Hashimoto’s

[Allcraft]

Antibodies and ultrasound confirm Hashimoto’s but to be told in Endocrinology “ I don’t know why you’re here, your GP could have told you” also said Polymyalgia Rheumatica is not a factor, eat what you want and aches and pains not a symptom. 😪

[SlowDragon Administrator]

Previous post

healthunlocked.com/thyroidu...

So you started on 25mcg Teva levothyroxine and then stopped after 4 days

Teva brand upsets many people

Try different brand

Mercury Pharma or Wockhardt 25mcg well tolerated

Are you currently taking any levothyroxine

Standard starter dose levothyroxine is 50mcg unless you are over 65

But perhaps try 25mcg again initially

Take on empty stomach with water and nothing else for at least an hour

Retest in 6-8 weeks

You will need several further increases in levothyroxine over coming months

ESSENTIAL to test vitamin D, folate, ferritin and B12

Please add most recent results

What vitamin supplements are you taking

See from previous posts you are already on gluten free and dairy free diet…..which is good

Acid reflux common hypothyroid symptom

Aches and pains frequently low vitamin D

[Allcraft in reply to SlowDragon]

I was restarted on Levothyroxine 50mcg ,two weeks ago by GP, a different brand and been ok on them, I was referred to Endocrinology and saw a nurse yesterday who was not helpful at all, basically said pop the pills and you’ll be ok!!!

[Buddy195 Administrator in reply to Allcraft]

I would ask for a retest of thyroid bloods 6-8 weeks after being on a consistent dose. Then ask for a print out of results and share with us for further advice to reach optimal dosing.

[SlowDragon Administrator in reply to Allcraft]

which brand is 50mcg tablets

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

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

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

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

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[SlowDragon Administrator in reply to Allcraft]

saw a nurse yesterday who was not helpful at all, basically said pop the pills and you’ll be ok!!!

Dose Levo should be slowly increased over next 6-12 months until Ft4 (levothyroxine) at least 70% through range

Ft3 hopefully similar

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we need to maintain good vitamin levels

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

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

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.

Some people need a bit less than guidelines, some a bit more