I've had 2 Thyroid operations and I'm left with a third of the gland. I'm fortunate in that it's producing thyroid hormones but I still feel pretty rotten most of the time. Fatigue, bone pain, feeling cold, brain fog and constipation to name but a few symptoms.
My recent private blood test results are as follows
Anti-Tg - 251 IU/ml range 0-115
Anti-TPO - 209 KU/I range 0-34
TSH - 1.85 mlIU range 0.35-5.5
FT4 - 16.20 pmol/l range 11.9-21.6
FT3 - 4.85 pmol/l range 3.1-6.8
My last US scan was over 7 years ago.
My question is - should I ask my gp if I need another US given my antibody levels are so high?
Thanks in advance
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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)
Is this how you did the test
Most people on levothyroxine only, find they need Ft4 (levothyroxine dose) at least 60-70% through range
So this suggests you need 25mcg dose increase in Levo
Increasing dose levothyroxine, and should SLOWLY lower TG antibodies.
Many with Hashimoto’s find it beneficial to have TSH as low as possible, often below range
TPO antibodies often lower on strictly gluten free and/or dairy free diet
when were vitamin D, folate, ferritin and B12 last tested
Hi SlowDragon,Thanks for your reply. Blood test done at 9am,I only drank water before test and I don't take levothyroxine. GP says all bloods within range. TSH has fluctuated from 1.35-3.3 and she doesn't take T4 into account. I have a healthy diet and I've tried to gut down on Gluten. I take omega 3 with vitamin D and simply heme iron supplement daily. I find gps are not interested and want to put everything down to the menopause. Despite having a low alp level for over 10 years. I'm planning on arranging private stool tests to check for infection/IBD. Thanks again
See thyroid specialist to get dose increase in Levo
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
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.
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
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
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.
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
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