I’ve been feeling unwell since October with increased fatigue, thinning hair, brittle snapping nails, constipation, headaches, muscle weakness, weight gain, joint pain, poor balance & vertigo. I saw the GP and had MRI head & spine. This showed multilevel degenerative osteoarthritis to the spine but no spinal cord issues. I had a TSH check back then that showed TSH as 1.4 (no free T4 etc).
In July I ordered a private thyroid check:
TSH 2.7 (0.35-4.94)
Free T3 3.9 (2.43-6.0)
Free T4 13 (9-19)
TPO 156 (0-5)
TGA 43 (0-4)
Having read everything I can about autoimmune hypothyroidism, I realise I should have tested vitamins etc too - they’re being tested tomorrow.
I haven’t seen a GP yet with results, I’m worried I’m going to be fobbed off as a hypochondriac.
What are your thoughts on these results?
I’m generally fit and usually do HIIT classes x3 a week plus gym, working full time and walks with my dog. I’m just too exhausted to keep up what I was doing with ease last summer.
Any advice welcome x
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RosieTheRoo2023
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When I had the test I didn’t realise that biotin could interfere - I take 12,000 micrograms daily - stopped for over a week now though. Also recently stopped taking lansoprazole and earlier this year stopped citalopram. Still taking my HRT though, can’t face a return of hot flushes at mo x
No diagnosis, haven’t been to see GP yet, had a private test as I suspected hypothyroidism due to symptoms. So not on medication. Blood was taken in the morning.
What time in the morning? Had you had breakfast? Coffee?
All these little things can have an effect.
We recommend having the blood draw before 9 am, with only water beforehand. That will give you the highest TSH.
A TSH of over 2 tells us that your thyroid is struggling but, your not hypo yet. And your FT4/3 are both below range, which is probably too low. Normally they are at least mid-range. So, even if you aren't technically hypo, it doesn't mean you can't have symptoms. You can. And, of course, the antibodies tell us you have Autoimmune Thyroiditis - aka Hashi's.
However, blood tests at best are just a snapshot in time. And with Hashi's levels can fluctuate enormously. So, just because those were your results on the day you had the blood taken, doesn't mean they're always like that. So, you can't draw much of a conclusion on one isolated blood test with results like that. You would need to have several tests at three monthly intervals to really see what's going on.
Of course, you are going to go hypo at some point, with levels that will make a doctor sit up and take notice. But, with those levels a doctor is going to say there's nothing wrong with you because they're all in-range. Except the antibodies, but s/he will probably ignore those! So, keep testing.
Thanks for that, I’m expecting to be brushed off by the GP in all honesty but I need to get my vitality back.
The blood was taken first thing, I wouldn’t have eaten as I don’t usually eat in the morning. I cut out caffeine about six weeks prior to the blood test as I was worried that my high caffeine intake could be causing problems. I would have had a decaf coffee. I’ve also cut out alcohol completely although I was never a huge drinker anyway.
I think next step is to go gluten free and then maybe reduce dairy. I understand that that Hashimoto can’t be cured but would be nice to reduce antibodies and see if that improves symptoms.
Forgot to say that my cholesterol has jumped from 4.5 to 6.4 in the space of two years.
No, reducing antibodies won't improve symptoms because it's not the antibodies are not causing symptoms. And, besides, there's no proven way of reducing antibodies. Not proven because antibodies fluctuate all the time. So, they might be over a hundred on one test, and down to two figures on the next. But that won't mean that you've done anything to reduce them permenantly. Besides, as more and more of the thyroid is destroyed, the immune system attacks will reduce in number, so the levels of antibodies will drop. They tend to be highest during and after an immune system attack to clean up the blood. It's not the antibodies attacking the thyroid.
I think next step is to go gluten free and then maybe reduce dairy.
I would say the next step is to try a gluten-free diet, because whilst it may help enormously if you are gluten-sensitive, not everyobdy is gluten-sensitive, so it doesn't help them. Same goes for dairy. It might be causing problems, but then again, it might not. It isn't obligatory to be gluten and dairy-free if you have Hashi's.
But, maybe get a Coeliac test before giving up gluten? Just to see if you have it.
Been taking lansoprazole for years, very recently stopped when I realised the damage it could be doing.
I know I need to see GP but waiting for these next blood tests to come back first. Hubby knows how I feel about being seen asa hypochondriac so he’s going to come with me.
Not convinced GP will see coeliac blood test as being relevant but I could ask. The GORD that I have seems to be genetic as it goes back several generations - makes me wonder if it’s more likely to be linked to dairy intolerance or the like. I had a negative h-pylori test before starting the PPI.
About 50% of autoimmune thyroid patients find dairy free diet helps or is essential
Are you already on dairy 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.
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
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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