I recently had blood tests due to feeling really fatigued especially after exercising. I’ve been on levo for 13 years for Hashimoto’s. Levels have been up and down. Last test was 0.75 and I felt fine. That was 9 months ago. Most recent test it was 7.16! No wonder I feel bad. All vits tested on the low side for vit D and Ferritin but in the ‘normal’ range.
I’m taking 125mcg daily. Docs response to recent result was retest in 6 weeks 😭 I feel that they haven’t looked at my history?! Why would they say this when I’m feeling ill now? I’m in the Uk so really difficult to speak to a dr 😣
I feel so helpless and I’m sick of feeling ill. Thanks for reading.
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Pegasus12
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Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
I take Levo first thing when I wake up, usually nothing for an hour but I have taken last thing at night too. I take a multi vit around 6pm with my dinner. So shouldn’t be any interference 🤷♀️
I started going to the gym recently to combat sluggish feeling and anxiety but unfortunately the exercise seems to have made my symptoms of tiredness worse.
So weight training causes inflammation, can this cause I’m immune system go into overdrive and then make thyroid worse (because I have Hashimoto’s)? Or am I putting 2 and 2 together and getting 48?!
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Clearly you are now in need of dose increase in Levo
Perhaps due to your recent increase in activity level or you were always under medicated
Alopecia suggests your hypothyroidism is autoimmune ….ie Hashimoto’s
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Do you get your T3 checked alongside TSH and T4? It could be due to low conversion from T4 levo to the most important hormone T3. T3 gives you energy as well as many other benefits. With low T3 you’ll be struggling. If your GP won’t test T3 then try ‘monitor my health’ privately on line for about £27 or so. They can test all three TSH, T4 and T3 together for you. If your T4 is high in the range and T3 low then you’re not converting very well to T3. If your T4 is low then you might need T4 dose increase. Then retest after 4-6 weeks.
because I have Hashimoto’s)? Or am I putting 2 and 2 together and getting 48?!
Do you already know for definite you have Hashimoto’s
Assuming yes…..if not had coeliac test …get tested
Poor gut function with Hashimoto’s 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 as per NICE Guidelines
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.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
Thank you for all your advice. Yes I had Hashimoto’s confirmed when I saw a specialist privately (when I worked for a company that offered healthcare insurance).
I asked my dr about going gluten free but they said no point unless I’m coeliac, but I don’t think I’ve ever been tested.
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Low TSH - but Dr increasing Levo?
TSH Rising with increased dose of Levothyroxine?!
TsH 0.03 after increase in levothyroxine 
Tsh 0.28 - Increase in L-thyroxine
