all of them recommend GP's keep TSH lower than that . healthunlocked.com/thyroidu... my-list-of-references-recommending-gp-s-keep-tsh-lower-in-range-
Some are taken from GP's update sites.. and one was written by specialist registrars in endocrinology and cardiology ..... so there should be no argument about their validity .
Well said Tattybogle. We are totally bored with being told it’s all in our heads.
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