Finally being treated for Hypothyroidism. - Thyroid UK

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Finally being treated for Hypothyroidism.

MsWhistledown profile image
18 Replies

Thanks to the advice of the amazing people in this community, I have finally been diagnosed.

I went for more blood tests on Tuesday, taking the advice of the community, I fasted and the test was done at 9:10am.

I got a phone call from my GP this morning and they said my TSH and antibodies were high and she is starting me on 25mcgs of levothyroxine. Wants me tested in 8 weeks to see levels and whether to increase. Unfortunately, the surgery was closed this afternoon so I was unable to get a print out of my results.

I also got my private test results from medicheck and the results are as follows:

TSH 7.11 0.27 - 4.2

Free T3 5.39pmol/L3.1 - 6.8 

free thyroxine 15.2pmol/L 12-22

THYROGLOBULIN ANTIBODIES 317 0 - 115

THYROID PEROXIDASE ANTIBODIES 600 0 - 34

FERRITIN. 38.2 30 - 150 

Folate 14.7nmol/L8.83 - 60.8

B12 102pmol/L37.5 - 188 

Vitamin D 71.8nmol/L50 - 250

I’d appreciate your advice on these results. Do I have Hashimotos? Or do I need further testing to find that out?

many thanks 😊

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SeasideSusie profile image
SeasideSusieRemembering

MsWhistledown

Do I have Hashimotos?

Yes, as confirmed by your raised antibodies.

FERRITIN. 38.2 30 - 150

This is very low. Below 30 suggests iron deficiency according to NICE:

From: cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

Your GP should do a full iron panel to confirm iron deficiency, the tests should include serum iron, saturation percentage, total iron binding capacity and ferritin.

To see if you also have anaemia a full blood count should be done.

You can have iron deficiency with or without anaemia so both tests need doing.

Folate 14.7nmol/L8.83 - 60.8

This is very low and folate is recommended to be at least half way through range which would be 35 plus with that range. Eating folate rich foods plus supplementing with a good quality bioavailable B Complex should help raise your level. Consider Thorne Basic B, Vitablossom Liposomal B Complex which is branded as Yipmai on Amazon. Pink Tribe brand on Amazon is very similar. Any of those would be OK.

Remember to leave of B Complex for 3-7 days before any blood test as it contains biotin which gives false results.

B12 102pmol/L37.5 - 188

This is fine, we suggest 100 plus. Do you supplement?

Vitamin D 71.8nmol/L50 - 250

Vit D is recommended to be 100-150nmol/L according to the Vit D Council, Vit D Society and Grassroots Health, with a recent blog post on Grassroots Health recommnending at least 125nmol/L. You may be able to increase your level naturally during the summer so if you don't supplement you should test again at the end of October to see if you need to supplement during the winter months.

The following will help you work out how much Vit D you should take to achieve the recommeded level. To work out 71.8nmol/L in ng/ml (the unit of measurement used in the article, then divide it by 2.5 which gives you 28.72ng/ml.

web.archive.org/web/2019070...

If taking D3 then you need it's important cofactors magnesium and Vit K2-MK7.

D3 should be taken 4 hours away from thyroid meds, as should magnesium.

Iron should be taken 4 hours away from thyroid meds and 2 hours away from any other supplements as it affects their absorption.

B Complex should be taken 2 hours away from thyroid meds.

MsWhistledown profile image
MsWhistledown in reply to SeasideSusie

Thanks SeasideSusie.

I’m going to work on my diet now and supplementing as you have advised. I’m still waiting for some other results of my blood tests from Tuesday which I think included full blood count.

I did supplement but slacked off the past few months due to stomach issues. I will get back on it now though.

I would not have known about how to take the supplements especially iron away from other supplements. Thank you 😊

SlowDragon profile image
SlowDragonAdministrator

Request GP run coeliac blood test

As listed in NICE guidelines

nice.org.uk/guidance/ng20/c...

1.1 Recognition of coeliac disease 

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.

Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid 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. 

 A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

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

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

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

nuclmed.gr/wp/wp-content/up...

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

restartmed.com/hashimotos-g...

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.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

Hashimoto’s and leaky gut often occur together

MsWhistledown profile image
MsWhistledown in reply to SlowDragon

Thanks SlowDragon.

I had a celiac blood test about 3 weeks ago due to stomach pain and constipation. It came back negative.

I will be starting a gluten free diet to see if this makes a difference.

I am practically dairy free already but will make sure I am more strict with that like I used to be.

