Hi I just wondered if anyone had any advice that might help me please I have attached my latest NHS blood test results, I am taking NDT thyroid medication called NP. Which at the moment I have started alternating for example one and then one and a half grain every other day.
I have seen endocrinologist's, private GP's and my own GP for advice, if I should be increasing my medication or reducing it but unfortunately gaining no clear answer.
I'm constantly tired and have lost weight I've had my thyroid done with Medichecks as well in November which the results were;
TSH - 0.020 (0.27 - 4.2)
Free T3 - 4.1 (3.1 - 6.8)
Free Thyroxine -13.3 (12-22)
Thyroglobulin Antibodies - 42.70 (0-115)
Thyroid Peroxidase Antibodies - 78.8 (0 - 34)
Any help and advice would be greatly appreciated, if anyone can recommend a good endocrinologist who specialises in NDT please could you let me know.
Thank you in advance
Written by
Bess48
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When taking any replacement thyroid hormone that contains T3 as all NDT does it’s absolutely ESSENTIAL to take the same dose every day
So either take 1 and half every day or 1 and quarter
Do you normally split the dose
Eg 1 grain waking ….remaining dose mid afternoon
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)
On NDT or T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test
ferritin it terrible at 38
Are you vegetarian or vegan
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40 30 to 180
Females 40 ≤ age < 50 30 to 207
Females 50 ≤ age < 60 30 to 264
Females Age ≥ 60 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Are you on strictly gluten free and/or dairy free diet
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
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