Long time since I posted however I've been having rashes in the groin area and general itching all over for nearly two years and I finally got a face to face appointment with dermatology a few weeks ago and a full blood test. Results have come back and they say "your thyroid function tests are indicating your dose may be slightly too high. High thyroid levels can cause some itching, so this may be factor. The other blood testing did not reveal any cause of itching."
The figure they are referring to is TSH which came back as 0.12 - although since taking Leveothyroxine for my Hypothyroidism (currently on 125mg daily) six years ago this figure has always been below the 0.27 range and I've not had any issues.
My Free T4 came back as 20.4 (top range 22, I understand that should be high so I think that is fine). As for vitamins I think they are low considering I am taking supplements daily, but they are in range so I guess they are not bothered. see below (range in brackets) - and what I am currently taking
Vitamin D - 65nmol/L (50-120) - D3 3000iu daily
B12 - 595ng/L (197-771) and Folate 7ug/L (3.9-25) - B12 1000ug / B Complex alternate days
Ferritin - 62 (30-400) and C reactive - 3 (0-5) - Iron 14mg daily - the full bloods also listed Transferrin % - 23 (25-45), g/L 3 (2-3.6), and Iron 17.5umol/L (5.8-34.5).
Everything else seems to be in range (hence the reply from Dermatology), I noticed the white blood cells results seem low to me (although are just in range!) - ie WBC 4 (4-10), Eosinophils 0.1 (0-0.5), Lymphocytes 1.1 (1-3), Neutrophils 2.3 (2-7), Basophils 0 (0-0.1), Monocytes 0.5 (0.2-1) all measured at 10*9/L.
There are still some blood results to come back (16th Jan) so I was not going to contact my GP until I get them. However any advise would be very welcome and address any fears I have re above.
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nigelm
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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)
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease and if not on high enough dose Levo or poor conversion of Ft4 to Ft3
Would suspect your Ft3 is low
Vitamin D - 65nmol/L (50-120) - D3 3000iu daily
B12 - 595ng/L (197-771) and Folate 7ug/L (3.9-25) - B12 1000ug / B Complex alternate days
Ferritin - 62 (30-400)
Vitamin D, folate and Ferritin are poor
Suggest you work on improving and then retest including thyroid antibodies
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
Many thanks for your comprehensive reply - I do have a yearly thyroid blood test (which does include Vit D, B12, Folate, Ferritin and C reactive) and also includes triiodothyronine which back in July this year was 4.80pmol/L (3.1-6.8). I do usually have those early morning before food and drink just in case.
Interesting re vitamins the B complex I currently take contains Thiamin (B1) 1.1mg, Riboflavin (B2) 1.4mg, Niacin 16mg NE , B6 1.4mg, Folic Acid 200µg, B12 2.5µg, Biotin 50µg, and Pantothenic acid 6mg - I will remember to leave off for a week before any blood tests.
So would you recommend I up my Vit D and Iron tablets?
I am going through the NHS in the UK and not sure if my GP has investigated Hashimoto’s at all and will try and speak with my GP once I get the further blood results and mention some of the things you have very kindly advised like the coeliac blood test and I had never though of gluten.
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)
Post discussing how biotin can affect test results
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.
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
Did they do a scraping? That way they can tell if it's fungus or something else. The boyfriend had a horrible dermatitis at the arch of his feet going up halfway to the ankle. Dermatology did a couple of biopsies and gave him a prescription for superstrong steroid cream. Taro-clobetasol. It's cleared up now and he has a followup appointment in early January.
Groin can be like athlete's foot especially if it's itchy. He didn't have that and we got new shoes and socks, the whole nine yards but it didn't clear up until he used the cream. Even not taking hot showers, just warm ones didn't help either. Hot showers are not good for the skin.
Thanks gabkad - no biopsy has been done although I think I've been given loads of different creams during the two years starting with, antifungal then the rash spread and my GP diagnosed flexural psoriasis and gave me Protopic cream which did the trick referred me to dermatology and 18 month later has online diagnosis and signed off BUT itching was still present and my GP said stop everything and referred me back - luckuli I chased and got a face to face (or groin!) appointment two weeks ago but trimate did not work so not on a stronger Lotriderm for a week and back to protopic. Also got prescribed Balneum Plus to stop itching on rest of body and some Bettamouse as they also noticed psoriasis in the scalp!! So diagnosis from dermatology was flexural and scalp psoriasis and nodular prurigo. Follow up is three months or more likely 5-6 months as they are way behind!!
I found that Levothyroxine (any brand, including liquid) causes me to itch from the top of my head down to the soles of my feet. It took me a long time to convince any doctors that it was Levo doing this but finally it was accepted and after 5 years I now have T3 prescribed on the NHS.
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