Thank you for your advice and the links I will read with interest. 😊

SlowDragon profile image
SlowDragonAdministrator in reply to MsWhistledown

Standard starter dose levothyroxine is 50mcg, unless over 65 years old

Starting on 25mcg, may make you feel more hypothyroid after 3-4 weeks as TSH starts to reduce and your own thyroid starts to not work so hard

Levothyroxine doesn’t top up failing thyroid, it replaces it

Get bloods retested 6-8 weeks after starting on levothyroxine and then can get dose increased to 50mcg

Likely to need more increases in dose over coming months

Always test thyroid levels early morning and last dose levothyroxine 24 hours before test

Watch out for brand of levothyroxine too

Many people find different brands of levothyroxine are not interchangeable

Only 3 brands make 25mcg tablets…..mercury Pharma, Wockhardt or Teva

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets 

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz 

Accord only make 50mcg and 100mcg tablets 

Accord is also boxed as Almus via Boots, 

 Many patients do NOT get on well with Teva brand of Levothyroxine.

Teva is lactose free. But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome 

Teva is the only brand that makes 75mcg tablet. 

So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

But for some people (usually if lactose intolerant, Teva is by far the best option)

Aristo (currently 100mcg only) is lactose free and mannitol free. 

March 2023 - Aristo now called Vencamil

healthunlocked.com/thyroidu...

Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets 

 

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

MsWhistledown profile image
MsWhistledown in reply to SlowDragon

Thanks again this all really good to know. GP insisted I must have blood test in 8 weeks and will increase after that.

Took my first tablet this morning on empty stomach and an hour before eating so will see how I get on over the next couple of weeks.

MsWhistledown profile image
MsWhistledown in reply to SlowDragon

I have been reading that iodine can have a negative affect on thyroid function. I am wondering whether I should be careful about how much intake I have of that? For example I drink alpro soya milk for my cereal and tea. It has iodine added to it? Do you think I should swap this out to soya milk that doesn’t have iodine added to it?

SeasideSusie profile image
SeasideSusieRemembering in reply to MsWhistledown

MsWhistledown

There is conflicting advice about soya and hypothyroidism and it's often recommended to avoid it. You might want to consider an alternative milk substitute. I've included an article about this but you can, of course, look into it further:

verywellhealth.com/soy-and-...

MsWhistledown profile image
MsWhistledown in reply to SeasideSusie

Thanks SeasideSusie, I’ll have a read.

SlowDragon profile image
SlowDragonAdministrator in reply to MsWhistledown

personally I would avoid all soya milk

Try oat milk instead…..a few have iodine added so check the ingredients list

Some are guaranteed gluten free…..eg Plenish oat milk

MsWhistledown profile image
MsWhistledown in reply to SlowDragon

Thanks SlowDragon, I have tried oat milk and can’t stand it. Also found it upset my tummy a bit. Maybe that wasn’t a gluten free one? Will source another alternative to try.

Gosierunn profile image
Gosierunn

I’m new here - I’m the process of getting diagnosis and treatment. Can I ask what the reasoning is for checking levels in the morning? And the need to fast?

All of my tests have been in the afternoon around 3pm - my antibodies are extremely high 2000.

Please note - I have severe health anxiety and trying to trying to navigate this all in the best way - so please be kind!

pennyannie profile image
pennyannie in reply to Gosierunn

Hello Gosierunn and welcome to the forum :

By tacking your question at the bottom of someone else's post/question your comments / question may not be seen.

Why not start your own thyroid journey by starting your own question/post as then it will be fully seen by those who can help you

eeng profile image
eeng in reply to Gosierunn

The reason for testing first thing in the morning is that the hormone that doctors take most notice of, TSH, varies throughout the day, and is highest in the early hours of the morning. Testing as early as possible in the morning means you are more likely to be diagnosed or get a dose increase than if you test in the afternoon. Hope that helps.

MsWhistledown profile image
MsWhistledown in reply to Gosierunn

Welcome Gosierunn.

The lovely experienced people of this forum will give you great advice regarding your question. I am new here as well and without them I would not have been diagnosed anytime soon. I was having my blood tests done in the afternoon after eating lunch and it wasn’t showing the true levels of my thyroid. By fasting and having blood test around 9am it showed high levels revealing hypothyroidism/Hashimotos. The experienced people on this forum will it explain it much better than me. Definitely worth posting your question separately so everyone can see it.

Wishing you good luck on your journey and hope you are feeling better soon 😊

SlowDragon profile image
SlowDragonAdministrator in reply to Gosierunn

Gosierunn

Anxiety is common hypothyroid symptom and will improve as your thyroid hormone levels improve once you start on levothyroxine

TSH (Thyroid Stimulating hormone) is highest early morning and lowest mid afternoon

Test early morning, ideally just before 9am, only drink water between waking and the test, to get highest TSH

Also get vitamin D, folate, ferritin and B12 levels tested

With high thyroid antibodies your GP should do coeliac blood test too

Gosierunn profile image
Gosierunn

Thank you everyone that’s super helpful - sorry to hijack your thread MsWhistledown ! I have ordered the medicheck thyroid kit as finding my GP unhelpful (not least because it’s literally a different one I speak / see each time)

MsWhistledown profile image
MsWhistledown in reply to Gosierunn

no problem at all. I had the same problem with my GP surgery. Keep pushing and you’ll get there.

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