How long should it take to get treatment?

[Brn2BWild]

My daughter in law has received two test results showing significantly low thyroid hormones, age did one test a year ago another 6 months ago because they " forgot" to do anything about the first test, and she is still chasing her GP but they still haven't done anything or offered any treatment.Her heart rate has dropped to 46 and her Fitbit keeps warning her that it drops further during the day.

Now I have had Hashimotos for 25 years, since my son was born and my GP, if I remember correctly, got me onto a starting dose within a month or so.

I am rather concerned about her health, her parents are not really involved in her life so I offered to help, but she and my son live across the other side of the country so it is not as if I can march down to her surgery to ask why she still hasn't been treated, and as Health unlocked helped me a great deal when I first became unwell due to what turned out to be Pernicious anemia a decade ago, I thought I would try again.

I actually went to thyroid UK website first and their link to their forum is here on health unlocked.

What are the current guidelines for starting treatment after test results confirming hypothyroidism, and what might she do if her GP is falling outside those ( I can only assume this is the case, I can't imagine what is happening to her is right).

She is a wonderful young woman but she is terrified of going to sleep and never waking up.

[Jaydee1507 Administrator]

welcome to the group.

Can you post her actual results along with reference ranges.

She needs 2 TSH results above range to begin treatment.

Also suggest she asks GP to test ferritin folate b12 and d3.

[Brn2BWild in reply to Jaydee1507]

I have emailed her and asked for her actual numbers, I also sent her the link here but feel she is probably a bit anxious about discussing this with anyone directly so will keep on until she is happy to contribute herself.

[SlowDragon Administrator]

Bloods should be retested 6-8 weeks after first abnormal test results

also request/politely insist that thyroid antibodies and vitamin levels are tested

For full Thyroid evaluation she needs TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

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)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Starting levothyroxine - flow chart

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[Brn2BWild in reply to SlowDragon]

Thank you for the flow chart, I have emailed it on and requested her actual test result numbers.

[SlowDragon Administrator in reply to Brn2BWild]

When we become hypothyroid it’s very common to then get low stomach acid, this leads to poor nutrient absorption and low vitamin levels as direct result

Low vitamin levels can cause symptoms in their own right, but also low vitamin levels tend to lower TSH, in effect hiding how hypothyroid you actually are

Very important to improve low vitamin levels to improve symptoms but also can help getting hypothyroidism diagnosed

[Brn2BWild in reply to SlowDragon]

Fascinating, thank you.I have been hypo for many years and

* I knew low stomach acid was a thing, and

*I knew I had difficulties with vitamin levels

but had chalked that 100% down to my PA, I had no idea that low stomach acid affects vitamin absorption, mainly because I had no idea where in the gut vitamins were absorbed for the first 15 years of my hypothyroidism and I strangely believed what the GP tells you is True and well considered, that was then, and when I found out due to my PA that seemed to answer the my low vitamin situation.

I know she is low on iron and had feared she was also heading down the PA route which is a nightmare to get diagnosed due to GP s ignorance.

and I am living proof what happens when you don't get any pa treatment for years.

so now, thanks to you, I am feeling more positive about her symptoms, because if hypothyroidism can cause low iron, and other vitamins, then there is a chance that is the only condition she has and I just need to figure out how to get her surgery to actually start her treatment.

It really is a relief, thank you very much.