Help to understand bloods etc

[Samfonz]

Hi

I am new to the forum but was diagnosed with Hashimotos in Jul 23 with these blood results

Thyroperoxidase Ab IU/ml - 181

T4 (free) pmol/L - 15.6

TSH mIU/L - 5.1

I have been on Levothyroxine Sodium 25mcg Tab since Jul 23 and my TSH is now 1.9. My doc is now only using this to check my progress. I also have high blood pressure 148/94, and cholesterol is 6 with doc wanting to discuss statins once BP is under control.

I am also taking Omeprazole 40mg daily to control acid reflux. This came on over the last 6 months and the omeprazole controls it, however my doc wants me to start reducing it to see if the symptoms reoccur.

From what I have read the BP and cholesterol are (maybe) related to my Hashimoto. I have previously always had low blood pressure. When I raised this with my doc re the cholesterol she said that it wasn't related. I would rather try and understand fully the impact of the Hashimoto than keep medicating the symptoms unnecessarily.

After a bit of reading I am today embarking on a gluten free diet in the hope that it will make me feel better in myself.

I am due to see the doc again in a week and want to be prepared to ask for more detailed blood tests rather than just rely on TSH. In addition I have gained 20kgs (now 93kgs and 5'4) in the last 3 years and am unable to shift it. I try to remain active and do go to the gym etc. I get pains in my hip flexor and in my left ankle which I think are tendon related. All in all I'm feeling a bit beaten. I'm not ready to give up and just medicate but I don't really know where to start.

Can someone please help?

[Bertwills]

Hello, welcome to the forum. You’re on the lowest dose of levothyroxine . How old are you? Usually 25 is a starter dose or the dose given to an older person. It’s more usual to move up to 50 mcg.

You’ve got Hashimoto’s disease as you have antibodies so going onto a gluten free diet may help you feel better.

Your doctor is wrong about cholesterol & thyroid problems. High cholesterol is directly linked to an under active thyroid. Also statins are not recommended for people with underactive thyroids. Post again with a question about statins & Google for more information.

Your TSH is the only test that your GP will do & although you’re on a low dose you’ll struggle to get a higher dose as your TSH has fallen to an acceptable level. Many people pay for private blood testing to get a better idea of their health.

Your weight gain is unfortunately part of being hypo. It’s often caused by moisture retention & exercise won’t reduce it. It really needs a dose increase. It sounds as if your doctor doesn’t know much about thyroid illness which is not unusual.

Being hypo reduces stomach acid so using Omeprazole isn’t recommended . Doctors are often unaware of this. You’re on a high dose too. Try to reduce it. Research alternative treatments. Post another question about low stomach acid & its consequences.

It’s important to take your levo hours away from the omeprazole too. You need to take levo on an empty stomach away from all food, supplements & medicines. 4 hours away from iron or magnesium supplements.

I suggest you read lots of posts on this forum & learn as much as you can.

[Dandelions]

Hi Samfonz!

There’s a wealth of information to find and people to learn from on this forum.

Many of us find doctors are not the most knowledgeable or helpful when you have a thyroid disease. So I recommend you do your own research as well.

I’m also on 25mcg of Levo at the moment and find it way too low.

A few things I have learnt here:

* ask your doctor to do a full thryoid panel. TsH, free T3 , free T4

As well as vitamin D, vitamin B12, ferritin and folate.

* vitamins/ nutrients in our bodies can often be low due to low stomach acid which prevents adequate absorptions of nutrients.

* If doctor doesn’t agree there are options to pay for a test private if you can afford this.

* post your results on here and ask for advice. Make sure to include the ranges. Each test is different in which ranges they use and it’s often as important to know where in the range you are . Simply knowing you fall within range, doesn’t mean you’ll feel good at that level. We need OPTIMAL levels.

* TSH is what most doctors will only look at. This is the least interesting variable in the panel. So simply judging your levels based on this, is wholly inadequate.

Good luck!! Let us know how it’s going.

[greygoose]

Hi Samfonz, welcome to the forum.

Your doctor is being negligent! Even if you're over 65, and the recommended starter dose is 25 mcg levo, it should have been increased to 50 mcg six weeks later, regardless.

She shouldn't be dosing by the TSH, but as she is, she should know that the aim is to get it down to 1 or under. 2 may be in-range but it is too high. It's the ranges that are wrong.

The majority of hypos have low stomach acid, not high. However the symptoms are the same so doctors always assume that the problem is high stomach acid. There are treatments for low stomach acid that can make you feel better, but I'm not on my own computor so don't have my links handy, but try googling low stomach acid and you will get some recommendations on how to raise it.

High cholesterol is not caused by statin deficiency! It's usually caused by low T3 . And with a TSH over 2, your T3 is going to be low. You do not need statins - and it is not recommended that women and hypos take them - you need an increase in levo to try and bring your FT3 level up.

High blood pressure can also be a hypo symptom. And as you're very under-medicated, you are bound to have symptoms like high blood pressure, high cholesterol and weight-gain.

The weight you have gained is more likely to be water-retention than fat. So, going to the gym won't get rid of it and could be counter-productive. It is using up your calories which you need to convert T4 to T3. And your FT3 is already too low, so your body really cannot sustain these trips to the gym. It would be far better to stick to just gentle walking or swimming until you get your FT3 to a better level.

A gluten-free diet is a good thing to try because a lot of Hashi's people are gluten-sensitive. But it doesn't help everyone. Try it and see, but if after three/four months you don't feel any better, try eating it again and see if you feel any worse.

I don't think there's much point in asking your GP to do the extra testing. For a start, she wouldn't understand the results - she sounds exceptionally ignorant! - and secondly, the lab probably wouldn't agree to do them, anyway. If you can it's best to do your own tests privately. She won't accept them but at least you'll know. But, there's no hurry to do that because right know, you know without a doubt that you need an increase in dose. Your TSH should not be over 2. So, best to concentrate on getting that in the immediate and you can worry about blood tests six weeks later.

[Samfonz]

Thanks everyone for your advice!!! This forum is amazing 😀

In answer to your questions about my age l’m 57, so it doesn’t seem that I’m on the right dose. I’ll ask to increase to 50mcg.

I’ve done some more reading and I will request a full blood test and see how I get on. I’ll also be sure to get my bloods done first thing in the morning having only had water. I was not aware of this so my bloods have been taken in the afternoon with my meds and food on board. Even if my doc is resistant to full bloods it will be interesting to see what my TSH comes back as, my last result it was 1.9.

I’m going to cut down, then out the omeprazole and if the acid returns I’ll manage it as low stomach acid.

I’ve also got myself some Vitamin D and B12. Would it be safe to just take this?