This forum is fantastic - have learned so much in 24 hours! Thank you all who have helped so far.
So with a possible Ord's Hashimoto issue, likely under-medicated levothyroxine (my starting dose should have been 90mg for my weight and symptoms, not 25mg to 50mg which is the guidance for over 65 age)
I need to get the following checked which so far haven't been and hopefully NHS endo apt soon can help with (ho ho ho):
Cortisol
Coeliac (as per NICE guidelines)
Get medicated properly and get TSH down (currently skirts at top and over TSH range)
I also need to address my poor nutrient levels - just about in range but on the floor so the GP will have brushed over them and why I didn't take them as seriously as I should have. Can I ask if anyone has advice on best way to raise these? @SlowDragon you were flagged as a bit of an expert here.
I also have high ESR and CRP reading but I'm thinking that goes hand in hand with Hashimoto's?
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I was started on 25mg then went to 50mg since Jan 23. My weight suggests i should have been started on 90mg.
Brand - now something else I have learned via this forum is there is difference between the brands - I assumed it was all generic! Currently on TEVA boxed in Hillcross packaging, had TEVA before and then Wockhardt - I've seen so many packets I bet I've had a roulette of brands. I'll be noting the brands going forward and seeing if they make a difference to me.
Yes definitely do all that before a blood test and always get an early morning apt.
Attached are vitamin results - that's all I have to date.
I was started on 25mg then went to 50mg since Jan 23. My weight suggests i should have been started on 90mg.
Many, many people can’t tolerate starting on more than 50mcg levothyroxine initially
Your GP was rather cautious starting you on 25mcg
But you’re on your way now that you are ready to go up to 75mcg daily
Many people don’t get on well with Teva
But for others it’s by far best brand
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz
Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots,
Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets
Lactose free brands - currently Teva or Vencamil only
Teva makes 25mcg, 50mcg, 75mcg and 100mcg
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva is lactose free.But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
Teva is the only brand that makes 75mcg tablet.
So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Vencamil, previously called Aristo (currently 100mcg only) is lactose free and mannitol free. 25mcg and 50mcg tablets hopefully available from summer 2024
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
HOWEVER, I am great at taking my levothyroxine but terrible at taking these but 24 hours ago I hadn't realised how important key nutrients were to the thyroid.
Under normal circumstances, serum ferritin levels are a sensitive marker for iron status but ferritin is an acute-phase reactant that becomes elevated in response to inflammation, complicating the diagnosis.
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
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
I've always had an issue with Iron absorption. The tablets prescribed to be when pregnant were brutal. Can definitely ass the above to diet though and will read on natural sources. Not had a full Iron panel done so will ask and if not get it private. Thank you.
One more question - is high inflammation CRP and ESR relative to hashimotos? They are not fining any other reason for it so far.
CRP and ESR just denote there is inflammation going on somewhere, but they dont tell us where. They are unfortunately very non specific. It could be anything from an AI condition like Hashis to fighting off a virus.
I know quite annoying to know - but doesn't seem to be anything else wrong. I've had a full PET scan recently too. I've had , or noticed I had, raised markers for just over a year now - they were tested as the joint/arm pains were bad.
I'm afraid that most doctors have very little training in nutrition.
I find it's really helpful to have sorted out my nutrition and my food intolerances. My nutritionist said that if you sort out nutritional problems then any medical problem will present more clearly.
The best and most cost effective way I have found to raise ferritin is the using the 305mg of Ferrous Fumorate twice a day daily. My results improved further when I added a timed released vitamin c dose.
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